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1.
Nature ; 604(7907):620-624, 2022.
Article in English | EMBASE | ID: covidwho-1821571

ABSTRACT

Governments, donors and others must step up to protect current and future generations from the devastating effects of malnutrition, as well as to prevent acute food insecurity. [Figure not available: see fulltext.].

2.
Progress in Nutrition ; 24(1), 2022.
Article in English | EMBASE | ID: covidwho-1819020

ABSTRACT

Objective: Body dissatisfaction is an increasing problem in adolescents, and it is thought that mindful eating and body image are related. These problems have become more serious during the pandemic period. This current study was carried out to examine the relationship between adolescents’ mindful eating, body image, and anthropometric measurements during COVID-19 pandemic. Methods: A total of 200 adolescents (100 boys and 100 girls) aged 11-17 years, were involved in the study. The data were collected by the researcher using the face-to-face interview method through a questionnaire. The Mindful Eating Questionnaire was used to determine mindful eating. The Stunkard body image scale was employed to evaluate the body image of individuals, and all anthropometric measurements were made by the researcher in accordance with technique. Results: The mean age of the individuals was 14.2±2.04 years, and more than half (52%) attended high school. 60.0% of obese boys and 38.0% of obese girls considered themselves obese. A statistically significant difference was found depending on gender in terms of body perception (p<0.05). No significant difference was found between the mindful eating scores of participants according to their body perception (p>0.05). A negative statistically significant correlation was determined between the total mindful eating score of those who described themselves as underweight, overweight, and obese, and BMI (kg/m2), waist circumference (cm), hip circumference (cm), and body fat (%) (p<0.05). It was also found there were negative significant relationships between mindful eating subscales, anthropometric measurements, and BMI (p<0.05). Conclusion: It was concluded that body image in adolescents was affected by gender and BMI, and anthropometric measurements were associated with mindful eating.

3.
Cancer Research ; 82(4 SUPPL), 2022.
Article in English | EMBASE | ID: covidwho-1779489

ABSTRACT

Purpose: In the state of Wisconsin, breast cancer patients from African American (AAs) communities have lower survival rates compared to their Caucasian counterparts. Multiple inequities related to sociodemographic factors, delays in diagnosis, advanced disease stage at presentation and presence of comorbidities including higher body mass index (BMI) contribute to these disparities, many of which have only widened during the COVID-19 pandemic. This study examined specific factors related to prolonged hospital length of stay (LOS) for breast cancer patients admitted to inpatient units during the pandemic. Methods: This analysis includes initial CY20 LOS medical record data for hospitalized patients 18 years and older with a diagnosis of breast cancer from 1/1/2020-12/31/2020. Supplemental data included disease registry and diagnostic data, and SES data determined by patient zip code. Poisson regression models with robust standard errors were used to compare the LOS index (LOSi) between groups of patients based on race, SES group, primary payer, and BMI. Results: A total of 272 patients with breast cancer that were admitted to inpatient oncology units were identified. Demographics included White (72.4%), Black (22.4%), and others (5.1%). Other characteristics included: low SES (8.8%), medium-low (9.5%), medium (15.4%), medium-high (11.0%), high SES (4.4%), and others (non-SMilwaukee county) (50.7%), Medicaid (8.8%), Medicare (61.3%), Managed care (29.0%), and others (0.73%). Body mass varied among the patients;underweight (0.36%), overweight (30.8%), obese (41.5%). There were significant differences in LOSi: Black (LOSi=1.24, p=0.01), medium-low SES (LOSi=1.46, p=0.02), Medicaid (LOSi=1.40, p=0.00), underweight (LOSi=1.66, p=0.00), and overweight (LOSi=1.23, p = 0.01) patients had slightly longer LOSi, with LOSi ratio above 1. Conclusion: This study shows how patient-specific factors such as race, SES, primary payer, and BMI contribute to inpatient LOS for breast cancer patients. Healthcare systems may benefit by addressing indicators and patients' factors to reduce hospital LOS, and ultimately healthcare costs.

4.
Espiritu, Adrian I.; Reyes, Nikolai Gil D.; Leochico, Carl Froilan D.; Sy, Marie Charmaine C.; Anlacan, Veeda Michelle M.; Jamora, Roland Dominic G.; Macalintal, Corina Maria Socorro A.; Robles, Joanne B.; Cataniag, Paulo L.; Flores, Manolo Kristoffer C.; Tangcuangco-Trinidad, Noreen Jhoanna C.; Juango, Dan Neftalie A.; Paas, Giuliani Renz G.; Chua, Audrey Marie U.; Estrada, Valmarie S.; Mejia, Philip Rico P.; Reyes, Therese Franz B.; Cañete, Maria Teresa A.; Zapata, Ferdinand Renfred A.; Castillo, Franko Eugenio B.; Esagunde, Romulo U.; Gantioque, Jean B.; Abbariao, Maritoni C.; Acebuque, Geramie M.; Corral, Evram V.; Escasura, Marian Irene C.; Ong, Marissa T.; Pineda, Arnold Angelo M.; Aradani, Khassmeen D.; Catindig, Joseree-Ann S.; Cinco, Mark Timothy T.; Ramos, Mark Erving H.; Cruz, Romulus Emmanuel H.; Dantes, Marita B.; Francisco, Norberto A.; Teleg, Rosalia A.; Bellosillo, Krisverlyn B.; Delfino, Jean Paolo M.; Diesta, Cid Czarina E.; Espiritu-Picar, Rosalina B.; Gamboa, Julie Anne V.; Matute, Cara Camille M.; Padilla, Franzelle P.; Punsalan, John Joshua Q.; Collantes, Ma Epifania V.; Que, Charmaine B.; Sampao, Hanifa A.; Sta. Maria, Maxine Camela S.; Fuentes, Marita M.; Manzano, Jennifer Justice F.; Umali, Rizza J.; Molina, Marc Conrad C.; Minerva-Ang, Hazel Claire M.; Surdilla, Arturo F.; Talabucon, Loreto, Wabe, Natasha F.; Banday, Christian Paul B.; Pangandaman, Nehar A.; Wasil, Avery Gail C.; Inocian, Elrey P.; Vatanagul, Jarungchai Anton S.; Apor, Almira Doreen Abigail O.; Dioquino, Carissa Paz C.; Villanueva, Emilio Q.; Dela Cruz, Prinz Andrew M.; Yumul, Maricar P.; Manuel, Maria Victoria G.; Pajantoy, Al Inde John A.; Roque, Josephine Cecilia V.; Yambao, Paul Emmanuel L.; Carandang-Concepcion, Ma Alma E.; Desquitado, Ma Caridad V.; Julao, Carl Kevin L.; Bornales, Dante P.; Maylem, Generaldo D.; Cuntapay, Mark Joseph F.; Lao-Reyes, Annabelle Y.; Manlegro, Nadia O.; Pelere, Dave Mar L.; Laxamana, Lina C.; Que, Diana-Lynn S.; Yu, Jeryl Ritzi T.; Martinez, Ma Socorro C.; Matic, Alexandria E.; Perez, John Angelo S.; Constantino, Glenn Anthony A.; Olano, Aldanica R.; Quiles, Liz Edenberg P.; Roxas, Artemio A.; Soliven, Jo Ann R.; Montojo-Tamayo, Michael Dorothy Frances, Joson, Ma Lourdes C.; Evangelista, Jojo R.; Nuñez, Ma Clarissa B.; Olaivar, Marietta C.; Perez, Dominique Q.; Armeña, Mark Deneb O.; Barja, Robert A.; Abejero, Joshua Emmanuel E.; Eribal, Maritzie R.; Alava, Ryndell G.; Kalbi, Muktader A.; Radja, Nasheera W.; Sali, Mohammad Elshad S..
Clinical Nutrition ESPEN ; 2022.
Article in English | ScienceDirect | ID: covidwho-1767997

ABSTRACT

Summary Background and Aims To explore the association between body mass index (BMI) and adverse outcomes in a large cohort of patients with coronavirus disease 2019 (COVID-19). Methods This is a secondary analysis of The Philippine COVID-19 Outcomes: a Retrospective study Of Neurological manifestations and Associated symptoms study, a 37-site, nationwide, multicenter, retrospective cohort study that investigated the clinical and neurological outcomes of adult patients with confirmed COVID-19 admitted from February to December 15, 2020. We analyzed data from patients with available BMI information during admission, along with other relevant details including age, sex, smoking status, clinical characteristics (specific and cumulative number of comorbid conditions, neurologic history and manifestations, non-neurologic presenting symptoms, treatment/s received), and in-hospital outcomes. Results A total of 4,463 patients with available BMI and outcome data were included in this secondary analysis. A total of 790 (17.7%) and 710 (15.9%) had the primary outcome of in-hospital mortality and need for invasive mechanical ventilation (IMV) over a median hospital stay of 13 (interquartile range: 8) days. Multivariable Cox proportional analysis found no significant association between World Health Organization BMI groups and these outcomes, although sensitivity analysis using lower Asia-Pacific cutoffs show a significant association between obesity and in-hospital mortality risk (hazard ratio 1.35;95% CI, 1.07-1.41;P = 0.012). Significant age interaction contributed to nonuniform risks observed for IMV requirement across BMI groups. Multivariable binary logistic regression analysis showed that being underweight was an independent predictor of prolonged IMV requirement regardless of BMI criteria used (P for both criteria < 0.01), whereas obesity was found to correlate with the need for intensive care unit admission using Asia-Pacific cutoffs (odds ratio [OR] 1.28;95% CI, 1.03 – 1.59;P = 0.029). Adjusted and sensitivity analyses demonstrated significant association between any BMI abnormality and odds of severe/critical COVID-19 (P < 0.05). Regardless of BMI classification system used, obese patients with concomitant acute neurologic presentation or diagnosis during their COVID-19 admission were shown to have lower odds of neurologic recovery (P for both criteria < 0.05). Conclusions We found BMI abnormalities to be associated with several adverse clinical and neurologic outcomes, although such associations may be more evident with the use of race-specific BMI criteria.

5.
Open Forum Infectious Diseases ; 8(SUPPL 1):S266-S267, 2021.
Article in English | EMBASE | ID: covidwho-1746671

ABSTRACT

Background. Over 32 million cases of COVID-19 have been reported in the US. Outcomes range from mild upper respiratory infection to hospitalization, acute respiratory failure, and death. We assessed risk factors associated with severe disease, defined as hospitalization within 21 days of diagnosis or death, using US electronic health records (EHR). Methods. Patients in the Optum de-identified COVID-19 EHR database who were diagnosed with COVID-19 in 2020 were included in the analysis. Regularized multivariable logistic regression was used to identify risk factors for severe disease. Covariates included demographics, comorbidities, history of influenza vaccination, and calendar time. Results. Of the 193,454 eligible patients, 36,043 (18.6%) were hospitalized within 21 days of COVID-19 diagnosis, and 6,397 (3.3%) died. Calendar time followed an inverse J-shaped relationship where severe disease rates rapidly declined in the first 25 weeks of the pandemic. BMI followed an asymmetric V-shaped relationship with highest rates of disease severity observed at the extremes. In the multivariable model, older age had the strongest association with disease severity (odds ratios and 95% confidence intervals of significant associations in Figure). Other risk factors were male sex, uninsured status, underweight and obese BMI, higher Charlson Comorbidity Index, and individual comorbidities including hypertension. Asthma and overweight BMI were not associated with disease severity. Blacks, Hispanics, and Asians experienced higher odds of disease severity compared to Whites. Conclusion. Odds of hospitalization or death have decreased since the start of the pandemic, with the steepest decline observed up to mid-August, possibly reflecting changes in both testing and treatment. Older age is the most important predictor of severe COVID-19. Obese and underweight, but not overweight, BMI were associated with increased odds of disease severity when compared to normal weight. Hypertension, despite not being included in many guidelines for vaccine prioritization, is a significant risk factor. Pronounced health disparities remain across race and ethnicity after accounting for comorbidities, with minorities experiencing higher disease severity.

6.
Open Forum Infectious Diseases ; 8(SUPPL 1):S271, 2021.
Article in English | EMBASE | ID: covidwho-1746664

ABSTRACT

Background. Obesity, Diabetes mellitus type 2, race and other characteristics has been associated with an increased risk of adverse outcomes in patients with COVID-19 disease. The prevalence of obesity in the United States in 2017-2018 was 42.4%. Webb County, Texas with a 95.6% Hispanic population shows an obesity prevalence of 35.8% in 2014. It is unclear whether obesity increases the risks of complications and mortality in Hispanic population from COVID-19 disease. Methods. This is a retrospective cohort study of patients admitted to the hospital with the diagnosis of COVID-19 between March 2020 and August 2020. 950 patients were tested and admitted to the hospital with the diagnosis of COVID-19 pneumonia. Patients were categorized into classes of body habitus by BMI: underweight (< 18.5), normal (18.5-24.9), overweight (25.0-29.9), obesity class 1 (30.0-34.9), obesity class 2 (35.0-39.9), and obesity class 3 ( >40.0). Results. 950 Hispanic patients were included (Male-52.8%, Female- 47.2%) in the study. In total, 19.05% of our patients died during the hospitalization with an increased risk of mortality in patients having obesity class 2 (RR 4.14, 95% CI = 2.2-7.7 p=< 0.0001), and obesity class 3 (RR 6.0, 95% CI = 1.3-4.6 p=< 0.0001) compared with those with normal BMI. Mortality was higher in obese patients who required invasive mechanical ventilation at 93.75% compared to obese patients who were non-ventilated at 4.29%. Patients with obesity class 2 and 3 had higher risks of in-hospital complications including AKI requiring renal replacement therapy, ARDS, and arrythmias most commonly atrial fibrillation/flutter at 26.7%, 18.42% and 13.5%. Characteristics of In-hospital complication complications due to COVID-19 disease Conclusion. Patients admitted to the hospital with the diagnosis of COVID-19 disease with obesity classes 2 and 3 have a significantly increased risk of mortality as compared to normal and overweight patients. Severe obesity was also associated with increased hospital complications of AKI, ARDS, and Atrial Fibrillation. This further affirms that obesity is a pertinent risk factor to be considered in COVID-19 patients.

7.
Open Forum Infectious Diseases ; 8(SUPPL 1):S341-S342, 2021.
Article in English | EMBASE | ID: covidwho-1746516

ABSTRACT

Background. Several risk factors are known to increase the severity of coronavirus disease 2019 (COVID-19) illness in adults, including age and obesity. Specific comorbidities affecting COVID-19 outcomes in children are less well defined. Methods. We performed a retrospective cohort study of overweight and obese (OW) children compared to underweight and normal weight (NW) children with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. Children between 2 and 18 years of age who were admitted to Texas Children's Hospital from April through December of 2020 with a positive SARS-CoV-2 polymerase chain reaction test were included. Asymptomatic patients undergoing surveillance testing for SARS-CoV-2 were excluded. Body mass index (BMI) was calculated using the Centers for Disease Control definition. Demographic and clinical information was obtained from the electronic medical record. Statistical analyses were performed using SAS 9.0. Results. We identified 145 total children who met inclusion criteria. Fifty-five (38%) children were NW and 90 (62%) children were OW. Demographics and characteristics are shown (Figure 1). Underlying asthma or chronic lung disease was present in 13 (24%) vs 31 (34%) in the NW and OW groups respectively (P=0.17). OW children were more likely to have pneumonia than NW children [relative risk1.6 (CI 1.40-2.45)]. An elevated BMI was also associated with an increased risk of requiring oxygen [relative risk 1.4 (CI 1.03-1.96)]. The median length of hospitalization was 4 days for NW versus 5 days for OW children (P=0.6). Admission to the Intensive Care Unit (ICU) was similar between the groups (P=0.7). There was no significant difference in treatments administered to children in the two groups, although there was a trend towards increased steroid (29 (53%) vs 59 (67%), P=0.13) and remdesivir (12 (22%) vs 30 (33%), P=0.14) use in the OW children. Four children in each group died. Conclusion. For children admitted with symptomatic COVID-19, being overweight or obese was significantly associated with having pneumonia and with requiring oxygen. A difference in ICU admission, length of hospitalization, and mortality was not observed. Obesity prevention along with vaccination efforts may prevent COVID-19 related morbidity in this group.

8.
Breast ; 56:S58, 2021.
Article in English | EMBASE | ID: covidwho-1735076

ABSTRACT

Goals: ESA are recombinant human erythropoietin preparations which stimulate bone marrow to produce RBC. Apart from relieving anaemia symptoms, the application of ESA can prevent the necessity of the red blood cells transfusion in patients with CIA and thus avoid transfusion-related complications. During the Covid-19 pandemic, the absence of the necessity of hospitalization to transfuse blood products presents an additional value. The aim of the study is to assess the results of the application of darbepoetin alfa in the treatment of anaemia in pts undergoing neoadjuvant chemotherapy for EBC. Methods: A retrospective assessmentwas carried out of the results of darbepoetin alfa (Aranesp®) treatment of 98 pts receiving neoadjuvant chemotherapy for EBC in the National Institute of Oncology in Poland in whom therapy was initiated in the period from 02 January 2019 to 16 February 2020. The drug was given to symptomatic anaemia patients, with a haemoglobin (Hb) level of 8–11 g/dL. In addition, it was also applied in chemotherapy-undergoing patients, with asymptomatic anaemia, with a haemoglobin concentration of <8 g/dL. The treatment was continued until a stable Hb level was reached ensuring the security of further oncological treatment without the necessity of RBC transfusion or termination of chemotherapy. Results: The results of darbepoetin alfa treatment were assessed in a group of 98 subsequent pts, in the course of neadjuvant chemotherapy for EBC. The pts received the following chemotherapy regimens: AC/PCL (35%), AC/PCL + carboplatin (9%), TCH (33%), TCH-P (8%), other (15%). At the moment of the initiation of ESA administration, 18% pts were aged 65 or more (max 76) while 82% below 65 yrs. of age (min 28). In the majority (90) of pts the number of Aranesp® doses administered did not exceed 3, only 8 received 4 doses. The estimated effectiveness in the <65 vs ≥65 years of age groups was 84.8% vs 79.8%, respectively. The estimated effectiveness values in the following BMI-dependent groups, namely: underweight + normal weight (BMI: 16–24.99), overweight (BMI 25–29.99) and obesity (BMI 30–43.1), were 86.3%, 76.6% and 72.0%, respectively. Conclusion(s): Darbepoetin alfa proved effective in the treatment of anaemia in chemotherapy-treated pts for EBC. The response to the treatment in the assessed group of pts was 85.7% There were no statistically significant age and BMI-related differences in ESA effectiveness. No significant side effects of darbepoetin alfa therapy were observed. Conflict of Interest: No significant relationships.

9.
Irish Medical Journal ; 114(9), 2021.
Article in English | EMBASE | ID: covidwho-1733356
10.
EPMA J ; 12(3): 243-264, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1682051

ABSTRACT

An increasing interest in a healthy lifestyle raises questions about optimal body weight. Evidently, it should be clearly discriminated between the standardised "normal" body weight and individually optimal weight. To this end, the basic principle of personalised medicine "one size does not fit all" has to be applied. Contextually, "normal" but e.g. borderline body mass index might be optimal for one person but apparently suboptimal for another one strongly depending on the individual genetic predisposition, geographic origin, cultural and nutritional habits and relevant lifestyle parameters-all included into comprehensive individual patient profile. Even if only slightly deviant, both overweight and underweight are acknowledged risk factors for a shifted metabolism which, if being not optimised, may strongly contribute to the development and progression of severe pathologies. Development of innovative screening programmes is essential to promote population health by application of health risks assessment, individualised patient profiling and multi-parametric analysis, further used for cost-effective targeted prevention and treatments tailored to the person. The following healthcare areas are considered to be potentially strongly benefiting from the above proposed measures: suboptimal health conditions, sports medicine, stress overload and associated complications, planned pregnancies, periodontal health and dentistry, sleep medicine, eye health and disorders, inflammatory disorders, healing and pain management, metabolic disorders, cardiovascular disease, cancers, psychiatric and neurologic disorders, stroke of known and unknown aetiology, improved individual and population outcomes under pandemic conditions such as COVID-19. In a long-term way, a significantly improved healthcare economy is one of benefits of the proposed paradigm shift from reactive to Predictive, Preventive and Personalised Medicine (PPPM/3PM). A tight collaboration between all stakeholders including scientific community, healthcare givers, patient organisations, policy-makers and educators is essential for the smooth implementation of 3PM concepts in daily practice.

11.
Critical Care and Shock ; 2021(September):241-246, 2021.
Article in English | EMBASE | ID: covidwho-1652366

ABSTRACT

Background: The diversity demography of coronavirus disease 2019 (COVID-19) has prompted us to collect data in our workplace. These data are essential because they can serve as a data bank of demographics in one big hospital in East Java. We analyzed patients' characteristics with COVID-19 admitted to the Intensive Care Unit (ICU) Special Hospital for Infections, Airlangga University, Surabaya. Methods: Retrospective study from medical record of 180 patients with confirmed COVID-19 admitted to the ICU Special Hospital for Infections, Airlangga University of Surabaya between April-September 2020. Results: Most of the patients were male (67.2%), with median age was 55 (22-83) years. The body mass index (BMI) data consisted of normal (48.9%), overweight (39.4%), obesity class I 7.8%, obesity class II 1.1%, obesity class III 0.6%, and underweight 2.2%. We found severe acute respiratory distress syndrome (ARDS) in 63.9%. The use of invasive mechanical ventilation was 74% of the total patients. Most of the . patients (85%) had comorbidity: hypertension, diabetes mellitus, and geriatrics. The average length of stay in the ICU was 8.5 days. We trans-ferred 29% of patients to a low-care ward, and 66.7% died. We identified gastrointestinal symptoms on admission to the ICU were 43.3%, pre-dominantly by nausea and vomiting. Forty-six point seven percent of patients with gastrointestinal symptoms during hospitalization consisted of gastric retention and diarrhea, some with hematin. Conclusion: The demographic data we present above are limited in our area. The demographic data of COVID-19 patients in other places may be different from the information we obtained. However, data like this may represent the patient's condition in areas similar to ours. Besides, this data can warn that the patient's condition, as in our data, requires special attention. It is necessary to add data from all corners of Indonesia to represent the demographic data of COVID-19 patients in Indonesia.

12.
Cogent Medicine ; 8, 2021.
Article in English | EMBASE | ID: covidwho-1617068

ABSTRACT

Background: The COVID-19 pandemic disrupted the lives of children and adolescents by invading their families, peer groups and school, worsening their prospects and causing anxiety about the future. Due to the threat of COVDI-19, restrictions were imposed worldwide, forcing changes in daily life, social interactions, education and work. There is no doubt that these strict restrictions have contributed immensely to reducing the risk of SARS-CoV-2 virus spread, but at the same time had significantly affected the health of young people in all its dimensions. The main aim of this study is to present changes in health and health behaviours between 2018 and 2021. Method: Data from the Youth and COVID-19 survey conducted in the first quarter of 2021 by the Institute of Mother and Child in Warsaw among adolescents aged 11-17 years (n=1571) as well as data from the Health Behaviour in School-aged Children (HBSC) according to the 2018 survey conducted in the same age groups (n=7701) were analysed. So were analysed indicators of physical development, mental health, subjective complaints and health behaviour. The prevalence of the aforementioned indicators was compared between 2018 and 2021, overall, by gender and age using chi2 test. Results: A significant increase was observed in the percentage of overweight and obese adolescents (according to WHO criteria) evident in the older age groups (15 and 17 years) and the percentage of underweight boys;an increase in the percentage of adolescents negatively assessing their health and well-being (according to the WHO5 scale-score indicating depressive symptoms) in each age group and both genders;frequently experiencing physical and mental health problems-in both genders such as headache, stomach ache, backache, feeling depressed, nervousness, difficulty in falling asleep and dizziness;only in girls-tiredness;in older adolescents-headache, stomach ache, backache, feeling depressed, irritability, nervousness, difficulty in falling asleep and dizziness;in each age group-feeling depressed;only in the youngest-tiredness. There was a significant decrease in the percentage of adolescents undertaking moderate-to-intensive physical activity at the recommended level of 60 minutes per day in both genders and each age group. However, there were positive changes in dietary behaviour: an increase in the percentage of adolescents eating daily with family in each age group, eating vegetables daily in both sexes and each age group, and a decrease in the percentage of adolescents frequently drinking sugary drinks in both sexes and each age group. Furthermore, no change was observed in the rate of frequent consumption of fruit and vegetables. Conclusion: The adverse effects of the pandemic on health and well-being are progressing rapidly, so urgent action is needed to help mitigate the severe effects of the pandemic and safeguard the future of young people.

13.
Obesity ; 29(SUPPL 2):87, 2021.
Article in English | EMBASE | ID: covidwho-1616067

ABSTRACT

Background: Childhood obesity is a major concern in the US. Children from low income and minority families are at a particularly high risk. Quarantine and remote learning during COVID-19 pandemic may have exacerbated unhealthy behaviors and worsened obesity in children. The goal of this study was to determine whether the pandemic affected prevalence of obesity in high-risk children. Methods: BMI of 11-21y old adolescents seen for well-child visits in a large practice in Brooklyn, NY pre-pandemic (Oct 1, 2019-Mar 15, 2020) was compared to BMI during the pandemic (Mar 16, 2020-Feb 28, 2021). BMI was stratified into underweight (UNWT), normal (NL), overweight (OVWT), and obese (OB) as per CDC definitions. OB was stratified into class I (95-120%), II (121-140%) and III (>140%). Because BMI categories were not normally distributed, Kruskal-Wallis test was used to evaluate differences between groups. Results: Of 244 patients, 55.3% were female;61.1% 10-15y;54.5% had Medicaid;82% self reported as Black. Pre-pandemic, 3.7% were UNWT, 54.1% NL, 15.6% OVWT, and 26.7% OB: 15.6% in Class I, 7.0% in Class II, 2.9% in Class III, and 1.2% > Class III. Intra-pandemic, 17.8% shifted into the next higher BMI category. This happened for only 6.8% with NL BMI, but increasingly worsened for obese children (p < 0.001): 28.9% of OWVT, 28.9% of Class I, 41.2% of Class II, and 57.0% of Class III reached a BMI >160% of 95th percentile. There were no observed differences between groups related to demographics. Conclusions: This pilot study shows that pre-pandemic obese children are at very high risk of worsening obesity while normal weight children are protected. Future research needs to focus on understanding specific differences in eating and sedentary behavior that affects weight gain.

14.
Kardiologia Polska ; 79(SUPPL 1):125-126, 2021.
Article in English | EMBASE | ID: covidwho-1589625

ABSTRACT

INTRODUCTION COVID-19 pandemic and following restrictions have impacted every life domain. Students are an especially affected group where social distancing, numerous quarantine periods and e-learning changed lifestyle as we knew. It is well documented that physical activity (PA) has a crucial impact on cardiovascular diseases prevention and is a healthy lifestyle habit. Aim of the study is assessment of physical activity among Polish university students during the normal week in the pandemic period (since 20th March 2020 to 20th March 2021). MATERIAL AND METHODS An online based survey distributed via different social media channels (e.g.: Facebook and e-mail newsletters). Data were collected from 1491 Polish undergraduates and 1200 met all study conditions (80.48%;77.25% were females;0.5% didn't specify gender;49.75% were medical university students). The questionnaire included IPAQ-Short Form and one authorès question. Respondents declared body mass index (BMI) and the amount of weekly physical activity (number of active days/week, active type and time every day, sitting hours and summary question in -5-0-+5 scale which compared activity changes with times before restrictions). Finally, we calculated total MET-min/week. RESULTS 33.17% (n = 398) of students were in a low physical activity group, 41.42% (n = 497) in a medium and 25.41% (n = 305) in a high. Average BMI was 22.26 kg/m2 (13.62-48.29 kg/m2). 11.5% (n = 138) participants were underweight (BMI <18.5), 14.67% (n = 176) overweight (BMI ≥25.0) and 3.92% (n = 47) obese (BMI ≥30.0). However correlations between higher BMI (r = -0.00369;P = 0.898) or gender (P = 0.145) with, respectively, lower MET-min/week or lower PA level werenèt statistically significant. 71.92% (n = 863) reported that pandemic negatively influenced their physical activity level, 8.25% (n = 99) didnèt notice any changes and 19.83% (n = 238) observed positive impact. CONCLUSIONS High number of Polish students didnèt meet physical activity requirements to be described as medium or highly active people. Moreover most students declared a negative impact on their PA due to COVID-19 pandemic. It is important to be aware by public health workers and physicians to encourage undergraduates to stay physically active even during restrictions (while taking all appropriate precautions) because of its numerous possible positive outcomes on cardiovascular health.

15.
Gastroenterology ; 160(6):S-517, 2021.
Article in English | EMBASE | ID: covidwho-1595566

ABSTRACT

Introduction: Many patients with Crohn’s disease (CD) and ulcerative colitis (UC) require immunosuppressant therapies. There is an established increased risk of infection with these therapies, especially when used in combination. COVID-19 has further focused attention on risk of therapy and infection;in particular risks of intensive care unit (ICU) stay and death. We examined data on immunosuppressant medications, hospital admissions, ICU admission and death in our population-based database in the 10 years immediately prior to COVID-19.Methods: The Lothian IBD Registry (LIBDR) contains an accurate record of all prevalent IBD patients in the NHS Lothian capture area (population 900,000) [1]. Pre-existing databases and electronic health records were linked by community health index (CHI) number, a unique identifier covering 100% of the population, for admissions between 01/01/2010 and 31/12/2019. All admissions <24hour duration were excluded. All diagnosis codes were recorded using the ICD-10 system. Primary care prescription data was recorded using British National Formulary (BNF) codes. Biologic prescribing data was available from secondary care registries. Logistic regression using Cox Proportional Hazards model was used to identify risk factors predicting death or admission to intensive care due to infection following admission for an infection.Results: There were 17,221 non-day case hospital admissions for 4,660 of the 8,381 patients in the LIBDR prevalent cohort in the study period. 2,964 of these admissions for 1,489 patients were for an infection. Respiratory, urinary tract and gastrointestinal infections accounted for almost 75% of infection admissions with no differences between sex or diagnosis. There were 88 admissions to ICU due to infection for 79 patients with respiratory infection being the most common. There were 119 patients who died within 30 days of an admission for infection who had an infection listed on their death certificate. For 1,511 of the admissions, the patient had attended a secondary care IBD clinic within the preceding 18 months. A primary care prescription for steroids, opioids, thiopurines or antibiotics was issued within 90 days preceding 2,236 admissions for infection. 184 patients were on biologic therapy at the time of ITU admission or death. Positive blood cultures (OR 6.02, p<0.001), opioid therapy (OR 3.08, p=0.014) and being underweight (OR 2.61, p=0.003) were predictive of poor outcome while attending secondary care follow up for IBD was protective (OR 0.62, p=0.049). Biologic therapy was not associated with risk of ITU admission or death due to infection.Conclusions: There is a significant burden of infection in the IBD population and it is the most common reason for their admission. Opioid therapy and low body mass index are independent predictors of severity of infection. 1 Jones, G.R. et al. Gut (2019)(Figure presented)

16.
Tumori ; 107(2 SUPPL):86, 2021.
Article in English | EMBASE | ID: covidwho-1571608

ABSTRACT

Background: Nutritional and lifestyle factors are thought to be associated with a higher risk for cancer and recurrence of disease. The literature confirms an important inverse association between adherence to a Mediterranean Diet (MedD) and cancer mortality (1,2). A recent survey reveales that improving physical activity advices in cancer care, in particular if given in a timely manner after diagnosis leads more patients (pts) to make exercise or start a rehabilitation with a specialist when indicated (3). The aim in this study was to analyze adherence to nutritional recommendation and physical activity in Covid-19 era. A secondary aim was to investigate the association between disease progression and specific aspects of diet and lifestyle. Methods: Personnel of LILT administered all questionnaires. All participants answered questions related to the adherence to MedD (MEDI-LITE questionnaire) at baseline (T0) and after 6 months (T1). Adherence scores to MedD were classified as “very low” (score 0-5), “low” (score 6-9), “moderate” (score 10-15), and “high” (score 16-18). IPAQ (questionnaire for monitoring physical activity) was administered (score Met<700: “low”, Met 700- 2519: “moderate”, Met>2520: “high” physical activity). Medical history and BMI were collected too. Results: Seventy-nine pts (20 males/59 females) were recruited from March 2020 to February 2021. Cancer diagnoses were: breast (36), colon (14), gastric (12), gynaecological (4), lung (2) and other cancer (9). Sixty-two pts completed at baseline MEDI-LITE questionnaire and 77 the IPAQ questionnaire. All patients had a personalized dietary program, but for limitation due to pandemic Covid- 19 era, only 29 pts had access to the control assessment. At T0 MEDI-LITE: 46 pts reports a score moderate, 13 pts score low and 3 pts has an score high. At T0 IPAQ questionnaire: 43 pts report score moderate physical activity, 29 pts score low, and 5 pts report score high. At T0 BMI: 27 pts results overweight, 22 pts are obese, 2 pts are underweight. At T1: 25 pts reported adequate nutrition. The correlations with the socio-anagraphic variables are in progress. Conclusions: The results suggest that adherence to the recommendations on body weight and MedD were relatively high in Covid-19 era and dietary habits of the pts followed by the specialist have improved. Physical activity was poor/moderate for lockdown, so it is very important to promote physical activity in oncology departments.

17.
European Heart Journal ; 42(SUPPL 1):3093, 2021.
Article in English | EMBASE | ID: covidwho-1554536

ABSTRACT

Background: The key role of patient self-monitoring, already well established by large-scale forward planning initiative such the British National Health Service's (NHS) long-term plan, has been emphasised by the COVID19 pandemic. In the management of hypertension, much can be achieved through the provision of blood pressure monitors to patients, along with appropriate education and online blood pressure (BP) recording facilities. However, it is important to ensure that patients have the correct equipment to reliably measure their own blood pressures and to ensure they purchase or are supplied with validated monitors and, as undersized cuffs yield artefactually elevated BP readings, with correctly sized cuffs. Purpose: To demonstrate the use of Body Mass Index (BMI) as an estimate of Middle Upper Arm Circumference (MUAC) for purposes of blood pressure monitor cuff size requirement estimation and the application of this strategy to a national Home Blood Pressure Monitoring (HBPM) programme. Methods: The relationship between MUAC and BMI is well established;MUAC is used surrogate measure of BMI particularly in identifying underweight patients especially in environments where accurate recording of weight and height is challenging. Here, we reverse this relationship to use the BMI (one of the most commonly recorded datum in primary care patient records) to estimate patient MUACs. First, using manufacturer recommended cuff arm-circumference ranges and aggregate pre-established MUAC to BMI linear equations, we generate a simplified BMI to cuff-size scheme. Second, we apply this scheme to a UK Integrated Care System (a regional NHS organisation supporting 1.7 million adult patients in an English city) to estimate cuff requirement under NHS England's BPM@h HBPM initiative (in which patients with poorly controlled hypertension are allocated free home BP monitors). Lastly, we propose a patient-level tool for BP monitor cuff size prediction. Results: Our simplified scheme proposes the following cuff predictions: Small (S: 17-22cm): BMI <18kg/m2;Medium (M: 22-32cm): BMI ≥18 and <28kg/m2;Large (M: 32-42cm): BMI ≥28 and <38kg/m2 and Extra-large (X: 42-50cm): BMI ≥38kg/m2. In our population of approximately 157,000 adult hypertensive patients, 6,039 were eligible for a BP monitor under the NHS England's BPM@h HBPM initiative. Using our simplified scheme, we predict cuff requirements as follows: S: 2%, M: 32%, L: 46%, X: 19%. Conclusion: Patient BMIs are a useful predictor of BP monitor cuff size requirement. They are readily available or calculatable from primary care records and their application to cuff size identification will improve accuracy of BP readings in HBPM initiatives. Our preliminary results suggest that the most commonly supplied standard cuff may be unsittable for well over 50% of patients and that extra-large cuff may be required for nearly 1 in 5 patients.

18.
EPMA J ; 12(3): 243-264, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1544597

ABSTRACT

An increasing interest in a healthy lifestyle raises questions about optimal body weight. Evidently, it should be clearly discriminated between the standardised "normal" body weight and individually optimal weight. To this end, the basic principle of personalised medicine "one size does not fit all" has to be applied. Contextually, "normal" but e.g. borderline body mass index might be optimal for one person but apparently suboptimal for another one strongly depending on the individual genetic predisposition, geographic origin, cultural and nutritional habits and relevant lifestyle parameters-all included into comprehensive individual patient profile. Even if only slightly deviant, both overweight and underweight are acknowledged risk factors for a shifted metabolism which, if being not optimised, may strongly contribute to the development and progression of severe pathologies. Development of innovative screening programmes is essential to promote population health by application of health risks assessment, individualised patient profiling and multi-parametric analysis, further used for cost-effective targeted prevention and treatments tailored to the person. The following healthcare areas are considered to be potentially strongly benefiting from the above proposed measures: suboptimal health conditions, sports medicine, stress overload and associated complications, planned pregnancies, periodontal health and dentistry, sleep medicine, eye health and disorders, inflammatory disorders, healing and pain management, metabolic disorders, cardiovascular disease, cancers, psychiatric and neurologic disorders, stroke of known and unknown aetiology, improved individual and population outcomes under pandemic conditions such as COVID-19. In a long-term way, a significantly improved healthcare economy is one of benefits of the proposed paradigm shift from reactive to Predictive, Preventive and Personalised Medicine (PPPM/3PM). A tight collaboration between all stakeholders including scientific community, healthcare givers, patient organisations, policy-makers and educators is essential for the smooth implementation of 3PM concepts in daily practice.

19.
Obes Res Clin Pract ; 15(6): 523-535, 2021.
Article in English | MEDLINE | ID: covidwho-1525912

ABSTRACT

During the course of the COVID-19 pandemic, obesity has been shown to be an independent risk factor for high morbidity and mortality. Obesity confers poor outcomes in younger (<60 years) patients, an age-group considered low-risk for complications, a privilege that is negated by obesity. Findings are consistent, the higher the body mass index (BMI) the worse the outcomes. Ectopic (visceral) obesity also promotes proinflammatory, prothrombotic, and vasoconstrictive states, thus enhancing the deleterious effects of COVID-19 disease. Less, albeit robust, evidence also exists for a higher risk of COVID-19 infection incurred with underweight. Thus, the relationship of COVID-19 and BMI has a J-curve pattern, where patients with both overweight/obesity and underweight are more susceptible to the ailments of COVID-19. The pathophysiology underlying this link is multifactorial, mostly relating to the inflammatory state characterizing obesity, the impaired immune response to infectious agents coupled with increased viral load, the overexpression in adipose tissue of the receptors and proteases for viral entry, an increased sympathetic activity, limited cardiorespiratory reserve, a prothrombotic milieu, and the associated comorbidities. All these issues are herein reviewed, the results of large studies and meta-analyses are tabulated and the pathogenetic mechanisms and the BMI relationship with COVID-19 are pictorially illustrated.


Subject(s)
COVID-19 , Body Mass Index , Body Weight , Humans , Pandemics , SARS-CoV-2
20.
Front Nutr ; 8: 649422, 2021.
Article in English | MEDLINE | ID: covidwho-1485085

ABSTRACT

Introduction: As coronavirus Disease 2019 (COVID-19) has evolved into a global pandemic, increasing numbers of reports have linked obesity to more severe COVID-19 illness and death. However, almost all the studies focused on an increased risk of mortality or intensive care unit (ICU) admission among hospitalized obese patients with COVID-19. Is obesity also associated with the incidence of acute lung injury (ALI) in the patients with COVID-19? How about underweight patients? The answer is lacking. Therefore, our following research will answer the above two questions. Methods: We collected and analyzed epidemiologic, demographic, clinical, and laboratory data from 193 confirmed cases of COVID-19 at Union Hospital, Tongji Medical College, Huazhong University of Science and Technology in Wuhan, China, between January 1, 2020, and March 13, 2020. They were followed up until April 15, 2020. Underweight was defined by body mass index (BMI) lower than 18.5 kg/m2, normal weight by 18.5-23.9 kg/m2, overweight by 24.0-27.9 kg/m2, and obesity as ≥28 kg/m2. Results: Among these patients, 5.70% were underweight, 58.03% were normal weight, 27.98% were overweight, and 8.29% were obese. Underweight patients were more likely to have a headache (P = 0.029). Obese patients were more likely than other groups to experience a decline in lymphocyte counts (P = 0.038), an increase in C-reactive protein (CRP; P = 0.023), bilateral multiple mottling, and ground glass opacity in the lungs (P = 0.007). Besides, the proportion of patients receiving human immunoglobulin + systematic corticosteroids treatment is the highest among the obese group compared with other BMI groups. After adjusting for potential confounders, underweight patients had a 6.483-fold higher (P = 0.012), and obese patients showed a 5.965-fold higher odds for developing ALI than normal-weight patients (P = 0.022). In addition, underweight patients were 3.255 times more likely than normal-weight patients to develop secondary infections (P = 0.041). Conclusions: Our study showed that both underweight and obese patients with COVID-19 tend to develop ALI compared with normal-weight patients. Underweight patients were more likely to develop a secondary infection than other patients.

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