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1.
BMC Endocr Disord ; 21(1): 144, 2021 Jul 03.
Article in English | MEDLINE | ID: covidwho-1295459

ABSTRACT

BACKGROUND: Although obesity, defined by body mass index (BMI), has been associated with a higher risk of hospitalisation and more severe course of illness in Covid-19 positive patients amongst the British population, it is unclear if this translates into increased mortality. Furthermore, given that BMI is an insensitive indicator of adiposity, the effect of adipose volume on Covid-19 outcomes is also unknown. METHODS: We used the UK Biobank repository, which contains clinical and anthropometric data and is linked to Public Health England Covid-19 healthcare records, to address our research question. We performed age- and sex- adjusted logistic regression and Chi-squared test to compute the odds for Covid-19-related mortality as a consequence of increasing BMI, and other more sensitive indices of adiposity such as waist:hip ratio (WHR) and percent body fat, as well as concomitant cardiometabolic illness. RESULTS: 13,502 participants were tested for Covid-19 (mean age 70 ± 8 years, 48.9% male). 1582 tested positive (mean age 68 ± 9 years, 52.8% male), of which 305 died (mean age 75 ± 6 years, 65.5% male). Increasing adiposity was associated with higher odds for Covid-19-related mortality. For every unit increase in BMI, WHR and body fat, the odds of death amongst Covid19-positive participants increased by 1.04 (95% CI 1.01-1.07), 10.71 (95% CI 1.57-73.06) and 1.03 (95% CI 1.01-1.05), respectively (all p < 0.05). Referenced to Covid-19 positive participants with a normal weight (BMI 18.5-25 kg/m2), Covid-19 positive participants with BMI > 35 kg/m2 had significantly higher odds of Covid-19-related death (OR 1.70, 95% CI 1.06-2.74, p < 0.05). Covid-19-positive participants with metabolic (diabetes, hypertension, dyslipidaemia) or cardiovascular morbidity (atrial fibrillation, angina) also had higher odds of death. CONCLUSIONS: Anthropometric indices that are more sensitive to adipose volume and its distribution than BMI, as well as concurrent cardiometabolic illness, are associated with higher odds of Covid-19-related mortality amongst the UK Biobank cohort that tested positive for the infection. These results suggest adipose volume may contribute to adverse Covid-19-related outcomes associated with obesity.


Subject(s)
Adiposity/physiology , COVID-19/mortality , Cardiovascular Diseases/epidemiology , Metabolic Syndrome/epidemiology , Obesity/epidemiology , Aged , Aged, 80 and over , Biological Specimen Banks/statistics & numerical data , Body Mass Index , COVID-19/complications , COVID-19/pathology , Cardiometabolic Risk Factors , Cardiovascular Diseases/complications , Cardiovascular Diseases/mortality , Cohort Studies , Databases, Factual , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/epidemiology , Diabetes Mellitus, Type 2/mortality , Female , Hospital Mortality , Humans , Male , Metabolic Syndrome/complications , Metabolic Syndrome/mortality , Middle Aged , Morbidity , Mortality , Obesity/complications , Obesity/mortality , Risk Factors , SARS-CoV-2/physiology , United Kingdom/epidemiology
2.
Dig Liver Dis ; 53(11): 1428-1432, 2021 11.
Article in English | MEDLINE | ID: covidwho-1240280

ABSTRACT

BACKGROUND: Due to the increasing rise of C. difficile infection, stool banks and donor programs have been launched to grant access to fecal microbiota transplantation (FMT). Our aim is to describe characteristics and outcomes of the donor program at our stool bank. METHODS: Donor candidates underwent a four-step selection process, including a clinical interview, blood and stool testing, a further questionnaire and a direct stool testing the day of each donation. From March 2020, specific changes to this process were introduced to avoid the potential transmission of COVID-19. We evaluated the rate of excluded candidates at each step of the screening, as well as the number of total fecal aliquots provided by qualified donors. RESULTS: Overall, 114 donor candidates were evaluated. Seventy-five candidates declined to join the program for logistic or personal issues, three were excluded after the questionnaire and seven for positive stool exams. Finally, 29 (25%) subjects qualified as stool donors, and provided 70 stool samples. Fifteen samples were excluded after direct molecular stool testing. A total of 127 aliquots was finally obtained. CONCLUSIONS: Donor recruitment for FMT is a challenging process, and only a small rate of candidates are eligible as donors.


Subject(s)
Biological Specimen Banks , Donor Selection/methods , Fecal Microbiota Transplantation , Adult , Biological Specimen Banks/organization & administration , Biological Specimen Banks/statistics & numerical data , Donor Selection/organization & administration , Donor Selection/statistics & numerical data , Feces/microbiology , Female , Humans , Infection Control/methods , Italy , Male , Program Evaluation , Prospective Studies
3.
Hum Hered ; 85(2): 66-68, 2020.
Article in English | MEDLINE | ID: covidwho-1145387

ABSTRACT

It is plausible that variants in the ACE2 and TMPRSS2 genes might contribute to variation in COVID-19 severity and that these could explain why some people become very unwell whereas most do not. Exome sequence data was obtained for 49,953 UK Biobank subjects, of whom 82 had tested positive for SARS-CoV-2 and could be presumed to have severe disease. A weighted burden analysis was carried out using SCOREASSOC to determine whether there were differences between these cases and the other sequenced subjects in the overall burden of rare, damaging variants in ACE2 or TMPRSS2. There were no statistically significant differences in weighted burden scores between cases and controls for either gene. There were no individual DNA sequence variants with a markedly different frequency between cases and controls. Whether there are small effects on severity, or whether there might be rare variants with major effect sizes, would require studies in much larger samples. Genetic variants affecting the structure and function of the ACE2 and TMPRSS2 proteins are not the main explanation for why some people develop severe symptoms in response to infection with SARS-CoV-2. This research was conducted using the UK Biobank Resource.


Subject(s)
Angiotensin-Converting Enzyme 2/genetics , Biological Specimen Banks/statistics & numerical data , COVID-19/genetics , Genetic Predisposition to Disease/genetics , Genetic Variation , Serine Endopeptidases/genetics , Severity of Illness Index , COVID-19/diagnosis , COVID-19/virology , Gene Frequency , Genotype , Humans , Polymorphism, Single Nucleotide , Risk Factors , SARS-CoV-2/physiology , United Kingdom , Whole Exome Sequencing/methods
4.
In Vivo ; 35(2): 965-968, 2021.
Article in English | MEDLINE | ID: covidwho-1100485

ABSTRACT

BACKGROUND/AIM: Adult outpatients with symptomatic COVID-19 treated with fluvoxamine, compared with placebo, had a lower likelihood of clinical deterioration over 15 days. Fluvoxamine strongly binds to the sigma-1 receptor (S1R) that regulates inflammation by inhibiting the production of cytokines, believed to be responsible for severe COVID-19. We evaluated the S1R locus on chr 9p13.3 in subjects tested positive for SARS-CoV-2. We focused on SNP rs17775810 that has been previously identified by examining loss-of-function mutations in the S1R gene associated with distal hereditary motor neuropathy. PATIENTS AND METHODS: We utilized UK Biobank (UKB) data. Data processing was performed on Minerva, a Linux mainframe with Centos 7.6, at the Icahn School of Medicine at Mount Sinai. RESULTS: The effect of rs17775810 genotype on survival was significant (p=0.036, 2 tailed Fisher exact test). The minor allele homozygotes (TT) had the lowest death rate (0%), whereas the non-TT genotypes (i.e. CT and CC) had the highest death rate (16.2%). CONCLUSION: The rs17775810 analysis corroborates the favorable effect of fluvoxamine on COVID-19 survival.


Subject(s)
Biological Specimen Banks/statistics & numerical data , COVID-19/genetics , Polymorphism, Single Nucleotide , Receptors, sigma/genetics , Alleles , Anti-Anxiety Agents/therapeutic use , COVID-19/drug therapy , COVID-19/virology , Cohort Studies , Female , Fluvoxamine/therapeutic use , Genotype , Homozygote , Humans , Male , Middle Aged , Receptors, sigma/metabolism , SARS-CoV-2/drug effects , SARS-CoV-2/physiology , Survival Analysis , United Kingdom
5.
Int J Epidemiol ; 49(5): 1454-1467, 2020 10 01.
Article in English | MEDLINE | ID: covidwho-1066329

ABSTRACT

BACKGROUND: The recent COVID-19 outbreak has generated an unprecedented public health crisis, with millions of infections and hundreds of thousands of deaths worldwide. Using hospital-based or mortality data, several COVID-19 risk factors have been identified, but these may be confounded or biased. METHODS: Using SARS-CoV-2 infection test data (n = 4509 tests; 1325 positive) from Public Health England, linked to the UK Biobank study, we explored the contribution of demographic, social, health risk, medical and environmental factors to COVID-19 risk. We used multivariable and penalized logistic regression models for the risk of (i) being tested, (ii) testing positive/negative in the study population and, adopting a test negative design, (iii) the risk of testing positive within the tested population. RESULTS: In the fully adjusted model, variables independently associated with the risk of being tested for COVID-19 with odds ratio >1.05 were: male sex; Black ethnicity; social disadvantage (as measured by education, housing and income); occupation (healthcare worker, retired, unemployed); ever smoker; severely obese; comorbidities; and greater exposure to particulate matter (PM) 2.5 absorbance. Of these, only male sex, non-White ethnicity and lower educational attainment, and none of the comorbidities or health risk factors, were associated with testing positive among tested individuals. CONCLUSIONS: We adopted a careful and exhaustive approach within a large population-based cohort, which enabled us to triangulate evidence linking male sex, lower educational attainment and non-White ethnicity with the risk of COVID-19. The elucidation of the joint and independent effects of these factors is a high-priority area for further research to inform on the natural history of COVID-19.


Subject(s)
COVID-19 Testing , COVID-19 , Confounding Factors, Epidemiologic , Biological Specimen Banks/standards , Biological Specimen Banks/statistics & numerical data , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Testing/methods , COVID-19 Testing/statistics & numerical data , Female , Humans , Male , Middle Aged , Predictive Value of Tests , Risk Assessment/methods , Risk Factors , SARS-CoV-2/isolation & purification , United Kingdom/epidemiology
6.
ESMO Open ; 6(1): 100024, 2021 02.
Article in English | MEDLINE | ID: covidwho-1007937

ABSTRACT

BACKGROUND: This study evaluated the consequences in Europe of the COVID-19 outbreak on pathology laboratories orientated toward the diagnosis of thoracic diseases. MATERIALS AND METHODS: A survey was sent to 71 pathology laboratories from 21 European countries. The questionnaire requested information concerning the organization of biosafety, the clinical and molecular pathology, the biobanking, the workload, the associated research into COVID-19, and the organization of education and training during the COVID-19 crisis, from 15 March to 31 May 2020, compared with the same period in 2019. RESULTS: Questionnaires were returned from 53/71 (75%) laboratories from 18 European countries. The biosafety procedures were heterogeneous. The workload in clinical and molecular pathology decreased dramatically by 31% (range, 3%-55%) and 26% (range, 7%-62%), respectively. According to the professional category, between 28% and 41% of the staff members were not present in the laboratories but did teleworking. A total of 70% of the laboratories developed virtual meetings for the training of residents and junior pathologists. During the period of study, none of the staff members with confirmed COVID-19 became infected as a result of handling samples. CONCLUSIONS: The COVID-19 pandemic has had a strong impact on most of the European pathology laboratories included in this study. Urgent implementation of several changes to the organization of most of these laboratories, notably to better harmonize biosafety procedures, was noted at the onset of the pandemic and maintained in the event of a new wave of infection occurring in Europe.


Subject(s)
COVID-19/prevention & control , Clinical Laboratory Services/statistics & numerical data , Pathology, Clinical/statistics & numerical data , Pathology, Molecular/statistics & numerical data , Surveys and Questionnaires , Thoracic Diseases/diagnosis , Biological Specimen Banks/organization & administration , Biological Specimen Banks/statistics & numerical data , COVID-19/epidemiology , COVID-19/virology , Clinical Laboratory Services/trends , Containment of Biohazards/statistics & numerical data , Disease Outbreaks , Europe/epidemiology , Forecasting , Humans , Pandemics , Pathology, Clinical/methods , Pathology, Clinical/trends , Pathology, Molecular/methods , Pathology, Molecular/trends , SARS-CoV-2/isolation & purification , SARS-CoV-2/physiology , Specimen Handling/methods , Specimen Handling/statistics & numerical data , Thoracic Diseases/therapy
11.
Diabetes Metab Syndr ; 14(5): 1149-1151, 2020.
Article in English | MEDLINE | ID: covidwho-622114

ABSTRACT

AIMS: We examined the link between BMI and risk of a positive test for SARS-CoV-2 and risk of COVID-19-related death among UK Biobank participants. METHODS: Among 4855 participants tested for SARS-CoV-2 in hospital, 839 were positive and of these 189 died from COVID-19. Poisson models with penalised thin plate splines were run relating exposures of interest to test positivity and case-fatality, adjusting for confounding factors. RESULTS: BMI was associated strongly with positive test, and risk of death related to COVID-19. The gradient of risk in relation to BMI was steeper in those under 70, compared with those aged 70 years or older for COVID-19 related death (Pinteraction = 0.03). BMI was more strongly related to test positivity (Pinteraction = 0.010) and death (Pinteraction = 0.002) in non-whites (predominantly South Asians and Afro-Caribbeans), compared with whites. CONCLUSIONS: These data add support for adiposity being more strongly linked to COVID-19-related deaths in younger people and non-white ethnicities. If future studies confirm causality, lifestyle interventions to improve adiposity status may be important to reduce the risk of COVID-19 in all, but perhaps particularly, non-white communities.


Subject(s)
Betacoronavirus/isolation & purification , Biological Specimen Banks/statistics & numerical data , Body Mass Index , Coronavirus Infections/mortality , Coronavirus Infections/virology , Pneumonia, Viral/mortality , Pneumonia, Viral/virology , Age Factors , COVID-19 , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Humans , Pandemics , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , Prognosis , Risk Factors , SARS-CoV-2 , Sex Factors , Survival Rate , United Kingdom/epidemiology
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