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1.
medrxiv; 2024.
Preprint in English | medRxiv | ID: ppzbmed-10.1101.2024.02.25.24303335

ABSTRACT

Introduction: To examine if patients exposed to primary care telemedicine (telephone or video) early in the COVID-19 pandemic had higher rates of downstream HbA1c measurement and improved HbA1c levels in the second year of the pandemic. Research Design and Methods In a cohort of 242, 848 Kaiser Permanente Northern California patients with diabetes, we examined associations between early-pandemic patient-initiated telemedicine visit and downstream HbA1c monitoring and results during the second year of the pandemic. Results Adjusted HbA1c measurement rates were significantly higher among patients with telemedicine exposure in the early-pandemic prior year than those with no visits in the prior year (91.0% testing for patients with video visits, 90.5% for telephone visits, visits, 86.7% for no visits, p < 0.05). Among those with HbA1c measured, the rates of having an HbA1c < 8% in the second year of the COVID-19 pandemic were also statistically significantly higher among patients with telemedicine exposure in the early-pandemic prior year than those with no visits in the prior year (68.5% with HbA1c< 8% for video visits, 67.3% for telephone visits, 66.6% for no visits, p < 0.05). Conclusions Access to telephone and video telemedicine throughout the early COVID-19 pandemic was associated with patients' continued engagement in recommended diabetes care. Although our study analyzed telemedicine use during a pandemic, telemedicine visits may continue to support ongoing health care access and positive clinical outcomes.


Subject(s)
Diabetes Mellitus , COVID-19 , Encephalitis, California
2.
medrxiv; 2024.
Preprint in English | medRxiv | ID: ppzbmed-10.1101.2024.02.21.24303099

ABSTRACT

Long-term COVID-19 complications are a globally pervasive threat, but their plausible social drivers are often not prioritized. Here, we use data from a multinational consortium to quantify the relative contributions of social and clinical factors to differences in quality of life among participants experiencing long COVID and measure the extent to which social variables impacts can be attributed to clinical intermediates, across diverse contexts. In addition to age, neuropsychological and rheumatological comorbidities, educational attainment, employment status, and female sex were identified as important predictors of long COVID-associated quality of life days (long COVID QALDs). Furthermore, a great majority of their impacts on long COVID QALDs could not be tied to key long COVID-predicting comorbidities, such as asthma, diabetes, hypertension, psychological disorder, and obesity. In Norway, 90% (95% CI: 77%, 100%) of the effect of belonging to the highest versus lowest educational attainment quintile was not attributed to intermediate comorbidity impacts. The same was true for 86% (73%, 100%) of the protective effects of full-time employment versus all other employment status categories (excluding retirement) in the UK and 74% (46%,100%) of the protective effects of full-time employment versus all other employment status categories in a cohort of four middle-income countries (MIC). Of the effects of female sex on long COVID QALDs in Norway, UK, and the MIC cohort, 77% (46%,100%), 73% (52%, 94%), and 84% (62%, 100%) were unexplained by the clinical mediators, respectively. Our findings highlight that socio-economic proxies and sex may be as predictive of long COVID QALDs as commonly emphasized comorbidities and that broader structural determinants likely drive their impacts. Importantly, we outline a multi-method, adaptable causal machine learning approach for evaluating the isolated contributions of social disparities to long COVID quality of life experiences.


Subject(s)
Diabetes Mellitus , Obesity , Sexual Dysfunctions, Psychological , COVID-19 , Asthma , Hypertension
3.
researchsquare; 2024.
Preprint in English | PREPRINT-RESEARCHSQUARE | ID: ppzbmed-10.21203.rs.3.rs-3978879.v1

ABSTRACT

Purpose The aim of this study was to observe the characteristics of COVID-19 infected maintenance hemodialysis (MHD) patients, identify the risk factors for severe illness and mortality in this population, and establish a preliminary risk prediction model for severe COVID-19 infection of MHD patients.Methods We included patients who underwent long-term maintenance hemodialysis and were hospitalized for COVID-19 infection at our hospital from December 2022 to March 2023. We retrospectively analyzed their demographic characteristics, clinical manifestations, laboratory tests, hemodialysis-related information, treatment strategies and complications. The patients were divided into severe (heavy and critical) and non-severe (mild and moderate) groups. Logistic regression and Cox proportional hazards analysis were used to identify the risk factors for severe COVID-19 progression.Results The presence of cerebrovascular disease, elevated NLR, fibrinogen, and D-dimer are independent risk indicators for severe COVID-19 infection in MHD patients in early stage. The presence of diabetes, cerebrovascular disease, and elevated D-dimer and NLR were associated with mortality.Conclusion MHD patients have a high probability of developing into severe and critical COVID-19 infection, and NLR, fibrinogen, and D-dimer can serve as early warning indicators for severe and critical progression of COVID-19 infection. The presence of diabetes, cerebrovascular disease, elevated NLR and D-dimer levels attribute to worse clinical outcomes and increased mortality.


Subject(s)
Sleep Initiation and Maintenance Disorders , Diabetes Mellitus , Cerebrovascular Disorders , COVID-19
4.
researchsquare; 2024.
Preprint in English | PREPRINT-RESEARCHSQUARE | ID: ppzbmed-10.21203.rs.3.rs-3963147.v1

ABSTRACT

Background: Type 2 diabetes mellitus (T2DM) is a public health crisis that requires adequate knowledge, attitudes, and practices (KAP) by health care providers to prevent or delay the progression of the disease. This study aimed to assess the KAP regarding T2DM among primary care providers (PCPs) in Central China.Methods: This multicenter cross-sectional study was conducted among 971 PCPs using self-administered KAP questionnaires. Questionnaires were designed to evaluate KAP regarding T2DM among PCPs, and was measured with SPSS software.Results: A total of 971 PCPs with a mean age of 44.0 ± 10.2 years were evaluated. 620 (63.9%) PCPs worked at village clinic and 605 (62.3%) PCPs have been working more than 20 years. Only 26.3% of the respondents participated in CME programs regarding diabetes in the past year due to Covid-19 pandemic. Overall, despite positive attitudes toward diabetes, there were substantial gaps in knowledge and practices. The PCPs scored 7.25 out of 14 points on the knowledge subscales, 7.13 out of 8 on the attitude subscales, and 4.85 out of 11 on the practice subscales. Gender, age, practice setting, professional titles, duration of practice and CME attendance were significant predictors of knowledge; Age, practice setting and duration of practice were significant predictors of attitudes; and family history of diabetes affected PCP practices.Conclusions: Despite positive attitudes toward diabetes, there were substantial gaps in knowledge and practices. These findings call for action from relevant health authorities and policy makers to improve PCPs' KAP regarding diabetes in Central China.


Subject(s)
Diabetes Mellitus, Type 2 , Diabetes Mellitus , COVID-19
5.
researchsquare; 2024.
Preprint in English | PREPRINT-RESEARCHSQUARE | ID: ppzbmed-10.21203.rs.3.rs-3960483.v1

ABSTRACT

Objective We aimed to assess a battery of inflammatory cytokines in SARS-CoV-2 patients to determine the cytokines of prognostic and/ predictive relevance in Covid-19.Methods In a cohort of total 100 SARS-CoV-2 patients (RT-PCR confirmed) hospitalized in associated SMHS hospital of GMC Srinagar, Kashmir (North India), the level of a battery of cytokines IL-6, IL-8, IL-10, IL-1α and VEGF, TNF-α and ferritin, were estimated by Enzyme Linked Immunosorbent Assay ( ELISA) on Multimode Microplate reader.Result The deranged levels of these cytokines were mostly found in patients > 60 years of age with cough and pneumonia as the most common symptoms. Correlation analysis revealed significant association between interleukin's IL-6, IL-8 and disease severity (p = 0.002) (p = 0.007) and poor disease outcome (p = 0.04), (p = 0.009) respectively. Similar association was also found between decreased levels of VEGF and poor disease outcome (p = 0.02). Further ROC analysis, univariant and multivariant (after adjusting for age, gender and other inflammatory markers), revealed increased IL-10 (AUC = 0.72) and IL-6 (AUC = 0.70) as independent markers of both disease severity(p = 0.02) (p = 0.01) and disease outcome (P = 0.03) (p = 0.02) and decreased VEGF (AUC = 0.69) as independent marker of disease outcome only (p = 0.03). Significant association of cough with IL-8 levels (p = 0.01) and of diabetes with raised ferritin levels (p = 0.01) with very high ferritin levels (> 1500ng/ml) as indicator of those that are likely to develop hyperinflammatory phenotype was found in SARS-CoV-2 patients.Conclusion We conclude ‘IL-6, IL10, VEGF and IL-8’ as the signature inflammatory cytokine panel in Covid-19. An increased IL-10, IL-6 levels proved to be equally significant independent prognosticators of Covid − 19 severity and predictors of poor disease outcome and decreased VEGF level as predictors of poor disease outcome in SARS-CoV-2 patients. Testing of the signature inflammatory cytokine panel is, therefore, recommended for optimal clinical decision making in Covid-19.


Subject(s)
Diabetes Mellitus , Pneumonia , Severe Acute Respiratory Syndrome , COVID-19 , Cough
6.
medrxiv; 2024.
Preprint in English | medRxiv | ID: ppzbmed-10.1101.2024.02.14.24302808

ABSTRACT

Background: The COVID-19 pandemic's global impact was mitigated through rapid vaccine development, leading to a mix of natural and vaccination-derived immunity. Immunological profile in hybrid immunity remains less studies, especially in regions where non-mRNA vaccines were used. This study focuses on the immunological profiles and predictors of immune response in one such population. Methods: This was a cross-sectional study to assess their humoral and cellular immune responses based on vaccination and infection history. Immunological assays were performed to measure anti-spike protein and neutralizing antibodies as well as interferon-γ release assay. Multivariable linear regression model was used to estimate predictors of immune response. Results: The study revealed significant differences in immune response among participants based on their hybrid immunity status, vaccination, and infection history. Higher antibody titres and cellular responses were observed in individuals with hybrid immunity, especially those with dual pre-Omicron and Omicron infections (3326 BAU/ml, IQR: 770.25-5678.25 and 4.92 IU of IFN-γ/mL, IQR:3.74-16.98 respectively, p <0.001). Age and comorbidities such as diabetes and hypertension were associated with lower antibody levels and cellular response, while vaccination and hybrid immunity correlated with higher immune responses. Conclusion: The prevalence of hybrid immunity was high, yet a substantial portion of the population lacks it, indicating the necessity for targeted immunization strategies. The findings underscore the importance of prioritizing high-risk individuals, such as elderly and individuals with comorbidities, for booster vaccinations to enhance community-level protection against COVID-19.


Subject(s)
Diabetes Mellitus , COVID-19 , Hypertension
7.
preprints.org; 2024.
Preprint in English | PREPRINT-PREPRINTS.ORG | ID: ppzbmed-10.20944.preprints202402.0736.v1

ABSTRACT

The human phospholipase B-II precursor (HPLBII-P) was originally purified from white blood cells but is also found in other cellular structures such as kidney glomeruli and tubuli. The objective of this report was to investigate the relationship of HPLBII-P in urine to acute kidney injury in patients with COVID-19 Methods Urine was collected at admission from 132 COVID-19 patients admitted to the intensive care units (ICU) because of respiratory failure. HPLBII-P was measured by a sensitive ELISA. For comparison, HNL was measured in urine, by the ELISA configured with mabs 763/8F, as a sign of tubular affection in addition to routine biomarkers of kidney disease Results Overall, the concentrations of urinary HPLBII-P were almost 3-fold higher in COVID-19 patients as compared to healthy controls (p


Subject(s)
Kidney Diseases , Diabetes Mellitus , COVID-19 , Respiratory Insufficiency
8.
medrxiv; 2024.
Preprint in English | medRxiv | ID: ppzbmed-10.1101.2024.02.12.24302726

ABSTRACT

BackgroundIn high Andean areas, there is greater insulin sensitivity which may be a protective factor against complications in subjects with diabetes mellitus. ObjectiveDetermine the association between altitude of residence and death from COVID-19 in deaths with diabetes mellitus in Peru during the first wave.. MethodsWe carried out a cross-sectional analysis of deaths registered in the National Death System of Peru (SINADEF in Spanish). We selected Peruvians with diabetes mellitus identified by presenting the diagnosis in any of the six boxes on the certificate. The dependent variable was death from COVID-19 as the basic cause of death, located in last place among causes A, B, C and D according to the Pan American Health Organization. The independent variable was the altitude of residence, categorized as less than 1 500 m a.s.l, 1 500 to 2 499 m a.s.l. and greater than 2 500 m a.sl. Through a multilevel analysis by geographic region and using a Poisson regression, we obtained the risk ratios of death from COVID-19 according to the altitude of residence. We adjusted by individual and contextual variables. ResultsWe included 16 406 deaths with diabetes mellitus between March-December 2020. 34.3% died from Covid19 and 9.7% came from areas above 2 500 m. The proportion of deaths from COVID-19 of those with residence altitude above 2 500 m was 20% lower compared to residents below 1 500 m (RR: 0.80; 95% CI: 0.70 - 0.91; p<0.001), adjusted for individual and socioeconomic factors. Its influence is also shown as the altitude changes every 100, 250, 500 and 1000 m a.s.l., through multilevel analysis. ConclusionA higher altitude of residence is associated with a lower proportion of deaths from COVID-19 in people with diabetes mellitus during the first wave in Peru. The study contribute to expanding knowledge of the effects of altitude with respect to mortality in people with diabetes mellitus in a context of a highly contagious and virulent infectious disease.


Subject(s)
Death , Communicable Diseases , Diabetes Mellitus , COVID-19
9.
medrxiv; 2024.
Preprint in English | medRxiv | ID: ppzbmed-10.1101.2024.02.08.24302520

ABSTRACT

The immune system plays a crucial role in many human diseases. In this context, genome-wide association studies (GWAS) offer valuable insights to elucidate the role of immunity in health and disease. The present multi-omics study aimed to identify genetic determinants of immune cell type distributions in the blood of healthy individuals and to assess whether the distributions of these cells may play a role for autoimmune and COVID-19 disease risk. To this end, the frequencies of different immune cells in 483 healthy individuals from the Berlin Aging Study II were quantified using flow cytometry, and GWAS was performed for 92 immune cell phenotypes. Additionally, we performed linear regression analyses of immune cell distributions using polygenic risk scores (PRS) based on prior GWAS for five autoimmune diseases as well as for COVID-19 infection and post-COVID syndrome ("long COVID"). We validated seven previously described immune loci and identified 13 novel loci showing genome-wide significant (=5.00E-8) association with different immune cell phenotypes. The most significant novel signal was conferred by the SLC52A3 locus, encoding for a riboflavin transporter protein, which was associated with naïve CD57+ CD8+ T cells (p=4.13E-17) and colocalized with SLC52A3 expression. Several novel loci contained immunologically plausible candidate genes, e.g., variants near TBATA and B3GAT1 representing genes associated with T cell phenotypes. The PRS of type 1 diabetes were significantly associated with CD8+ T cells at different differentiation states (p[≤]7.02E-4), and PRS of long COVID were associated with early-differentiated CD4+ T cells (p[≤]1.54E-4). In conclusion, our extensive immune cell GWAS analyses highlight several novel genetic loci of likely relevance for immune system function. Furthermore, our PRS analyses point to a shared genetic basis between immune cell distributions in healthy adults and T1D (CD8+ T cells) as well as long COVID (CD4+ T cells).


Subject(s)
Diabetes Mellitus , COVID-19 , Autoimmune Diseases
10.
preprints.org; 2024.
Preprint in English | PREPRINT-PREPRINTS.ORG | ID: ppzbmed-10.20944.preprints202402.0420.v1

ABSTRACT

Abstract: Background: Patients with diabetes are particularly susceptible to COVID-19 infection, which can result in severe respiratory illness. Methods: This study conducted a comparative as-sessment of the impact of antiviral therapy using molnupiravir and favipiravir in COVID-19 pa-tients with underlying diabetes. A cohort of one hundred individuals infected with SARS-CoV-2, diagnosed with diabetes, and consecutively admitted, was included in the present study. These patients were treated with antivirals according to local guidelines: Group F (51 cases) was treated with favipiravir – 10 days and Group M (49 cases) was treated with molnupiravir – 5 days. Re-sults: In Group F, the average hospitalization was higher than in Group M (11.29±2.27 vs. 7.14±3.16, p


Subject(s)
Diabetes Mellitus , COVID-19 , Respiratory Insufficiency
11.
medrxiv; 2024.
Preprint in English | medRxiv | ID: ppzbmed-10.1101.2024.02.05.24302369

ABSTRACT

The novel coronavirus (COVID-19) is known to be the fifth pandemic causing massive deaths worldwide. This virus has not only been deeply associated with acute respiratory distress, but also acute kidney injury (AKI). This study describes the baseline characteristics and various outcomes of AKI based on the KDIGO 2012 Clinical Practice Guidelines in patients hospitalized with COVID-19 at a Philippine tertiary hospital. A total of 195 patient records were retrospectively reviewed for the study. Of the 195 patients, 81(42%) patients developed AKI. Significant baseline characteristics included older age (56.28 + 14.12), presence of hypertension (p=0.004), diabetes mellitus (p=0.002), and cardiovascular disease (p=0.003). Also, the use of diuretics, inotropes and antibiotics were more prevalent in patients who developed AKI. Most of the patients who had AKI were categorized as stage 1 (49.38%).  Mechanical ventilation was significantly (p<0.001) more prevalent in patients with AKI (20.99%) compared to patients without AKI (5.26%). There was significantly higher rates (p<0.001) of renal replacement therapy in patients with AKI (30.86%). Lastly, higher mortality rates were observed in patients with AKI (50.62%) versus patients without AKI (12.28%). Our study demonstrated that patients with COVID-19 can develop AKI and tend to have a poorer prognosis.


Subject(s)
Diabetes Mellitus , Kidney Diseases , COVID-19 , Cardiovascular Diseases , Acute Kidney Injury , Hypertension
12.
medrxiv; 2024.
Preprint in English | medRxiv | ID: ppzbmed-10.1101.2024.02.02.24302216

ABSTRACT

Introduction: Among adults who test positive for COVID-19, some develop long COVID (symptoms lasting [≥]3 months), and some do not. We compared 3 groups on selected measures to help determine strategies to reduce COVID impact. Methods: Using Stata and data for 385,617 adults from the 2022 Behavioral Risk Factor Surveillance System, we compared adults reporting long COVID, those with just a positive test, and those who never tested positive, on several health status and risk factor measures plus vaccination rates (data for 178,949 adults in 29 states). Results: Prevalence of just COVID was 26.5% (95% CI 26.2-26.8) and long COVID was 7.4% (7.3-7.6). Compared with adults with just COVID those with long COVID had worse rates for 13 of 17 measures of chronic disease, disability, and poor health status, while those with just COVID had the best results for 15 of the 17 measures among all 3 groups. The 5 risk factors (obesity, diabetes, asthma, cardiovascular disease, and COPD) previously associated with COVID deaths, increased long COVID but not just COVID rates, which were highest among younger and higher income adults. Adults with long COVID had the highest rate among the 3 groups for any COVID risk factors and data from 29 states showed they had the lowest rates for [≥]3 vaccine doses of 35.6%, vs. 42.7% and 50.3% for those with just a positive test, and neither, respectively. Vaccination with [≥]3 vaccines vs. <3 reduced long COVID rates by 38%, and just COVID rates by 16%. Conclusions: Results show the seriousness of long COVID vs. just a positive test and that increasing vaccine coverage by targeting adults with risk factors shows promise for reducing COVID impact.


Subject(s)
Chronic Disease , Diabetes Mellitus , Obesity , COVID-19 , Cardiovascular Diseases , Pulmonary Disease, Chronic Obstructive , Asthma
13.
researchsquare; 2024.
Preprint in English | PREPRINT-RESEARCHSQUARE | ID: ppzbmed-10.21203.rs.3.rs-3921756.v1

ABSTRACT

purpose Brain abscess following sinonasal mucormycosis is a rare but life-threatening condition that usually occurs during the patient's treatment. Therefore, it is important to pay close attention to its identification and treatment and since our knowledge is mostly based on case reports, a well-documented way of treatment for such cases is yet to be found. Methods A retrospective case series study was conducted at a tertiary hospital. Initially, all patients with brain abscesses following sino-nasal mucormycosis were included, and then patients whose brain abscesses were treated without opening the dura during surgery were selected for the study. The patients received radical debridement of necrotic tissues as well as the infected bones adjacent to the brain abscess cavity. But the dura was not incised. Then they were treated medically for their underlying disease and also with Amphotericine-B. Their brain abscess was monitored 3 weeks post-operatively. Results Three patients with an average age of 41 years were included in the study. All patients had a history of diabetes and had previously been treated for COVID-19 before developing symptoms of sino-nasal infection. The average size of the abscesses was less than 2 cm. Two patients had abscesses in the temporal lobe and one in the frontal lobe. Conclusion Treating brain abscesses adjacent to the skull base by removing infected tissues and bones surrounding the brain abscess without opening the dura can be a viable treatment option for mucormycosis-induced brain abscesses of less than 2 cm. Ethics approval statement: IR.TUMS.AMIRALAM.REC.1402.036


Subject(s)
Diabetes Mellitus , Mouth Neoplasms , Mucormycosis , COVID-19 , Nose Diseases , Brain Abscess , Necrosis
14.
preprints.org; 2024.
Preprint in English | PREPRINT-PREPRINTS.ORG | ID: ppzbmed-10.20944.preprints202402.0077.v1

ABSTRACT

Aims: The study aims to take the COVID-19 pandemic as an example to provide a scientific reference for diabetic patients’ self-health management and nurses’ work for these patients when facing future pandemics. Review Methods: It conducted a comprehensive literature search and analysed relevant texts. This article reviews the daily health management of diabetic patients in the context of the COVID-19 pandemic and the role that nurses should play in this process. Results: Diabetic patients face challenges in self-health management during the pandemic, including disruptions in healthcare access, increased mental problems, and unhealthy lifestyles. Nurses serve as the front-line interface between these patients and the healthcare system. Adopting telehealth and remote consultation has effectively bridged the gap created by social distancing measures. Conclusion: Daily self-health management can significantly improve glycemic control and reduce the risk of diabetes-related complications, which is vital during the pandemic when patients may be experiencing disruptions to their routine care. Moreover, empowering patients through educational initiatives led by nurses can bring better self-monitoring, medication adherence, and lifestyle modifications, all of which are crucial in mitigating the effects of diabetes on the body’s immune response, thus reducing the severity of COVID-19 if contracted.


Subject(s)
Diabetes Mellitus , COVID-19
15.
authorea preprints; 2024.
Preprint in English | PREPRINT-AUTHOREA PREPRINTS | ID: ppzbmed-10.22541.au.170667171.10307493.v1

ABSTRACT

This article briefly reviews ocean and seas as huge and novel biomedical resources for anti-infection, which includes tuberculosis, H. Pylori, and HIV infection as well as SARS-CoV-2, and as promising biomedical resources for infection-induced major non-communicable diseases (mNCDs), such as cardiovascular disease, diabetes, and cancer. These marine natural products (MNPs) and organisms include sea cucumbers, sea snake, sponge, marine algae and microalgae, etc. As key biomedical resources for the discovery of marine drugs, bioactive molecules, and agents for treatment of infectious diseases and mNCDs, MNPs have bioactive potentials of antioxidant, anti-infection, anti-inflammatory, anticoagulant, anti-diabetic effects, and cancer treatment. In addition, their anti-inflammatory mechanisms for infectious diseases are also involved. It’s time to protect ocean ecosystem for human better sustainable development in the new era of ocean economy.


Subject(s)
Diabetes Mellitus , Neoplasms , Cardiovascular Diseases , HIV Infections , Communicable Diseases , Tuberculosis
16.
authorea preprints; 2024.
Preprint in English | PREPRINT-AUTHOREA PREPRINTS | ID: ppzbmed-10.22541.au.170667498.89387459.v1

ABSTRACT

Background: The aim of our analysis was to evaluate the impact of the COVID-19 pandemic on the procurement program and kidney transplantation in Slovakia and to identify the risk factors for a severe course of COVID-19 disease, as well as the risk factors for COVID-19 fatalities, with focus on the parameters preceding the infection. Methods: 305 KTRs (68.8% males) with confirmed SARS-CoV-2 positivity were included in the multicentric retrospective analysis. Results: The procurement program and kidney transplants in Slovakia dropped in the observed period by 28.6% (P<0.0001) and by 33.5% (P<0.0001) respectively. Age over 59 years (OR=1.03, P=0.0088) and diabetes mellitus (OR=2.04, P=0.0106) were identified as independent risk factors for severe course of the disease. Risk factors for death were age over 59 years (OR=1.05, P=0.0003) and graft dysfunction with CKD-EPI<0.5 mL/s (OR=4.87, P=0.0029). The prevalence of the alpha variant in Slovakia was associated with a severe course in KTRs treated with corticoids (OR=5.72, P=0.0273) and in graft dysfunction with CKD-EPI<0.5 mL/s (OR=2.94, P=0.0076); the risk of death was higher in KTRs over 59 years (OR=1.07, P=0.0173) and again with CKD-EPI<0.5 mL/s (OR=4.42, P=0.0393). KTRs had a 3.7 times lower risk of infection compared to hemodialysis patients (14% vs 52%, P<0.0001), with mortality of 9.8% vs 30% (P<0.0001). Conclusion: The procurement and transplant program is sustainable even during a pandemic, provided that measures are set up quickly. Morbidity and mortality from COVID-19 in KTRs was comparable to the situation in EU countries.


Subject(s)
Death , Diabetes Mellitus , Primary Graft Dysfunction , COVID-19
17.
authorea preprints; 2024.
Preprint in English | PREPRINT-AUTHOREA PREPRINTS | ID: ppzbmed-10.22541.au.170668403.32370968.v1

ABSTRACT

Major marine natural products (MNPs) and marine organisms include sea urchin, sea squirts or ascidians, sea cucumbers, sea snake, sponge, soft coral, marine algae, and microalgae. As vital biomedical resources for the discovery of marine drugs, bioactive molecules, and agents for treatment of infectious diseases and major non-communicable diseases (mNCDs), these MNPs have bioactive potentials of antioxidant, anti-infection, anti-inflammatory, anticoagulant, anti-diabetic effects, cancer treatment, and improvement of human immunity. This article reviews MNPs as huge and novel biomedical resources for anti-infection of coronavirus (SARS-CoV-2 and its variants), as well tuberculosis, H. Pylori, and HIV infection, and as promising biomedical resources for SARS-CoV-2 infection related cardiovascular disease (irCVD), and other mNCDs, such as diabetes and cancer. In addition, the anti-inflammatory mechanisms of current MNPs against SARS-CoV-2 infection which link to human immunity are also involved. It’s time to protect this ecosystem for human better sustainable development in the new era of ocean economy.


Subject(s)
Diabetes Mellitus , Neoplasms , Motion Sickness , COVID-19 , Cardiovascular Diseases , HIV Infections , Communicable Diseases , Tuberculosis
18.
authorea preprints; 2024.
Preprint in English | PREPRINT-AUTHOREA PREPRINTS | ID: ppzbmed-10.22541.au.170669145.58358929.v1

ABSTRACT

Corticosteroids are the most important factor to reduce the mortality in patients with moderate-severe COVID-19. The aim of the study was to analyze the impact of methylprednisolone pulse (MPP) on in-hospital mortality of patients with acute respiratory distress syndrome (ARDS) due to COVID-19. We conducted a retrospective, single-center observational study We selected adult patients admitted to the hospital with the diagnosis of COVID-19 between March and June 2020. A total of 306 patients were analyzed. In-hospital crude mortality rate was 17%. Diabetes mellitus (HR 5.5, 95% CI 1.40–4.55), dementia (HR 7.7, 95% CI 4.25-13.87) and ARDS (HR 4.2, 95% CI 2.34-7.46) were associated with in -hospital mortality. In patients diagnosed of ARDS, the only in-hospital mortality risk factor was dementia (HR 5.2, 95% CI 2.44–11.07), whereas MPP was a protective factor (HR 0.2, 95% CI 0.09–0.63)


Subject(s)
Respiratory Distress Syndrome , Dementia , Diabetes Mellitus , COVID-19 , Acute Disease
19.
authorea preprints; 2024.
Preprint in English | PREPRINT-AUTHOREA PREPRINTS | ID: ppzbmed-10.22541.au.170669219.91370250.v1

ABSTRACT

Background: While the coronavirus disease 2019 (COVID-19) is most commonly associated with the respiratory system, disorders in other organ systems, such as the cardiovascular, neurologic, or renal, can also contribute to disease fatality. This study aimed to evaluate the relation of comorbidities to COVID-19 short-term mortality. Method: This was a single-center observational study with a historical cohort method at Bethesda Hospital Yogyakarta, Indonesia. COVID-19 diagnosis was made by utilizing reverse transcriptase-polymerase chain reaction (RT-PCR) on nasopharyngeal swabs. Patient data were retrieved from electronic medical records and used for Charlson Comorbidity Index assessments. In-hospital mortality was monitored throughout their hospital stay. Results: This study enrolled 333 patients. According to the total number of comorbidities in Charlson, 11.7% (n=39) of patients had no comorbidities; 30.9% (n=103) of patients had one comorbidity; 20.1% (n=67) of patients had two comorbidities; and 37.2% (n=124) of patients had more than three comorbidities. In multivariate analysis, these variables were significantly related to short-term mortality in COVID-19 patients: older age (odds ratio [OR] per year 1.64; 95% confidence interval [CI] 1.23-2.19; p 0.001), myocardial infarction (OR 3.57 ; 95% CI 1.49-8.56; p: 0.004), diabetes mellitus (OR 2.41; 95 CI 1.17-4.97; p: 0.017), renal disease (OR 5.18 ; 95% CI 2.07-12.97; p <0.001), and longer duration of stay (OR 1.20; 95% CI 1.08-1.32; p <0.001). Conclusion: Our study revealed multiple risk factors for mortality in patients with COVID-19. The coexistence of cardiovascular disease, diabetes, and renal problem are significant predictors of short-term mortality in COVID-19 patients.


Subject(s)
Diabetes Mellitus , Kidney Diseases , Myocardial Infarction , COVID-19 , Cardiovascular Diseases
20.
authorea preprints; 2024.
Preprint in English | PREPRINT-AUTHOREA PREPRINTS | ID: ppzbmed-10.22541.au.170670045.55494016.v1

ABSTRACT

Objective: to investigate a possible bi-directional association between gestational diabetes (GDM) and the SARS-CoV-2 infection during pregnancy. Design: case-control study with prospective data collection for the case group and 1:2 matching with historical controls Setting: University Hospital of Bern, Switzerland Population: 224 pregnant women: 75 cases with SARS-CoV-2 infection during pregnancy, matched 1:2 with controls based on parity, BMI and ethnicity. Methods: SARS-CoV-2 infection was diagnosed by RT-PCR. Screening for GDM was performed by 75mg oral glucose tolerance test at 26 weeks’ gestation in all women. Main Outcomes: Prevalence of GDM was calculated in both groups. Multivariate binary logistic regression analysis was performed to assess risk factors for GDM and inpatient COVID-19 management. Results: 34.6% of the patients in the case group suffered from GDM, vs. 16.1% in the control group (p=0.002). 35.7% patients were diagnosed with GDM after the SARS-CoV-2 infection, vs. 33.3% diagnosed before infection (OR(95%CI) 1.11(0.40-3.08), p=0.84), with no correlation between the time-point of infection and GDM diagnosis. SARS-CoV-2 (OR(95%CI) 2.79 (1.42, 5.47), p=0.003) and BMI (OR(95%CI) 1.12 (1.05, 1.19), p=0.001) were significant independent risk factors for GDM. Conclusions: The significantly higher rate of GDM among women with SARS-CoV-2 infection during pregnancy, as compared to matching controls, suggests that GDM increases the risk of infection. On the other hand, SARS-CoV-2 during pregnancy might increase the risk of developing GDM. Vaccination and caution in using protective measures should be recommended to pregnant women, particularly those with co-morbidities. Funding: none Keywords: SARS-CoV-2, gestational diabetes, COVID-19


Subject(s)
Diabetes Mellitus , COVID-19 , Diabetes, Gestational
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