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1.
Int J Mol Sci ; 22(15)2021 Aug 02.
Article in English | MEDLINE | ID: covidwho-1736939

ABSTRACT

Mitochondria are complex intracellular organelles traditionally identified as the powerhouses of eukaryotic cells due to their central role in bioenergetic metabolism. In recent decades, the growing interest in mitochondria research has revealed that these multifunctional organelles are more than just the cell powerhouses, playing many other key roles as signaling platforms that regulate cell metabolism, proliferation, death and immunological response. As key regulators, mitochondria, when dysfunctional, are involved in the pathogenesis of a wide range of metabolic, neurodegenerative, immune and neoplastic disorders. Far more recently, mitochondria attracted renewed attention from the scientific community for their ability of intercellular translocation that can involve whole mitochondria, mitochondrial genome or other mitochondrial components. The intercellular transport of mitochondria, defined as horizontal mitochondrial transfer, can occur in mammalian cells both in vitro and in vivo, and in physiological and pathological conditions. Mitochondrial transfer can provide an exogenous mitochondrial source, replenishing dysfunctional mitochondria, thereby improving mitochondrial faults or, as in in the case of tumor cells, changing their functional skills and response to chemotherapy. In this review, we will provide an overview of the state of the art of the up-to-date knowledge on intercellular trafficking of mitochondria by discussing its biological relevance, mode and mechanisms underlying the process and its involvement in different pathophysiological contexts, highlighting its therapeutic potential for diseases with mitochondrial dysfunction primarily involved in their pathogenesis.


Subject(s)
Metabolic Diseases/physiopathology , Mitochondria/physiology , Mitochondrial Dynamics , Neoplasms/physiopathology , Neurodegenerative Diseases/physiopathology , Animals , Humans , Metabolic Diseases/therapy , Neoplasms/therapy
2.
Cardiovasc Diabetol ; 21(1): 24, 2022 02 14.
Article in English | MEDLINE | ID: covidwho-1686015

ABSTRACT

BACKGROUND: Pre-existing cardiometabolic comorbidities place SARS-CoV-2 positive patients at a greater risk for poorer clinical course and mortality than those without it. We aimed to analyze real-world registry data focused primarily on participants with cardiometabolic diseases (CMD), which were remotely obtained via a digital platform. METHODS: Participants were divided into two groups: CMD or no cardiometabolic disease (non-CMD). They were evaluated based on their medical history, current medications/supplements, COVID-19 status, demographics, and baseline characteristics. The frequency of medications/supplements for CMD were compared using relative risks and 95% confidence intervals. The WHO (Five) Well-Being Index (WHO-5) were collected monthly for 6 months to assess psychological well-being which included cheerfulness, calmness, vigor, rest, and engagement with daily activities of interest. RESULTS: The 791 enrollees represented 49 U.S. states. The CMD group had significantly higher (p < 0.0001) BMI (mean + 3.04 kg/m2) and age (mean + 9.15 years) compared to non-CMD group. In the CMD group, participants who tested positive for COVID-19 had lower (p < 0.0001) well-being scores than those without COVID-19. For the 274 participants on CMD medications/supplements, there was no statistical difference in risk of COVID-19 contracture based on medication/supplement type; however, all six participants who were not being treated for CMD were COVID-19 positive (RR ~ 104). For 89 participants who were on treatment for diabetes or insulin resistance, there was a 90% reduced risk of COVID-19 incidence (p = 0.0187). CONCLUSION: The well-being score of the CMD group was dependent on whether they tested positive for COVID-19. Type of CMD treatment did not impact COVID-19 status, but absence of treatment significantly increased COVID-19 incidence. With respect to SARS-CoV-2, our analysis supports continued use of the statins, ACE-I, ARBs, and diabetes medications in CMD patients. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04348942.


Subject(s)
COVID-19/epidemiology , Heart Diseases/epidemiology , Metabolic Diseases/epidemiology , Adult , COVID-19/diagnosis , Cardiometabolic Risk Factors , Comorbidity , Female , Heart Diseases/diagnosis , Heart Diseases/therapy , Humans , Incidence , Longitudinal Studies , Male , Metabolic Diseases/diagnosis , Metabolic Diseases/therapy , Middle Aged , Prognosis , Prospective Studies , Registries , Risk Assessment , Time Factors , United States/epidemiology
3.
Lancet Diabetes Endocrinol ; 9(11): 786-798, 2021 11.
Article in English | MEDLINE | ID: covidwho-1586178

ABSTRACT

Up to 50% of the people who have died from COVID-19 had metabolic and vascular disorders. Notably, there are many direct links between COVID-19 and the metabolic and endocrine systems. Thus, not only are patients with metabolic dysfunction (eg, obesity, hypertension, non-alcoholic fatty liver disease, and diabetes) at an increased risk of developing severe COVID-19 but also infection with SARS-CoV-2 might lead to new-onset diabetes or aggravation of pre-existing metabolic disorders. In this Review, we provide an update on the mechanisms of how metabolic and endocrine disorders might predispose patients to develop severe COVID-19. Additionally, we update the practical recommendations and management of patients with COVID-19 and post-pandemic. Furthermore, we summarise new treatment options for patients with both COVID-19 and diabetes, and highlight current challenges in clinical management.


Subject(s)
COVID-19/epidemiology , COVID-19/metabolism , Disease Management , Metabolic Diseases/epidemiology , Metabolic Diseases/metabolism , Angiotensin-Converting Enzyme 2/metabolism , COVID-19/therapy , Diabetes Mellitus/epidemiology , Diabetes Mellitus/metabolism , Diabetes Mellitus/therapy , Humans , Hypertension/epidemiology , Hypertension/metabolism , Hypertension/therapy , Metabolic Diseases/therapy , Non-alcoholic Fatty Liver Disease/epidemiology , Non-alcoholic Fatty Liver Disease/metabolism , Non-alcoholic Fatty Liver Disease/therapy , Obesity/epidemiology , Obesity/metabolism , Obesity/therapy
4.
Am J Chin Med ; 49(2): 237-268, 2021.
Article in English | MEDLINE | ID: covidwho-1365230

ABSTRACT

Intestinal flora is essential for maintaining host health and plays a unique role in transforming Traditional Chinese Medicine (TCM). TCM, as a bodyguard, has saved countless lives and maintained human health in the long history, especially in this COVID-19 pandemic. Pains of diseases have been removed from the effective TCM therapy, such as TCM preparation, moxibustion, and acupuncture. With the development of life science and technology, the wisdom and foresight of TCM has been more displayed. Furthermore, TCM has been also inherited and developed in innovation to better realize the modernization and globalization. Nowadays, intestinal flora transforming TCM and TCM targeted intestinal flora treating diseases have been important findings in life science. More and more TCM researches showed the significance of intestinal flora. Intestinal flora is also a way to study TCM to elucidate the profound theory of TCM. Processing, compatibility, and properties of TCM are well demonstrated by intestinal flora. Thus, it is no doubt that intestinal flora is a core in TCM study. The interaction between intestinal flora and TCM is so crucial for host health. Therefore, it is necessary to sum up the latest results in time. This paper systematically depicted the profile of TCM and the importance of intestinal flora in host. What is more, we comprehensively summarized and discussed the latest progress of the interplay between TCM and intestinal flora to better reveal the core connotation of TCM.


Subject(s)
Drugs, Chinese Herbal/therapeutic use , Dysbiosis/microbiology , Gastrointestinal Microbiome , Medicine, Chinese Traditional , Autoimmune Diseases/microbiology , Autoimmune Diseases/therapy , COVID-19 , Cardiovascular Diseases/microbiology , Cardiovascular Diseases/therapy , Diabetes Mellitus/microbiology , Diabetes Mellitus/therapy , Electroacupuncture , Gastrointestinal Diseases/microbiology , Gastrointestinal Diseases/therapy , Humans , Metabolic Diseases/microbiology , Metabolic Diseases/therapy , Neoplasms/microbiology , Neoplasms/therapy , Non-alcoholic Fatty Liver Disease/microbiology , Non-alcoholic Fatty Liver Disease/therapy , Obesity/microbiology , Obesity/therapy , Renal Insufficiency, Chronic/microbiology , Renal Insufficiency, Chronic/therapy , SARS-CoV-2
5.
Nutrients ; 13(8)2021 Aug 18.
Article in English | MEDLINE | ID: covidwho-1360798

ABSTRACT

Throughout the 20th and 21st centuries, the incidence of non-communicable diseases (NCDs), also known as chronic diseases, has been increasing worldwide. Changes in dietary and physical activity patterns, along with genetic conditions, are the main factors that modulate the metabolism of individuals, leading to the development of NCDs. Obesity, diabetes, metabolic associated fatty liver disease (MAFLD), and cardiovascular diseases (CVDs) are classified in this group of chronic diseases. Therefore, understanding the underlying molecular mechanisms of these diseases leads us to develop more accurate and effective treatments to reduce or mitigate their prevalence in the population. Given the global relevance of NCDs and ongoing research progress, this article reviews the current understanding about NCDs and their related risk factors, with a focus on obesity, diabetes, MAFLD, and CVDs, summarizing the knowledge about their pathophysiology and highlighting the currently available and emerging therapeutic strategies, especially pharmacological interventions. All of these diseases play an important role in the contamination by the SARS-CoV-2 virus, as well as in the progression and severity of the symptoms of the coronavirus disease 2019 (COVID-19). Therefore, we briefly explore the relationship between NCDs and COVID-19.


Subject(s)
COVID-19/therapy , Metabolic Diseases/therapy , Animals , COVID-19/epidemiology , COVID-19/metabolism , COVID-19/physiopathology , Chronic Disease , Humans , Metabolic Diseases/epidemiology , Metabolic Diseases/physiopathology , Noncommunicable Diseases/epidemiology , Noncommunicable Diseases/therapy , Prevalence , Risk Factors , SARS-CoV-2/isolation & purification , Severity of Illness Index
6.
Prim Care Diabetes ; 15(4): 653-681, 2021 08.
Article in English | MEDLINE | ID: covidwho-1253459

ABSTRACT

BACKGROUND: The Coronavirus disease 2019 (COVID-19) pandemic has led to a dramatic crisis in health care systems worldwide. These may have significant implications for the management of cardiometabolic diseases. We conducted a systematic review of published evidence to assess the indirect impact of the COVID-19 pandemic on hospitalisations for cardiovascular diseases and their management. METHODS: Studies that evaluated volume of hospitalisations for cardiometabolic conditions and their management with comparisons between the COVID-19 and pre-COVID periods were identified from MEDLINE, Embase and the reference list of relevant studies from January 2020 to 25 February 2021. RESULTS: We identified 103 observational studies, with most studies assessing hospitalisations for acute cardiovascular conditions such as acute coronary syndrome, ischemic strokes and heart failure. About 89% of studies reported a decline in hospitalisations during the pandemic compared to pre-pandemic times, with reductions ranging from 20.2 to 73%. Severe presentation, less utilization of cardiovascular procedures, and longer patient- and healthcare-related delays were common during the pandemic. Most studies reported shorter length of hospital stay during the pandemic than before the pandemic (1-8 vs 2-12 days) or no difference in length of stay. Most studies reported no change in in-hospital mortality among hospitalised patients. CONCLUSION: Clinical care of patients for acute cardiovascular conditions, their management and outcomes have been adversely impacted by the COVID-19 pandemic. Patients should be educated via population-wide approaches on the need for timely medical contact and health systems should put strategies in place to provide timely care to patients at high risk. SYSTEMATIC REVIEW REGISTRATION: PROSPERO 2021: CRD42021236102.


Subject(s)
COVID-19 , Cardiovascular Diseases/therapy , Health Services Accessibility/trends , Hospitalization/trends , Metabolic Diseases/therapy , Cardiovascular Diseases/diagnosis , Cardiovascular Diseases/mortality , Hospital Mortality/trends , Humans , Metabolic Diseases/diagnosis , Metabolic Diseases/mortality , Observational Studies as Topic , Prognosis , Severity of Illness Index , Time Factors
9.
Circulation ; 143(19): 1831-1834, 2021 05 11.
Article in English | MEDLINE | ID: covidwho-1169909

ABSTRACT

During the past year, clinicians and the public have been focused on the coronavirus disease 2019 (COVID-19) pandemic and its associated societal and economic effects. However, once the acute phase of this crisis has passed, we will face an enormous wave of death and disability as a result of common chronic diseases (CCDs), with cardiometabolic diseases at the crest (Figure). A tsunami results when an earthquake on the ocean floor creates huge waves that can wreak devastation far distant from the original upheaval, especially when warnings are ignored. Similarly, underlying global and national demographic and risk factor profiles have for some time presaged an overwhelming burden of CCDs. However, although the pandemic has created additional impetus that unless heeded will amplify the consequences of this burden, the rapid adaptations and innovations in care and research prompted by the urgent response to it may also offer us the means to stem this flood.


Subject(s)
COVID-19 , Cardiovascular Diseases , Metabolic Diseases , Pandemics , SARS-CoV-2 , COVID-19/complications , COVID-19/epidemiology , COVID-19/therapy , Cardiovascular Diseases/epidemiology , Cardiovascular Diseases/etiology , Cardiovascular Diseases/therapy , Chronic Disease , Humans , Metabolic Diseases/epidemiology , Metabolic Diseases/etiology , Metabolic Diseases/therapy , Risk Factors
13.
Am J Med Genet A ; 185(1): 68-72, 2021 01.
Article in English | MEDLINE | ID: covidwho-855991

ABSTRACT

The national importance of telemedicine for safe and effective patient care has been highlighted by the current COVID-19 pandemic. Prior to the 2020 pandemic the Division of Genetics and Metabolism piloted a telemedicine program focused on initial and follow-up visits in the patients' home. The goals were to increase access to care, decrease missed work, improve scheduling, and avoid the transport and exposure of medically fragile patients. Visits were conducted by physician medical geneticists, genetic counselors, and biochemical dietitians, together and separately. This allowed the program to develop detailed standard operating procedures. At the onset of the COVID-19 pandemic, this pilot-program was deployed by the full team of 22 providers in one business day. Two physicians remained on-site for patients requiring in-person evaluations. This model optimized patient safety and workforce preservation while providing full access to patients during a pandemic. We provide initial data on visit numbers, types of diagnoses, and no-show rates. Experience in this implementation before and during the pandemic has confirmed the effectiveness and value of telemedicine for a highly complex medical population. This program is a model that can and will be continued well-beyond the current crisis.


Subject(s)
COVID-19/epidemiology , Delivery of Health Care/organization & administration , Endocrinology/organization & administration , Genetics, Medical/organization & administration , Models, Organizational , Pandemics , Telemedicine/organization & administration , Adolescent , Adult , Child , Child, Preschool , Delivery of Health Care/methods , Delivery of Health Care/standards , Endocrinology/education , Female , Genetic Counseling/methods , Genetic Counseling/organization & administration , Genetic Counseling/standards , Genetic Diseases, Inborn/epidemiology , Genetic Diseases, Inborn/therapy , Genetic Testing/methods , Genetic Testing/standards , Genetics, Medical/education , Humans , Implementation Science , Infant , Infant, Newborn , Internship and Residency/methods , Internship and Residency/organization & administration , Internship and Residency/standards , Male , Metabolic Diseases/epidemiology , Metabolic Diseases/therapy , Middle Aged , Patient Safety , Pilot Projects , Program Evaluation , Telemedicine/methods , Young Adult
14.
Diabetes Obes Metab ; 22(10): 1942-1945, 2020 10.
Article in English | MEDLINE | ID: covidwho-102319

ABSTRACT

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 or COVID-19) has been declared a pandemic by the World Health Organization and sent all countries scrambling to review emergency healthcare provisions. There is global evidence of each nation struggling to effectively manage the number of people being diagnosed with the virus. These are testing times which have not been experienced in recent generations and there are a number of insecurities regarding the management of people with COVID-19 and cardiometabolic diseases. This review highlights the current concerns related to COVID-19 and provides advice in terms of the therapeutic uncertainty and potential adverse harms associated with therapy when managing people, particularly those with cardiometabolic diseases, who have contracted or are at increased risk of contracting COVID-19.


Subject(s)
COVID-19/complications , COVID-19/therapy , Cardiovascular Diseases/therapy , Metabolic Diseases/therapy , Uncertainty , Aged , COVID-19/epidemiology , Cardiovascular Diseases/complications , Cardiovascular Diseases/epidemiology , Chloroquine/therapeutic use , Clinical Trials as Topic/methods , Clinical Trials as Topic/standards , Delivery of Health Care/methods , Delivery of Health Care/standards , Female , Glucocorticoids/therapeutic use , Humans , Hydroxychloroquine/therapeutic use , Hypoglycemic Agents/therapeutic use , Male , Metabolic Diseases/complications , Metabolic Diseases/epidemiology , Middle Aged , Pandemics , SARS-CoV-2/physiology
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