Relationship between Metabolic Syndrome Components and COVID-19 Disease Severity in Hospitalized Patients: A Pilot Study.

Background: Preliminary data suggest that patients with comorbidities are more susceptible to severe COVID-19 infection. However, data regarding the presence of metabolic syndrome (MetS) in patients with COVID-19 are scarce. Aim: In the present study, we aim to investigate the association between MetS components and disease severity in hospitalized COVID-19 patients. Methods: We conducted a prospective observational study of 90 hospitalized patients with COVID-19 pneumonia at a tertiary hospital. The study population consisted of inpatients who tested positive by the reverse transcription polymerase chain reaction (RT-PCR) for SARS-CoV-2. Patients with critical COVID-19 disease on admission were excluded. Adult Treatment Panel III of the National Cholesterol Education Program (NCEP-ATP III) criteria were used to define MetS. Laboratory analysis and thorax CT were performed on admission. Results: 90 patients, 60 moderate and 30 severe COVID-19 patients, included in the study. The percentage of MetS cases was higher among severe COVID-19 patients (p=0.018). Of the MetS criteria fasting blood glucose (p=0.004), triglycerides (p=0.007) were significantly higher in patients with severe COVID-19 disease with no statistical significance found in waist circumference (WC) (p=0.348), systolic blood pressure (p=0.429), and HDL-C levels (p=0.263) between two groups. Body mass index (BMI) values were similar in both severe and moderate cases (p=0.854). In logistic regression analysis, serum triglycerides (p=0.024), HDL-C (p=0.006), and WC (p=0.004) were found as independent prognostic factor for severe COVID-19 infection. Conclusion: Severe COVID-19 patients have higher rates of MetS. Serum triglycerides, HDL-C, and WC have an impact on disease severity in COVID-19.

Effect of COVID-19 Infection on the Functional Exercise Capacity and Echocardiographic Findings of Healthcare Workers

Objective: COVID-19 disease has affected all segments of society, especially healthcare workers. We aimed to evaluate the exercise capacity and cardiac functions of healthcare workers who had COVID-19 infection. Methods: Forty healthcare workers with COVID-19 infection (21 females, 19 males), who have completed their treatment, were assessed on the 30th day of recovery. Twenty healthy volunteers were matched as a control group. Exercise capacity was measured using the sixminute walk test (6MWT). The results of 6MWT were given as an absolute value in meters. Cardiac functions were evaluated by echocardiography. Results: Walking distances were similar in both healthcare workers with COVID-19 and healthy controls. 0´ pulse and 6´ pulse were significantly high in healthcare workers, whereas 0´ SpO2 was low in 6MWT. The thorax CT findings showed a positive correlation with the total number of symptoms and clinical severity. Ejection fraction (EF) showed a negative correlation with 6´ pulse, and the right atrial area revealed a negative correlation with 6´ SO2. The mean distance in 6MWT performed by inpatients and outpatients was 546.9±36.8 m vs 511.8±54.0 m, respectively. The walking distance and EF of outpatients were lower than inpatients. Enoxaparin treatment was independently associated with walking distance and EF. Conclusion: COVID-19 infection and hospitalization status affect cardiac functions and physical functional capacity. In our study, we showed that prophylactic enoxaparin use was the strongest independent factor affecting EF and walking distance in healthcare workers with mild to moderate COVID-19 infection. We think that it is important to follow up with healthcare professionals in terms of possible impairments in cardiac function and exercise capacity after COVID-19 infection. (English) [ FROM AUTHOR] Amaç: COVID-19 enfeksiyonu, başta sağlık çalışanları olmak üzere toplumun tüm kesimlerini etkilemiştir. COVID-19 enfeksiyonu olan sağlık çalışanlarının egzersiz kapasitesini ve kalp fonksiyonlarını değerlendirmeyi amaçladık. Gereç ve Yöntem: COVID-19 enfeksiyonlu (21 kadın, 19 erkek) tedavilerini tamamlayan 40 sağlık çalışanı, iyileşmelerinin otuzuncu gününde değerlendirildi. Yirmi sağlıklı gönüllü kontrol grubu olarak eşleştirildi. Egzersiz kapasitesi altı dakika yürüme testi (6DYT) ile ölçüldü. 6DYT sonuçları metre cinsinden mutlak değer olarak verildi. Kalp fonksiyonları ekokardiyografi ile değerlendirildi. Bulgular: COVID-19 enfeksiyonu geçirmiş sağlık çalışanları ve sağlıklı kontrollerde yürüme mesafesi benzerdi. Sağlık çalışanlarında 0' nabız ve 6' nabız anlamlı olarak yüksek, 6DYT'de 0' SpO2 düşüktü. Toraks BT bulguları, toplam semptom sayısı ve klinik şiddet ile pozitif korelasyon gösterdi. Ejeksiyon fraksiyonu (EF) 6' nabız ile negatif korelasyon ve RA alanı 6' SO2 ile negatif korelasyon bulundu. Yatan hastalar ve ayaktan hastalar tarafından yapılan 6DYT'de ortalama mesafe sırasıyla 546.9±36.8m ve 511.8±54.0m idi. Ayaktan hastaların yürüme mesafesi ve EF'si yatan hastalara göre daha düşüktü. Enoksaparin tedavisi bağımsız olarak yürüme mesafesi ve EF ile ilişkiliydi. Sonuç: COVID-19 enfeksiyonu ve hastanede yatış durumu, kardiyak fonksiyonları ve fiziksel fonksiyonel kapasiteyi etkilemektedir. Çalışmamızda, hafif ve orta dereceli COVID-19 enfeksiyonu geçirmiş sağlık çalışanlarında, EF ve yürüme mesafesini etkileyen en güçlü bağımsız faktörün profilaktik enoksaparin kullanımı olduğunu gösterdik. Sağlık çalışanlarının COVID-19 enfeksiyonu sonrası kardiyak fonksiyon ve egzersiz kapasitesinde olası sorunlar açısından takibinin önemli olduğu düşünmekteyiz. (Turkish) [ FROM AUTHOR] Copyright of Southern Clinics of Istanbul Eurasia is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

COVID-19 pneumonia in patients with impaired fasting glucose, newly diagnosed diabetes and pre-existing diabetes: a tertiary center experience.

COVID-19 infection is known to increase mortality in patients with diabetes. We aim to demonstrate the differences in disease course and clinical outcomes of patients with COVID-19 regarding the presence of impaired fasting glucose, pre-existing diabetes mellitus (DM) or new-onset DM. 236 patients with positive reverse transcription-PCR tests for SARS-CoV-2 were included in this single-center, retrospective observational study between March 2020 and May 2021. Laboratory results, comorbidities, medications and imaging findings were noted. Logistic regression was used to estimate associated factors for admission to the intensive care unit (ICU). 43 patients with normal glucose, 53 with impaired fasting glucose, 60 with newly diagnosed DM, and 80 with pre-existing DM were classified. Patients with pre-existing DM had higher fasting glucose and glycated hemoglobin than the other groups (p<0.001 for all). Patients with newly diagnosed DM were more likely to need dexamethasone 6 mg (p=0.001). In both newly diagnosed diabetes and impaired fasting glucose groups, 250 mg methylprednisolone was needed at higher rates (p=0.002). Newly diagnosed DM had higher rates of intubation (21.6%) and more mortality (20.0%) (p=0.045 and p=0.028, respectively). Mortality and hospitalization in the ICU were lower in the group receiving antidiabetic treatment. The risk of ICU attendance was higher in patients with impaired fasting glucose (HR=1.71, 95% CI: 0.48 to 6.08) and newly diagnosed DM (HR=1.88, 95% CI: 0.57 to 6.17), compared with pre-existing DM and non-diabetics. Newly diagnosed DM and impaired fasting glucose are associated with increased mortality and intubation in inpatients with COVID-19.