Metabolic Impacts of Confinement during the COVID-19 Pandemic Due to Modified Diet and Physical Activity Habits.

While the detrimental effects of a chronic positive energy balance due to a sedentary lifestyle have been well established, the impacts of a short period of abruptly reduced physical activity and overeating arising from strict confinement due to the COVID-19 pandemic will soon start to emerge. To reasonably anticipate major consequences according to the available evidence, we hereby review the literature for studies that have explored the health impacts of several weeks of a reduction in physical activity and daily step-count combined with modified eating habits. These studies identify as main metabolic consequences increases in insulin resistance, total body fat, abdominal fat and inflammatory cytokines. All these factors have been strongly associated with the development of metabolic syndrome, which in turn increases the risk of multiple chronic diseases. A plausible mechanism involved in these impacts could be a positive energy balance promoted by maintaining usual dietary intake while reducing energy expenditure. This means that just as calorie intake restriction could help mitigate the deleterious impacts of a bout of physical inactivity, overeating under conditions of home confinement is very likely to exacerbate these consequences. Moreover, hypertension, diabetes, and cardiovascular disease have been identified as potential risk factors for more severely ill patients with COVID-19. Thus, adequate control of metabolic disorders could be important to reduce the risk of severe COVID-19.

Cardiac magnetic resonance in the diagnosis of the unusually detected acute myocarditis in the young people: a case report.

Myocarditis is among the causes of arrhythmic sudden cardiac death (SCD) in young athletes, with viral infection being the most common cause worldwide. Myocarditis recently has been reported as one of the cardiac complications of coronavirus disease 2019 (COVID-19) in athletes. Here we present a case of a 20-year-old male recreational soccer player with an episode of loss of consciousness in the context of respiratory infection. The patient reports having woken up with symptoms of an upper respiratory tract infection, and after playing a soccer match, he developed dizziness and a headache. He then suffered vasovagal syncope without loss of sphincter control. Physical examination, heart auscultation, peripheral and carotid pulses, and blood, microbiological/serological tests result on admission were normal. Moreover, no jugular engorgement at 45º, malleolar edema, or other heart failure signs were found. The 12-lead electrocardiogram (ECG), echocardiogram, 24-hour Holter-ECG did not reveal any significant finding. A cardiac magnetic resonance (CMR) was finally performed, revealing an abnormal signal increase was observed at the apical level in the short-tau inversion-recovery (STIR) and 4-chamber sequences. In addition, a pattern of apical fibrosis was observed in 4- and 2-chamber and short-axis late enhancement sequences for assessment of myocardial viability confirming the diagnosis of myocarditis. In athletes with suspected myocarditis, CMR seems to be a useful diagnostic tool, with excellent sensitivity for detecting inflammation, myocardial edema, and/or focal scarring.