Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 39
Filtrar
Añadir filtros

Base de datos
Intervalo de año
1.
Endocrinol Metab (Seoul) ; 36(1): 196-200, 2021 02.
Artículo en Inglés | MEDLINE | ID: covidwho-1121720

RESUMEN

Although obesity is a risk factor for infection, whether it has the same effect on coronavirus disease 2019 (COVID-19) need confirming. We conducted a retrospective propensity score matched case-control study to examine the association between obesity and COVID-19. This study included data from the Nationwide COVID-19 Registry and the Biennial Health Checkup database, until May 30, 2020. We identified 2,231 patients with confirmed COVID-19 and 10-fold-matched negative test controls. Overweight (body mass index [BMI] 23 to 24.9 kg/m2; adjusted odds ratio [aOR], 1.16; 95% confidence interval [CI], 1.1.03 to 1.30) and class 1 obesity (BMI 25 to 29.9 kg/m2; aOR, 1.27; 95% CI, 1.14 to 1.42) had significantly increased COVID-19 risk, while classes 2 and 3 obesity (BMI ≥30 kg/m2) showed similar but non-significant trend. Females and those <50 years had more robust association pattern. Overweight and obesity are possible risk factors of COVID-19.


Asunto(s)
/epidemiología , Obesidad/virología , Sobrepeso/virología , Adulto , Anciano , Índice de Masa Corporal , /estadística & datos numéricos , Estudios de Casos y Controles , Bases de Datos Factuales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Obesidad/fisiopatología , Oportunidad Relativa , Sobrepeso/fisiopatología , Puntaje de Propensión , Sistema de Registros , Factores de Riesgo , Adulto Joven
2.
Curr Opin Clin Nutr Metab Care ; 24(3): 229-235, 2021 05 01.
Artículo en Inglés | MEDLINE | ID: covidwho-1080974

RESUMEN

PURPOSE OF REVIEW: This manuscript reviews evidence collected during COVID-19 pandemic and provides information on the impact of body composition on severity and outcomes of the disease, analysing methods used for body composition assessment. Malnutrition-screening tools will also be discussed to screen and diagnose the patients at higher risk of COVID-19 severity and related worse outcomes. RECENT FINDINGS: COVID-19 can occur in a wide range of presentation, from asymptomatic to severe forms. Among the major risk factors for worse severity, overnutrition, undernutrition and body composition play a role in the ability to respond to SARS-CoV-2 infection. Excess fat accumulation (i.e. obesity) or lean mass loss and functionality (i.e. sarcopenia) or a combination of both (i.e. sarcopenic obesity) can affect whole-body functioning. These body composition alterations in the short-term can influence susceptibility and immunological responses to the virus, inflammatory reaction, metabolic and respiratory distress, while in the long-term can modulate disease outcomes, namely length of stay, time required for recovery, risk of ICU-acquired weakness and long-term disabilities, and potentially increase the risk of death. SUMMARY: Individuals with malnutrition, sarcopenia, obesity, sarcopenic obesity and older adults with abnormal body composition or malnutrition risk may require tailored medical nutrition therapy to improve short and long-term COVID-19 outcomes.


Asunto(s)
Composición Corporal , Desnutrición/virología , Estado Nutricional , Adulto , Anciano , Anciano de 80 o más Años , /virología , Femenino , Humanos , Masculino , Desnutrición/fisiopatología , Persona de Mediana Edad , Terapia Nutricional , Obesidad/fisiopatología , Obesidad/virología , Hipernutrición/fisiopatología , Hipernutrición/virología , Sarcopenia/fisiopatología , Sarcopenia/virología , Índice de Severidad de la Enfermedad
3.
Obes Rev ; 22(4): e13221, 2021 04.
Artículo en Inglés | MEDLINE | ID: covidwho-1079006

RESUMEN

Obesity and obesogenic comorbidities have been associated with COVID-19 susceptibility and mortality. However, the mechanism of such correlations requires an in-depth understanding. Overnutrition/excess serum amino acid profile during obesity has been linked with inflammation and reprogramming of translational machinery through hyperactivation of amino acid sensor mammalian target of rapamycin (mTOR), which is exploited by SARS-CoV-2 for its replication. Conversely, we have shown that the activation of general control nonderepressible 2 (GCN2)-dependent amino acid starvation sensing pathway suppresses intestinal inflammation by inhibiting the production of reactive oxygen species (ROS) and interleukin-1 beta (IL-1ß). While activation of GCN2 has shown to mitigate susceptibility to dengue infection, GCN2 deficiency increases viremia and inflammation-associated pathologies. These findings reveal that the amino acid sensing pathway plays a significant role in controlling inflammation and viral infections. The current fact is that obesity/excess amino acids/mTOR activation aggravates COVID-19, and it might be possible that activation of amino acid starvation sensor GCN2 has an opposite effect. This article focuses on the amino acid sensing pathways through which host cells sense the availability of amino acids and reprogram the host translation machinery to mount an effective antiviral response. Besides, how SARS-CoV-2 hijack and exploit amino acid sensing pathway for its replication and pathogenesis is also discussed.


Asunto(s)
Aminoácidos/metabolismo , N-Acetilhexosaminiltransferasas/fisiología , Obesidad/epidemiología , /metabolismo , Comorbilidad , Humanos , Inflamación , Obesidad/fisiopatología , Biosíntesis de Proteínas/fisiología , Serina-Treonina Quinasas TOR/fisiología , Replicación Viral/fisiología
4.
Proc Natl Acad Sci U S A ; 118(8)2021 02 23.
Artículo en Inglés | MEDLINE | ID: covidwho-1075324

RESUMEN

COVID-19 transmits by droplets generated from surfaces of airway mucus during processes of respiration within hosts infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. We studied respiratory droplet generation and exhalation in human and nonhuman primate subjects with and without COVID-19 infection to explore whether SARS-CoV-2 infection, and other changes in physiological state, translate into observable evolution of numbers and sizes of exhaled respiratory droplets in healthy and diseased subjects. In our observational cohort study of the exhaled breath particles of 194 healthy human subjects, and in our experimental infection study of eight nonhuman primates infected, by aerosol, with SARS-CoV-2, we found that exhaled aerosol particles vary between subjects by three orders of magnitude, with exhaled respiratory droplet number increasing with degree of COVID-19 infection and elevated BMI-years. We observed that 18% of human subjects (35) accounted for 80% of the exhaled bioaerosol of the group (194), reflecting a superspreader distribution of bioaerosol analogous to a classical 20:80 superspreader of infection distribution. These findings suggest that quantitative assessment and control of exhaled aerosol may be critical to slowing the airborne spread of COVID-19 in the absence of an effective and widely disseminated vaccine.


Asunto(s)
/fisiopatología , Espiración/fisiología , Obesidad/fisiopatología , Aerosoles , Factores de Edad , Animales , Índice de Masa Corporal , /virología , Estudios de Cohortes , Humanos , Moco/química , Moco/virología , Obesidad/epidemiología , Obesidad/virología , Tamaño de la Partícula , Primates , Sistema Respiratorio/metabolismo , Carga Viral
5.
Lancet HIV ; 8(1): e24-e32, 2021 01.
Artículo en Inglés | MEDLINE | ID: covidwho-1059582

RESUMEN

BACKGROUND: Whether HIV infection is associated with risk of death due to COVID-19 is unclear. We aimed to investigate this association in a large-scale population-based study in England. METHODS: We did a retrospective cohort study. Working on behalf of NHS England, we used the OpenSAFELY platform to analyse routinely collected electronic primary care data linked to national death registrations. We included all adults (aged ≥18 years) alive and in follow-up on Feb 1, 2020, and with at least 1 year of continuous registration with a general practitioner before this date. People with a primary care record for HIV infection were compared with people without HIV. The outcome was COVID-19 death, defined as the presence of International Classification of Diseases 10 codes U07.1 or U07.2 anywhere on the death certificate. Cox regression models were used to estimate the association between HIV infection and COVID-19 death; they were initially adjusted for age and sex, then we added adjustment for index of multiple deprivation and ethnicity, and then for a broad range of comorbidities. Interaction terms were added to assess effect modification by age, sex, ethnicity, comorbidities, and calendar time. RESULTS: 17 282 905 adults were included, of whom 27 480 (0·16%) had HIV recorded. People living with HIV were more likely to be male, of Black ethnicity, and from a more deprived geographical area than the general population. 14 882 COVID-19 deaths occurred during the study period, with 25 among people with HIV. People living with HIV had higher risk of COVID-19 death than those without HIV after adjusting for age and sex: hazard ratio (HR) 2·90 (95% CI 1·96-4·30; p<0·0001). The association was attenuated, but risk remained high, after adjustment for deprivation, ethnicity, smoking and obesity: adjusted HR 2·59 (95% CI 1·74-3·84; p<0·0001). There was some evidence that the association was larger among people of Black ethnicity: HR 4·31 (95% CI 2·42-7·65) versus 1·84 (1·03-3·26) in non-Black individuals (p-interaction=0·044). INTERPRETATION: People with HIV in the UK seem to be at increased risk of COVID-19 mortality. Targeted policies should be considered to address this raised risk as the pandemic response evolves. FUNDING: Wellcome, Royal Society, National Institute for Health Research, National Institute for Health Research Oxford Biomedical Research Centre, UK Medical Research Council, Health Data Research UK.


Asunto(s)
/epidemiología , Infecciones por VIH/epidemiología , Infecciones por VIH/mortalidad , Pandemias , Adolescente , Adulto , Grupo de Ascendencia Continental Africana , Factores de Edad , Anciano , Anciano de 80 o más Años , Grupo de Ascendencia Continental Asiática , /virología , Coinfección , Grupo de Ascendencia Continental Europea , Femenino , Infecciones por VIH/etnología , Infecciones por VIH/virología , VIH-1/patogenicidad , Humanos , Masculino , Persona de Mediana Edad , Obesidad/fisiopatología , Modelos de Riesgos Proporcionales , Estudios Retrospectivos , Factores de Riesgo , Factores Sexuales , Fumar/fisiopatología , Clase Social , Reino Unido/epidemiología
6.
Int J Obes (Lond) ; 44(8): 1784-1789, 2020 08.
Artículo en Inglés | MEDLINE | ID: covidwho-1023845

RESUMEN

BACKGROUND/OBJECTIVES: During the 2019 coronavirus disease (COVID-19) outbreak, obesity may contribute to COVID-19 transmission and deterioration. In addition, many patients with COVID-19 infection have suffered liver damage which might contribute to a worse prognosis. We conducted a clinical epidemiological analysis to investigate the association of overweight/obesity and abnormal liver function (ALF) with hospitalized duration in patients infected with COVID-19. SUBJECTS/METHODS: Fifty-eight patients with diagnosed COVID-19 (22 women & 36 men; average age: 49.2 ± 13.1 yr) were included, and their clinical data were collected at The Second Affiliated and Yuying Children's Hospital of Wenzhou Medical University, Zhejiang. Overweight/obesity was determined as body mass index (BMI) ≥24 kg/m2, ALF was determined as alanine aminotransferase >40 U/L, and prolonged hospitalization was lasting more than the median value of the hospitalized days (19 days) in this population. RESULTS: The proportions of prolonged hospitalization were elevated in patients with overweight/obesity and ALF compared with those without overweight/obesity (62.1% versus 26.1%, P = 0.010) and those without ALF (70.6% versus 41.5%, P = 0.043). Kaplan-Meier analysis showed that the hospitalized duration was increased from the patients with neither overweight/obesity nor ALF to those with either overweight/obesity or ALF, and to those with both of overweight/obesity and ALF (mean with 95% confidence interval: 16.4 [14.5-18.3] versus 25.3 [21.6-29.1] versus 28.3 [24.6-32.0], P for trend = 0.001). Being discharged from hospital in time was inversely and independently associated with BMI (hazard ratio [HR] = 0.75, 95% CI: 0.63-0.90, P for trend = 0.002) and ALT (HR = 0.95, 95% CI: 0.92-0.99, P for trend = 0.007). CONCLUSIONS: Present findings suggested that overweight/obesity and/or ALF contributed to predicting a probability of prolonged hospitalization in patients with COVID-19 infection, to whom extra attentions and precautions should be paid during clinical treatments.


Asunto(s)
Alanina Transaminasa/sangre , Infecciones por Coronavirus/epidemiología , Tiempo de Internación/estadística & datos numéricos , Hígado/fisiopatología , Neumonía Viral/epidemiología , Adulto , China/epidemiología , Infecciones por Coronavirus/sangre , Infecciones por Coronavirus/complicaciones , Femenino , Hospitalización/estadística & datos numéricos , Humanos , Hígado/virología , Pruebas de Función Hepática , Masculino , Persona de Mediana Edad , Obesidad/complicaciones , Obesidad/epidemiología , Obesidad/fisiopatología , Sobrepeso/complicaciones , Sobrepeso/epidemiología , Sobrepeso/fisiopatología , Pandemias , Neumonía Viral/sangre , Neumonía Viral/complicaciones , Estudios Retrospectivos
7.
Nutrients ; 12(11)2020 Nov 16.
Artículo en Inglés | MEDLINE | ID: covidwho-927616

RESUMEN

The present study aimed at identifying psychological and psychosocial variables that might predict weight gain during the COVID-19 lockdown in patients affected by overweight/obesity with and without a psychiatric diagnosis. An online survey was administered between 25 April and 10 May 2020, to investigate participants' changes in dietary habits during the lockdown period. 110 participants were recruited and allocated to two groups, 63 patients had no psychiatric diagnosis; there were 47 patients with psychiatric diagnosis. ANOVA analyses compared the groups with respect to psychological distress levels, risk perception, social support, emotion regulation, and eating behaviors. For each group, a binary logistic regression analysis was conducted, including the factors that were found to significantly differ between groups. Weight gain during lockdown was reported by 31 of the participants affected by overweight/obesity without a psychiatric diagnosis and by 31 patients with a psychiatric diagnosis. Weight gain predictors were stress and low depression for patients without a psychiatric diagnosis and binge eating behaviors for patients with a psychiatric diagnosis. Of patients without a psychiatric diagnosis, 60% reported much more frequent night eating episodes. The risk of night eating syndrome in persons affected by overweight/obesity with no psychiatric diagnosis should be further investigated to inform the development of tailored medical, psychological, and psychosocial interventions.


Asunto(s)
Infecciones por Coronavirus/prevención & control , Trastornos Mentales/fisiopatología , Obesidad/fisiopatología , Sobrepeso/fisiopatología , Pandemias/prevención & control , Neumonía Viral/prevención & control , Cuarentena/estadística & datos numéricos , Aumento de Peso , Adulto , Análisis de Varianza , Betacoronavirus , Dieta/psicología , Dieta/estadística & datos numéricos , Encuestas sobre Dietas , Conducta Alimentaria/psicología , Femenino , Humanos , Modelos Logísticos , Masculino , Trastornos Mentales/psicología , Persona de Mediana Edad , Obesidad/psicología , Sobrepeso/psicología , Cuarentena/psicología
8.
Front Endocrinol (Lausanne) ; 11: 556962, 2020.
Artículo en Inglés | MEDLINE | ID: covidwho-895296

RESUMEN

From the beginning of 2020, the governments and the health systems around the world are tackling infections and fatalities caused by the novel severe acute respiratory syndrome coronavirus (SARS-CoV-2) resulting in the coronavirus disease 2019 (COVID-19). This virus pandemic has turned more complicated as individuals with co-morbidities like diabetes, cardiovascular conditions and obesity are at a high risk of acquiring infection and suffering from a more severe course of disease. Prolonged viral infection and obesity are independently known to lower the immune response and a combination can thus result in a "cytokine storm" and a substantial weakening of the immune system. With the rise in obesity cases globally, the chances that obese individuals will acquire infection and need hospitalization are heightened. In this review, we discuss why obesity, a low-grade chronic inflammation, contributes toward the increased severity in COVID-19 patients. We suggest that increased inflammation, activation of renin-angiotensin-aldosterone system, elevated adipokines and higher ectopic fat may be the factors contributing to the disease severity, in particular deteriorating the cardiovascular and lung function, in obese individuals. We look at the many lessons learnt from the 2009 H1N1 influenza A pandemic and relate it to the very little but fast incoming information that is available from the SARS-CoV-2 infected individuals with overweight and obesity.


Asunto(s)
Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/epidemiología , Inflamación/fisiopatología , Virus de la Influenza A/aislamiento & purificación , Gripe Humana/epidemiología , Obesidad/fisiopatología , Neumonía Viral/epidemiología , Infecciones por Coronavirus/inmunología , Infecciones por Coronavirus/virología , Humanos , Gripe Humana/inmunología , Gripe Humana/virología , Pandemias , Neumonía Viral/inmunología , Neumonía Viral/virología
10.
Front Endocrinol (Lausanne) ; 11: 583006, 2020.
Artículo en Inglés | MEDLINE | ID: covidwho-883849

RESUMEN

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its clinical manifestation (COVID-19; coronavirus disease 2019) have caused a worldwide health crisis. Disruption of epithelial and endothelial barriers is a key clinical turning point that differentiates patients who are likely to develop severe COVID-19 outcomes: it marks a significant escalation in respiratory symptoms, loss of viral containment and a progression toward multi-organ dysfunction. These barrier mechanisms are independently compromised by known COVID-19 risk factors, including diabetes, obesity and aging: thus, a synergism between these underlying conditions and SARS-CoV-2 mechanisms may explain why these risk factors correlate with more severe outcomes. This review examines the key cellular mechanisms that SARS-CoV-2 and its underlying risk factors utilize to disrupt barrier function. As an outlook, we propose that glucagon-like peptide 1 (GLP-1) may be a therapeutic intervention that can slow COVID-19 progression and improve clinical outcome following SARS-CoV-2 infection. GLP-1 signaling activates barrier-promoting processes that directly oppose the pro-inflammatory mechanisms commandeered by SARS-CoV-2 and its underlying risk factors.


Asunto(s)
Envejecimiento/patología , Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/epidemiología , Diabetes Mellitus/fisiopatología , Péptido 1 Similar al Glucagón/metabolismo , Inflamación/fisiopatología , Obesidad/fisiopatología , Neumonía Viral/epidemiología , Infecciones por Coronavirus/inmunología , Infecciones por Coronavirus/metabolismo , Infecciones por Coronavirus/virología , Humanos , Pandemias , Neumonía Viral/inmunología , Neumonía Viral/metabolismo , Neumonía Viral/virología
11.
Front Endocrinol (Lausanne) ; 11: 582870, 2020.
Artículo en Inglés | MEDLINE | ID: covidwho-844283

RESUMEN

The pandemic of COVID-19, caused by the coronavirus, SARS-CoV-2, has had a global impact not seen for an infectious disease for over a century. This acute pandemic has spread from the East and has been overlaid onto a slow pandemic of metabolic diseases of obesity and diabetes consequent from the increasing adoption of a Western-lifestyle characterized by excess calorie consumption with limited physical activity. It has become clear that these conditions predispose individuals to a more severe COVID-19 with increased morbidity and mortality. There are many features of diabetes and obesity that may accentuate the clinical response to SARS-CoV-2 infection: including an impaired immune response, an atherothrombotic state, accumulation of advanced glycation end products and a chronic inflammatory state. These could prime an exaggerated cytokine response to viral infection, predisposing to the cytokine storm that triggers progression to septic shock, acute respiratory distress syndrome, and multi-organ failure. Infection leads to an inflammatory response and tissue damage resulting in increased metabolic activity and an associated increase in the mechanisms by which cells ingest and degrade tissue debris and foreign materials. It is becoming clear that viruses have acquired an ability to exploit these mechanisms to invade cells and facilitate their own life-cycle. In obesity and diabetes these mechanisms are chronically activated due to the deteriorating metabolic state and this may provide an increased opportunity for a more profound and sustained viral infection.


Asunto(s)
Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/epidemiología , Diabetes Mellitus/fisiopatología , Estilo de Vida , Obesidad/fisiopatología , Neumonía Viral/epidemiología , Infecciones por Coronavirus/inmunología , Infecciones por Coronavirus/virología , Susceptibilidad a Enfermedades , Humanos , Pandemias , Neumonía Viral/inmunología , Neumonía Viral/virología
12.
PLoS One ; 15(10): e0240394, 2020.
Artículo en Inglés | MEDLINE | ID: covidwho-841003

RESUMEN

BACKGROUND: The SARS-CoV-2 pandemic compounds Mexico's pre-existing challenges: very high levels of both non-communicable diseases (NCD) and social inequity. METHODS AND FINDINGS: Using data from national reporting of SARS-CoV-2 tested individuals, we estimated odds of hospitalization, intubation, and death based on pre-existing non-communicable diseases and socioeconomic indicators. We found that obesity, diabetes, and hypertension are positively associated with the three outcomes in a synergistic manner. The municipal poverty level is also positively associated with hospitalization and death. CONCLUSIONS: Mexico's response to COVID-19 is complicated by a synergistic double challenge: raging NCDs and extreme social inequity. The response to the current pandemic must take both into account both to be effective and to ensure that the burden of COVID-19 not falls disproportionately on those who are already disadvantaged.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Adulto , Factores de Edad , Betacoronavirus/fisiología , Comorbilidad , Infecciones por Coronavirus/fisiopatología , Infecciones por Coronavirus/terapia , Complicaciones de la Diabetes , Diabetes Mellitus/fisiopatología , Femenino , Hospitalización , Humanos , Hipertensión/fisiopatología , Intubación , Masculino , México/epidemiología , Persona de Mediana Edad , Obesidad/fisiopatología , Pandemias , Neumonía Viral/fisiopatología , Neumonía Viral/terapia , Pobreza , Factores Sexuales , Factores Socioeconómicos
13.
Obes Rev ; 21(11): e13089, 2020 11.
Artículo en Inglés | MEDLINE | ID: covidwho-767598

RESUMEN

We conducted a systematic review of observational studies to examine the effects of body mass index (BMI) and obesity (BMI ≥ 30 kg/m2 ) on coronavirus disease 2019 (COVID-19). Medline, Embase, and the Cochrane Library were searched. Sixteen articles were finally included in the meta-analysis, and a random effects model was used. BMI was found to be higher in patients with severe disease than in those with mild or moderate disease (MD 1.6, 95% CI, 0.8-2.4; p = .0002) in China; however, the heterogeneity was high (I2 = 75%). Elevated BMI was associated with invasive mechanical ventilation (IMV) use (MD 4.1, 95% CI, 2.1-6.1; p < .0001) in Western countries, and this result was consistent across studies (I2 = 0%). Additionally, there were increased odds ratios of IMV use (OR 2.0, 95% CI, 1.4-2.9; p < .0001) and hospitalization (OR 1.4, 95% CI, 1.3-1.60; p < .00001) in patients with obesity. There was no substantial heterogeneity (I2 = 0%). In conclusion, obesity or high BMI increased the risk of hospitalization, severe disease and invasive mechanical ventilation in COVID-19. Physicians must be alert to these early indicators to identify critical patients.


Asunto(s)
Betacoronavirus , Índice de Masa Corporal , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/fisiopatología , Obesidad/complicaciones , Obesidad/fisiopatología , Neumonía Viral/complicaciones , Neumonía Viral/fisiopatología , Humanos , Pandemias , Índice de Severidad de la Enfermedad
14.
Front Endocrinol (Lausanne) ; 11: 562, 2020.
Artículo en Inglés | MEDLINE | ID: covidwho-760858

RESUMEN

A better understanding of the SARS-CoV-2 virus behavior and possible risk factors implicated in poor outcome has become an urgent need. We performed a systematic review in order to investigate a possible association between body weight and prognosis among patients diagnosed with COVID-19. We searched in Cochrane Library, EMBASE, MEDLINE, WHO-Global Literature on Coronavirus Disease, OpenGrey, and Medrxiv. We used the ROBINS-I tool or Cross-Sectional/Prevalence Study Quality tool from AHRQ, to evaluate the methodological quality of included studies. Nine studies (two prospective cohorts, four retrospective cohorts and three cross-sectional) were included and assessed the relationship between obesity and COVID-19 prognosis. Risk of bias of the included studies ranged from moderate to critical. Clinical and methodological heterogeneity among them precluded meta-analyses. Most of the included studies showed some degree of association to: (a) higher BMI and worse clinical presentation and (b) obesity and need of hospitalization. The results were inconsistent about the impact of obesity on mortality. Based on limited methodological quality studies, obesity seems to predict poor clinical evolution in patients with COVID-19. Further studies with appropriate prospective design are needed to reduce the uncertainty on this evidence.


Asunto(s)
Betacoronavirus/aislamiento & purificación , Índice de Masa Corporal , Infecciones por Coronavirus/mortalidad , Obesidad/fisiopatología , Neumonía Viral/mortalidad , Estudios de Cohortes , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/virología , Humanos , Pandemias , Neumonía Viral/epidemiología , Neumonía Viral/virología , Pronóstico , Tasa de Supervivencia
15.
Obes Rev ; 21(11): e13128, 2020 11.
Artículo en Inglés | MEDLINE | ID: covidwho-731029

RESUMEN

The linkage of individuals with obesity and COVID-19 is controversial and lacks systematic reviews. After a systematic search of the Chinese and English language literature on COVID-19, 75 studies were used to conduct a series of meta-analyses on the relationship of individuals with obesity-COVID-19 over the full spectrum from risk to mortality. A systematic review of the mechanistic pathways for COVID-19 and individuals with obesity is presented. Pooled analysis show individuals with obesity were more at risk for COVID-19 positive, >46.0% higher (OR = 1.46; 95% CI, 1.30-1.65; p < 0.0001); for hospitalization, 113% higher (OR = 2.13; 95% CI, 1.74-2.60; p < 0.0001); for ICU admission, 74% higher (OR = 1.74; 95% CI, 1.46-2.08); and for mortality, 48% increase in deaths (OR = 1.48; 95% CI, 1.22-1.80; p < 0.001). Mechanistic pathways for individuals with obesity are presented in depth for factors linked with COVID-19 risk, severity and their potential for diminished therapeutic and prophylactic treatments among these individuals. Individuals with obesity are linked with large significant increases in morbidity and mortality from COVID-19. There are many mechanisms that jointly explain this impact. A major concern is that vaccines will be less effective for the individuals with obesity.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/fisiopatología , Obesidad/epidemiología , Obesidad/fisiopatología , Neumonía Viral/epidemiología , Neumonía Viral/fisiopatología , Comorbilidad , Humanos , Internacionalidad , Pandemias
16.
J Allergy Clin Immunol ; 146(2): 307-314.e4, 2020 08.
Artículo en Inglés | MEDLINE | ID: covidwho-701780

RESUMEN

BACKGROUND: The Centers for Disease Control and Prevention advises that patients with moderate to severe asthma belong to a high-risk group that is susceptible to severe coronavirus disease 2019 (COVID-19). However, the association between asthma and COVID-19 has not been well-established. OBJECTIVE: The primary objective was to determine the prevalence of asthma among patients with COVID-19 in a major US health system. We assessed the clinical characteristics and comorbidities in asthmatic and nonasthmatic patients with COVID-19. We also determined the risk of hospitalization associated with asthma and/or inhaled corticosteroid use. METHODS: Medical records of patients with COVID-19 were searched by a computer algorithm (March 1 to April 15, 2020), and chart review was used to validate the diagnosis of asthma and medications prescribed for asthma. All patients had PCR-confirmed COVID-19. Demographic and clinical features were characterized. Regression models were used to assess the associations between asthma and corticosteroid use and the risk of COVID-19-related hospitalization. RESULTS: Of 1526 patients identified with COVID-19, 220 (14%) were classified as having asthma. Asthma was not associated with an increased risk of hospitalization (relative risk, 0.96; 95% CI, 0.77-1.19) after adjusting for age, sex, and comorbidities. The ongoing use of inhaled corticosteroids did not increase the risk of hospitalization in a similar adjusted model (relative risk, 1.39; 95% CI, 0.90-2.15). CONCLUSIONS: Despite a substantial prevalence of asthma in our COVID-19 cohort, asthma was not associated with an increased risk of hospitalization. Similarly, the use of inhaled corticosteroids with or without systemic corticosteroids was not associated with COVID-19-related hospitalization.


Asunto(s)
Asma/epidemiología , Betacoronavirus/patogenicidad , Enfermedad de la Arteria Coronaria/epidemiología , Infecciones por Coronavirus/epidemiología , Diabetes Mellitus/epidemiología , Hipertensión/epidemiología , Obesidad/epidemiología , Neumonía Viral/epidemiología , Administración por Inhalación , Corticoesteroides/uso terapéutico , Adulto , Factores de Edad , Anciano , Antiasmáticos/uso terapéutico , Asma/diagnóstico , Asma/tratamiento farmacológico , Asma/fisiopatología , Técnicas de Laboratorio Clínico/métodos , Comorbilidad , Enfermedad de la Arteria Coronaria/diagnóstico , Enfermedad de la Arteria Coronaria/fisiopatología , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/fisiopatología , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/fisiopatología , Femenino , Hospitalización/estadística & datos numéricos , Humanos , Hipertensión/diagnóstico , Hipertensión/fisiopatología , Illinois/epidemiología , Masculino , Persona de Mediana Edad , Modelos Estadísticos , Obesidad/diagnóstico , Obesidad/fisiopatología , Pandemias , Neumonía Viral/diagnóstico , Neumonía Viral/fisiopatología , Prevalencia , Estudios Retrospectivos , Factores de Riesgo
17.
Ann Allergy Asthma Immunol ; 125(5): 600-602, 2020 11.
Artículo en Inglés | MEDLINE | ID: covidwho-693736
18.
J Pediatr (Rio J) ; 96(5): 546-558, 2020.
Artículo en Inglés | MEDLINE | ID: covidwho-693435

RESUMEN

OBJECTIVE: To identify factors that contribute to the increased susceptibility and severity of COVID-19 in obese children and adolescents, and its health consequences. SOURCES: Studies published between 2000 and 2020 in the PubMed, MEDLINE, Scopus, SciELO, and Cochrane databases. SUMMARY OF FINDINGS: Obesity is a highly prevalent comorbidity in severe cases of COVID-19 in children and adolescents; social isolation may lead to increase fat accumulation. Excessive adipose tissue, deficit in lean mass, insulin resistance, dyslipidemia, hypertension, high levels of proinflammatory cytokines, and low intake of essential nutrients are factors that compromise the functioning of organs and systems in obese individuals. These factors are associated with damage to immune, cardiovascular, respiratory, and urinary systems, along with modification of the intestinal microbiota (dysbiosis). In severe acute respiratory syndrome coronavirus 2 infection, these organic changes from obesity may increase the need for ventilatory assistance, risk of thromboembolism, reduced glomerular filtration rate, changes in the innate and adaptive immune response, and perpetuation of the chronic inflammatory response. CONCLUSIONS: The need for social isolation can have the effect of causing or worsening obesity and its comorbidities, and pediatricians need to be aware of this issue. Facing children with suspected or confirmed COVID-19, health professionals should 1) diagnose excess weight; 2) advise on health care in times of isolation; 3) screen for comorbidities, ensuring that treatment is not interrupted; 4) measure levels of immunonutrients; 5) guide the family in understanding the specifics of the situation; and 6) refer to units qualified to care for obese children and adolescents when necessary.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Obesidad Pediátrica/epidemiología , Neumonía Viral/epidemiología , Adolescente , Niño , Humanos , Obesidad/epidemiología , Obesidad/fisiopatología , Pandemias
19.
Med Hypotheses ; 143: 110129, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: covidwho-663304

RESUMEN

In trying to understand the biochemical mechanism involved in the recent pandemic COVID-19, there is currently growing interest in angiotensin-converting enzyme II (ACE2). Nevertheless, the attempts to counteract COVID-19 interference with this enzymatic cascade are frustrating, and the results have thus far been inconclusive. Let's start again by considering the involved factors in an alternative way: we could postulate that COVID-19 could be more aggressive/fatal due to a high level of "basal" inflammation with low Nitric Oxide (NO) levels in hypertensive, diabetic and obese patients. Interestingly, the "protective" effects of several factors (such as estrogens) may play a role by increasing the formation of endogenous NO. From a therapeutic point of view, phosphodiesterase type 5 inhibitors such as oral Tadalafil, could be used in order to increase the basal NO levels. In this way, we don't fight the virus, but we may be able to mitigate its effects.


Asunto(s)
Betacoronavirus/fisiología , Infecciones por Coronavirus/tratamiento farmacológico , Óxido Nítrico/metabolismo , Pandemias , Neumonía Viral/tratamiento farmacológico , Animales , Betacoronavirus/efectos de los fármacos , Infecciones por Coronavirus/complicaciones , Síndrome de Liberación de Citoquinas/etiología , Síndrome de Liberación de Citoquinas/fisiopatología , Estrógenos/fisiología , Humanos , Hipertensión/complicaciones , Hipertensión/fisiopatología , Inflamación , Interleucinas/fisiología , Modelos Animales , Modelos Biológicos , Óxido Nítrico/uso terapéutico , Obesidad/complicaciones , Obesidad/fisiopatología , Uso Fuera de lo Indicado , Peptidil-Dipeptidasa A/efectos de los fármacos , Peptidil-Dipeptidasa A/fisiología , Inhibidores de Fosfodiesterasa 5/farmacología , Inhibidores de Fosfodiesterasa 5/uso terapéutico , Neumonía Viral/complicaciones , Receptores Virales/efectos de los fármacos , Receptores Virales/fisiología , Citrato de Sildenafil/farmacología , Citrato de Sildenafil/uso terapéutico , Tadalafilo/farmacología , Tadalafilo/uso terapéutico
20.
Med Hypotheses ; 143: 110112, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: covidwho-654445

RESUMEN

In coronavirus disease-19 (COVID-19), four major factors have been correlated with worse prognosis: aging, hypertension, obesity, and exposure to androgen hormones. Angiotensin-converting enzyme-2 (ACE2) receptor, regulation of the renin-angiotensin-aldosterone system (RAAS), and transmembrane serine protease 2 (TMPRSS2) action are critical for the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) cell entry and infectivity. ACE2 expression and RAAS are abnormal in hypertension and obesity, while TMPRSS2 is overexpressed when exposed to androgens, which may justify why these factors are overrepresented in COVID-19. Among therapeutic targets for SARS-CoV-2, we hypothesized that spironolactone, a long used and safe mineralocorticoid and androgen receptors antagonist, with effective anti-hypertensive, cardioprotective, nephroprotective, and anti-androgenic properties may offer pleiotropic actions in different sites to protect from COVID-19. Current data shows that spironolactone may concurrently mitigate abnormal ACE2 expression, correct the balances membrane-attached and free circulating ACE2 and between angiotensin II and Angiotensin-(1-7) (Ang-(1-7)), suppress androgen-mediated TMPRSS2 activity, and inhibit obesity-related RAAS dysfunctions, with consequent decrease of viral priming. Hence, spironolactone may provide protection from SARS-CoV-2, and has sufficient plausibility to be clinically tested, particularly in the early stages of COVID-19.


Asunto(s)
Antagonistas de Andrógenos/uso terapéutico , Andrógenos/fisiología , Betacoronavirus/fisiología , Infecciones por Coronavirus/tratamiento farmacológico , Antagonistas de Receptores de Mineralocorticoides/uso terapéutico , Pandemias , Neumonía Viral/tratamiento farmacológico , Sistema Renina-Angiotensina/efectos de los fármacos , Espironolactona/uso terapéutico , Antagonistas de Andrógenos/farmacología , Inhibidores de la Enzima Convertidora de Angiotensina/uso terapéutico , Cardiotónicos/farmacología , Cardiotónicos/uso terapéutico , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/fisiopatología , Inducción Enzimática/efectos de los fármacos , Humanos , Hipertensión/complicaciones , Hipertensión/tratamiento farmacológico , Hipertensión/fisiopatología , Riñón/efectos de los fármacos , Masculino , Antagonistas de Receptores de Mineralocorticoides/farmacología , Obesidad/complicaciones , Obesidad/fisiopatología , Peptidil-Dipeptidasa A/biosíntesis , Peptidil-Dipeptidasa A/efectos de los fármacos , Neumonía Viral/complicaciones , Neumonía Viral/epidemiología , Neumonía Viral/fisiopatología , Pronóstico , Receptores Virales/efectos de los fármacos , Factores de Riesgo , Serina Endopeptidasas/efectos de los fármacos , Distribución por Sexo , Espironolactona/farmacología , Internalización del Virus/efectos de los fármacos
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA