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1.
researchsquare; 2021.
Preprint Dans Anglais | PREPRINT-RESEARCHSQUARE | ID: ppzbmed-10.21203.rs.3.rs-244649.v1

Résumé

Objectives: Study bidirectional relationships between weight gain, obesity and COVID-19 infection risk during the pandemic.Methods: MEDLINE, Embase, MedRxiv, and WHO COVID-19 Database were searched till June 2, 2020. Newspaper and internet article sources were identified using a media database. Meta-analysis was conducted using random- and fixed effect models.Results: Ten studies published from 5 countries met inclusion criteria; five studies (provided 17 analyses/types of results) were included in meta-analysis. The studies suggested bidirectional relationships and some dose-response relationships. Meta-analysis showed obesity was associated with increased COVID-19 infection risk (Odds ratio, OR=1.69, 95% CI: 1.41, 2.02). COVID-19 risk increased with obesity (OR=1.43 (1.18, 1.73)) and severe obesity (OR=1.96 (1.49, 2.59)). Obesity was positively associated with COVID-19 mortality (OR=1.64, 95% CI: 1.20, 2.25) and its severity: admission to intensive care unit (ICU) (OR=2.01 (1.25, 3.23)), and invasive mechanical ventilation (IMV) use (OR=8.20 (2.10, 31.91)). We also observed a stronger association in younger age groups (β=-0.29 (-0.47 to -0.10)).Conclusions: Obesity was positively associated with higher COVID-19 infection risk, severity, and mortality. Appropriate treatment of COVID-19 patients with obesity and weight management are warranted.

2.
medrxiv; 2020.
Preprint Dans Anglais | medRxiv | ID: ppzbmed-10.1101.2020.10.07.20207282

Résumé

ObjectiveThis study examined the associations between type-2 diabetes (T2DM) and self-reported/familial COVID-19 infection and investigated health-related outcomes among those with diabetes during Chinas nationwide quarantine. MethodsThe 2020 China COVID-19 Survey was administered anonymously via social media (WeChat) across China. It was completed by 10,545 adults in all of mainland Chinas 31 provinces. The survey consisted of 74 items covering sociodemographic characteristics, preventive measures for COVID-19, lifestyle behaviors, and health-related outcomes during the period of quarantine. Regression models examined associations among study variables, adjusting for covariates. ResultsDiabetes was associated with a six-fold increased risk of reporting COVID-19 infection among respondents or their family members. Among patients with diabetes, individuals who rarely wore masks had double the risk of suspected COVID-19 infection compared with those who always wore masks, with an inverse J-shaped relationship between face mask wearing and suspected COVID-19 infection. People with T2DM tended to have both poor knowledge of COVID-19 and poor compliance with preventive measures, despite perceiving a high risk of personal infection (40.0% among respondents reporting T2DM and 8.0% without T2DM). Only 54-55% of these respondents claimed to consistently practice preventive measures, including wearing face masks. Almost 60% of those with T2DM experienced food or medication shortages during the quarantine period, which was much higher than those without T2DM. Importantly, respondents who experienced medication shortages reported a 63% higher COVID-19 infection rate. ConclusionsT2DM was associated with an increased risk of self-reported personal and family member COVID-19 infection, which is mitigated by consistent use of face masks. FundingThe project is supported in part by research grants from the China Medical Board (Grant number: 16-262), the National Key Research and Development Program of China (Grant Number: 2017YFC0907200 & 2017YFC0907201), the University Alliance of the Silk Road (Grant number: 2020LMZX002), and Xian Jiaotong University Global Health Institute. Research in ContextO_ST_ABSEvidence before this studyC_ST_ABSDuring the COVID-19 pandemic, it has become increasingly clear that the risk factors for initial infection and subsequent poor health outcomes include, but are not limited to, social vulnerability, economic status, older age, and obesity. While community-wide masking has been recommended by the World Health Organization to control COVID-19, its overall effectiveness has not been clearly evaluated. Added value of this studyThrough an anonymous survey disseminated and promoted through WeChat, the largest social media platform in China, we sought to understand the impact of COVID-19 on the health, wellbeing, and health-related behaviors of adults in China. Specifically, this study examined how individuals with chronic diseases managed the threat, including their COVID-19 related knowledge, attitudes, and adherence to preventive measures such as wearing face masks, and their disease-related self-care. Implications of the available evidenceThis study demonstrates that type-2 diabetes mellitus is associated with an increased risk of COVID-19 infection, which is mitigated by consistent use of face masks.

3.
researchsquare; 2020.
Preprint Dans Anglais | PREPRINT-RESEARCHSQUARE | ID: ppzbmed-10.21203.rs.3.rs-56290.v1

Résumé

Background This study primarily aimed to evaluate the associations between mental distress and COVID-19-related changes in behavioral outcomes, and potential modifiers (age, gender, and educational attainment) of such associations.Methods An online survey using anonymous network sampling was conducted in China during April-May, 2020 using a 74-item questionnaire distributed through social media. A national sample of 10,545 adults in 31 provinces provided data on socio-demographic characteristics, COVID-19-related mental distress, and changes in behavioral outcomes. Structural equation models were used for data analyses.Results About 13% of adults reported experiencing at least one symptom of mental distress. After adjusting for covariates, greater mental distress was associated with increased smoking and alcohol consumption (among current smokers and drinkers) and with both increased and decreased physical activity. Underweight adults were more likely to lose body weight (≥ 1 kg) whereas overweight adults were more likely to gain weight by the same amount. Association between mental distress and change in physical activity was stronger in adults aged 40 and above and those with high education.Conclusions Mental distress was associated with increased smoking in males but not females. These findings inform the design of tailored public health interventions aimed to mitigate long-term negative consequences of mental distress on outcomes.

4.
medrxiv; 2020.
Preprint Dans Anglais | medRxiv | ID: ppzbmed-10.1101.2020.03.24.20042374

Résumé

Background: The Chinese government implemented a metropolitan-wide quarantine of Wuhan city on 23rd January 2020 to curb the epidemic of the coronavirus COVID-19. Lifting of this quarantine is imminent. We modelled the effects of two key health interventions on the epidemic when the quarantine is lifted. Method: We constructed a compartmental dynamic model to forecast the trend of the COVID-19 epidemic at different quarantine lifting dates and investigated the impact of different rates of public contact and facial mask usage on the epidemic. Results: We estimated that at the end of the epidemic, a total of 65,572 (46,156-95,264) individuals would be infected by the virus, among which 16,144 (14,422-23,447, 24.6%) would be infected through public contacts, 45,795 (32,390-66,395, 69.7%) through household contact, 3,633 (2,344-5,865, 5.5%) through hospital contacts (including 783 (553-1,134) non-COVID-19 patients and 2,850 (1,801-4,981) medical staff members). A total of 3,262 (1,592-6,470) would die of COVID-19 related pneumonia in Wuhan. For an early lifting date (21st March), facial mask needed to be sustained at a relatively high rate ([≥]85%) if public contacts were to recover to 100% of the pre-quarantine level. In contrast, lifting the quarantine on 18th April allowed public person-to-person contact adjusted back to the pre-quarantine level with a substantially lower level of facial mask usage (75%). However, a low facial mask usage (<50%) combined with an increased public contact (>100%) would always lead a significant second outbreak in most quarantine lifting scenarios. Lifting the quarantine on 25th April would ensure a smooth decline of the epidemics regardless of the combinations of public contact rates and facial mask usage. Conclusion: The prevention of a second epidemic is viable after the metropolitan-wide quarantine is lifted but requires a sustaining high facial mask usage and a low public contact rate.

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