ABSTRACT
PurposeThe causal effects of body fat mass and body fat-free mass on coronavirus disease 2019 (COVID-19) severity remain unclear. Here, we used Mendelian randomization (MR) to evaluate the causal relationships between body fat-related traits and COVID-19 severity. Material and MethodsWe identified single nucleotide polymorphisms associated with body mass index (BMI) and direct measures of body fat (i.e., body fat percentage, body fat mass, and body fat-free mass) in 461,460, 454,633, 454,137, and 454,850 individuals of European ancestry from the UK Biobank, respectively. We then performed two-sample MR to ascertain their effects on severe COVID-19 (cases: 4,792; controls: 1,054,664) from the COVID-19 Host Genetics Initiative. ResultsWe found that an increase in BMI, body fat percentage, and body fat mass by one standard deviation were each associated with severe COVID-19 (odds ratio (OR)BMI = 1.49, 95%CI: 1.19-1.87, P = 5.57x10-4; ORbody fat percentage = 1.94, 95%CI: 1.41-2.67, P = 5.07x10-5; and ORbody fat mass = 1.61, 95%CI: 1.28-2.04, P = 5.51x10-5). Further, we evaluated independent causal effects of body fat mass and body fat-free mass using multivariable MR and revealed that only body fat mass was independently associated with severe COVID-19 (ORbody fat mass = 2.91, 95%CI: 1.71-4.96, P = 8.85x10-5 and ORbody fat-free mass = 1.02, 95%CI: 0.61-1.67, P = 0.945). ConclusionsThis study demonstrates the causal effects of body fat accumulation on COVID-19 severity and indicates that the biological pathways influencing the relationship between COVID-19 and obesity are likely mediated through body fat mass.
ABSTRACT
Medicines are fundamental components of treatment, management and control of various diseases. However, despite all their benefits, adverse reactions can be evoked by the use of medicines. Medicinal products achieve maximum advantage when they are appropriately used based on the sound understanding of their risks and benefits. To achieve this, evaluation and monitoring of the safety of medicines under real-life conditions, the appropriate pharmacovigilance systems, are essential. The World Health Organization (WHO) is a specialised agency of the United Nations which commits broad range of works to secure international public health. Pharmacovigilance is embraced as the WHO Programme for International Drug Monitoring (PIDM), which is led and organised by the Safety and Vigilance of Medicines group in the Department of Essential Medicines and Health Products in WHO. Pharmacovigilance is defined by the WHO as “the science and activities relating to the detection, assessment, understanding and prevention of adverse effects or any other drug-related problem” . Any other drug-related problems include such as substandard medicine, medication error, lack of efficacy, misuse, abuse, and Substandard/Spurious/Falsely-labelled/Falsified/Counterfeit (SSFFC) products. Whilst the world has made significant progresses in accessing essential medicines through the global efforts such as the UN Millennium Development Goals (MDGs), pharmacovigilance system is not well enough developed. The access to new medicines or the use of medicines in new environments can bring issues to concern. This article outlines the WHO PIDM, the core programme of pharmacovigilance in WHO, on its development, overview and current status. In addition, Safety and Vigilance of Medicines group's activities in order to tackle above concerns are also introduced.
ABSTRACT
<p>Medicines are fundamental components of treatment, management and control of various diseases. However, despite all their benefits, adverse reactions can be evoked by the use of medicines. Medicinal products achieve maximum advantage when they are appropriately used based on the sound understanding of their risks and benefits. To achieve this, evaluation and monitoring of the safety of medicines under real-life conditions, the appropriate pharmacovigilance systems, are essential. The World Health Organization (WHO) is a specialised agency of the United Nations which commits broad range of works to secure international public health. Pharmacovigilance is embraced as the WHO Programme for International Drug Monitoring (PIDM), which is led and organised by the Safety and Vigilance of Medicines group in the Department of Essential Medicines and Health Products in WHO. Pharmacovigilance is defined by the WHO as “the science and activities relating to the detection, assessment, understanding and prevention of adverse effects or any other drug-related problem” . Any other drug-related problems include such as substandard medicine, medication error, lack of efficacy, misuse, abuse, and Substandard/Spurious/Falsely-labelled/Falsified/Counterfeit (SSFFC) products. Whilst the world has made significant progresses in accessing essential medicines through the global efforts such as the UN Millennium Development Goals (MDGs), pharmacovigilance system is not well enough developed. The access to new medicines or the use of medicines in new environments can bring issues to concern. This article outlines the WHO PIDM, the core programme of pharmacovigilance in WHO, on its development, overview and current status. In addition, Safety and Vigilance of Medicines group's activities in order to tackle above concerns are also introduced.</p>
ABSTRACT
Vaccines are one of the most successful stories in public health in human history. Currently, immunisation averts about 2.5 million deaths every year in the world. To obtain appropriate vaccination is one of the fundamental elements of the human rights on health and is regarded as the responsibility for citizens, communities and governments. Vaccines used for the national immunisation programmes are generally safe and effective when appropriately used. However, vaccination is never zero-risk as any pharmaceuticals and effective vaccines may produce some undesirable side effects. The success of national immunisation programme needs the public's confidence in vaccines, by monitoring risk-benefit balance of vaccines and providing relevant information through pharmacovigilance activities. Pharmaceuticals including vaccines achieve maximum advantage when they are appropriately used based on the sound understanding of their risks and benefits. Pharmacovigilance is defined by the WHO as “the science and activities relating to the detection, assessment, understanding and prevention of adverse effects or any other drug-related problem” and essential for accurate evaluation of risk-benefit balance of pharmaceuticals. The WHO pursues actions to increase vaccination coverage and aims to spur research and development of Dengue and Malaria vaccines. In addition, the elapsed time between introduction of new vaccines in developed countries and in developing countries is being shortened, and technical cooperation facilitate local manufacture of vaccines in developing countries. This results in increasing immunisation rate and administration of various vaccines including relatively new vaccines on a global mass scale. Under such circumstances with increasing importance of vaccine pharmacovigilance more than ever, the article outlines the global movements on vaccine pharmacovigilance, mainly focus on the WHO's activities.
