Understanding the Impacts of Novel Coronavirus Outbreaks on People Who Use Drugs: A Systematic Review to Inform Practice and Drug Policy Responses to COVID-19.

People who use drugs (PWUD) experience many social and health harms and are considered at greater risk of acquiring COVID-19. Little research has examined the impact of coronaviruses either on PWUD, or on services targeted to PWUD. We report the findings of a systematic review of empirical evidence from studies which have examined the impact of coronaviruses (Severe Acute Respiratory Syndrome (SARS-CoV-1) and Middle Eastern Respiratory Syndrome (MERS-CoV) and COVID-19) on PWUD or on service responses to them. Five databases were searched (MEDLINE, PsycINFO, CINAHL, ASSIA and EMBASE) as well as COVID-19 specific databases. Inclusion criteria were studies reporting any impact of SARS, MERS or COVID-19 or any service responses to those, published between January 2000 and October 2020. Weight of Evidence judgements and quality assessment were undertaken. In total, 27 primary studies were included and grouped by seven main themes: treatment/recovery services; emergency medical settings; low-threshold services; prison setting, PWUD/substance use disorder (SUD) diagnosis; people with SUD and HIV; 'Sexual minority' men. Overall, research in the area was scant, and of average/poor quality. More robust research is required to inform on-going and future responses to coronavirus epidemics for PWUD.

Overweight and cardiovascular risk factors in 4- to 18-year-olds.

BACKGROUND: The objective of this study was to investigate the relationships between overweight and high waist circumference and cardiovascular risk factors in children. MATERIAL AND METHODS: We carried out a secondary analysis of data from 1,944 participants of the 'National Diet and Nutrition Survey: young people aged 4-18 years'. Blood pressure and blood lipid levels were compared in overweight versus non-overweight and high versus low waist circumference groups. Overweight was defined using international cut-offs for body mass index. High waist circumference was defined as >or= 91st percentile of UK waist circumference charts. Analyses were done separately by sex and age group (4-10 and 11-18 years for overweight, and 11-17 years for waist circumference). RESULTS: Overweight and high waist circumference were associated with increased systolic blood pressure, mean arterial pressure, low-density lipoprotein cholesterol (LDLC) and triacylglycerol, and decreased high-density lipoprotein cholesterol (HDLC). Those who were both overweight and had a high waist circumference had the highest blood pressure, plasma LDLC and triacylglycerol, and the lowest plasma HDLC. CONCLUSION: Overweight and high waist circumference were associated with increased blood pressure and a less favourable lipid profile. Children who were both overweight and had a high waist circumference had the most unfavourable cardiovascular risk profile. Both measurements may be useful in identifying children with increased health risks.