Maintaining changes in physical activity among type 2 diabetics - A systematic review of rehabilitation interventions.

The prevalence of type 2 diabetes mellitus (T2DM) is increasing worldwide, and physical activity (PA) is a suitable way of preventing and managing the disease. However, improving long-term levels of PA in people with T2DM is a challenge and the best approach to rehabilitation in this regard is unknown. With the aim of outlining the existing knowledge regarding the maintenance of active lifestyles among people with T2DM after rehabilitation programs and gaining knowledge about options and challenges for their long-term engagement in PA, a systematic review of original research articles assessing PA after rehabilitation programs was conducted. Two thousand two hundred and forty-one articles were identified through PubMed or secondary sources and subjected to various inclusion criteria. Only articles published between the 1st of January 2000 and the 30th of June 2020 were considered. Additionally, the minimum time frame from intervention start to last PA assessment was 6 months and only articles based on interventions performed in Europe were included. The review was based on eighteen randomized controlled trials, four randomized trials without control, and four case studies. The 26 articles described 30 interventions that were categorized as personalized counseling, generalized teaching, supervised exercise, or a combination of personalized and generalized interventions. Statistical and narrative syntheses revealed no clear pattern regarding the effectiveness in eliciting maintained changes in PA. However, across categories, individual involvement, goal setting, social support, and the formation of habits are argued to be important components in sustaining PA and relieving challenges associated with the transition out of rehabilitation programs.

Acute and persistent symptoms in non-hospitalized PCR-confirmed COVID-19 patients

BackgroundReports of persistent symptoms after hospitalization with COVID-19 have raised concern of a "long COVID" syndrome. This study aimed at characterizing acute and persistent symptoms in non- hospitalized patients with polymerase chain reaction (PCR) confirmed COVID-19. MethodsCohort study of 445 non-hospitalized participants identified via the Danish Civil Registration System with a SARS-CoV-2-positive PCR-test and available biobank samples for genetic analyses. Participants received a digital questionnaire on demographics and COVID-19-related symptoms. Persistent symptoms: symptoms >four weeks (in sensitivity analyses >12 weeks). Results445 participants were included, of whom 34% were asymptomatic. Most common acute symptoms were fatigue, headache, and sneezing, while fatigue and reduced smell and taste were reported as most severe. Persistent symptoms, most commonly fatigue and memory and concentration difficulties, were reported by 36% of 198 symptomatic participants with follow-up >four weeks. Risk factors for persistent symptoms included female sex (women 44% vs. men 24%, odds ratio 2.7, 95%CI:1.4-5.1, p=0.003) and BMI (odds ratio 1.1, 95%CI:1.0-1.2, p=0.001). ConclusionAmong non-hospitalized PCR-confirmed COVID-19 patients one third were asymptomatic while one third of symptomatic participants had persistent symptoms illustrating the heterogeneity of disease presentation. These findings should be considered in future health care planning and policy making related to COVID-19.

Impact of SARS-CoV-2 antibodies at delivery in women, partners and newborns

BackgroundOnly few studies have focused on serological testing for SARS-CoV-2 in pregnant women and no previous study has investigated the frequency in partners. The aim was to investigate the frequency and impact of SARS-CoV-2 in parturient women, their partners and newborns. MethodsFrom April 4th to July 3rd, 2020, all parturient women, their partners and newborns were invited to participate in the study. Participating women and partners had a pharyngeal swab and a blood sample taken at admission and immediately after delivery a blood sample was drawn from the umbilical cord. The swabs were analyzed for SARS-CoV-2 RNA by PCR and the blood samples were analyzed for SARS-CoV-2 antibodies. Full medical history, obstetric- and neonatal information were available. ResultsA total of 1,361 parturient women, 1,236 partners and 1,342 newborns participated in the study. No associations between previous COVID-19 disease and obstetric- or neonatal complications were found. The adjusted serological prevalence was 2.9% in women and 3.8% in partners. The frequency of blood type A was significantly higher in women with antibodies compared to women without antibodies. 17 newborns had SARS-CoV-2 IgG antibodies, and none had IgM antibodies. Full serological data from 1,052 families showed an absolute risk of infection of 0.37 if the partner had antibodies. Only 55% of individuals with antibodies reported symptoms. ConclusionThis large prospective cohort study reports no association between COVID-19 and obstetric- or neonatal complications. The family pattern showed a substantial increase in absolute risk for women living with a partner with antibodies.

SARS-CoV-2 in first trimester pregnancy - does it affect the fetus?

BackgroundSeveral viral infections are known to be harmful to the fetus in the first trimester of pregnancy and can cause increased nuchal translucency thickness and pregnancy loss. Currently, no evidence exists regarding possible effects of SARS-CoV-2 in first trimester pregnancies. MethodsCohort 1 included pregnant women with a double test taken between Feb. 17 and Apr. 23, 2020, during the SARS-CoV-2 epidemic peak in Denmark. The double test was taken as part of the first trimester risk assessment. Cohort 2 included women with a first trimester pregnancy loss before double test. Serum from the double test or from a blood sample, in case of pregnancy loss, was analyzed for SARS-CoV-2 antibodies. The results were correlated to the nuchal translucency thickness and the number of pregnancy losses. ResultsIn total, 1,019 pregnant women with double test and 36 women with pregnancy loss participated in the study. Thirty (2.9%) women had SARS-CoV-2 antibodies in the serum from the double test. All women with pregnancy loss prior to the double test were negative for SARS-CoV-2 antibodies. There were no significant differences in nuchal translucency thickness for women testing positive (n=14) versus negative (p=0.20) or grey zone (n=16) versus negative (p=0.28). In total, 54 women experienced a pregnancy loss of whom two had grey zone or positive SARS-CoV-2 antibodies. ConclusionMaternal SARS-CoV-2 infection did not seem harmful in first trimester pregnancies. Infection had no effect on the nuchal translucency thickness and women with SARS-CoV-2 antibodies were not overrepresented among women with pregnancy loss.