Association of obesity with COVID-19 diseases severity and mortality: A meta-analysis of studies

Predictive Ability of Previous Pain and Disease Conditions on the Presentation of Post-COVID Pain in a Danish Cohort of Adult COVID-19 Survivors

BACKGROUND

Even though many post-COVID pain risk factors have been identified, little is known about the predictive profiles of these risk factors for the development of post-COVID pain.

METHODS

Data was collected from two separate questionnaires assessing demographics, pre-existing medical comorbidities, pain history, and post-COVID pain experience. Socioeconomic data and COVID-19 RT-PCR test results were collected from Danish registries. The study cohort (n = 68,028) was stratified into two groups reporting pre-COVID pain (n = 9090) and no pre-COVID pain (n = 55,938). Forward-selection prediction models were employed to identify predictor profiles for post-COVID pain in the full study cohort (Model 1) and the stratified groups with (Model 2) and without (Model 3) pre-COVID pain from 58 potential risk factors.

RESULTS

Model 1 achieved a 5-fold cross-validated AUC (cvAUC) of 0.68. Use of pain medication, stress, high income, age, female gender, and weight were the top predictors contributing to 97% of the model performance. Model 2 (cvAUC = 0.69) identified use of pain medication, breathing pain, stress, height, physical activity, and weight as the top predictors contributing to 98.6% of model predictive performance. Model 3 (cvAUC = 0.65) identified stress, female gender, weight, higher education, age, high income, and physical activity as the top predictors contributing to 98.5% of model predictive performance. Height was unique to Model 2, while being female and higher income were unique to Model 3.

CONCLUSIONS

The study highlights potential important predictors, and further research is needed to describe these in detail. The results may apply to the understanding of post-viral pain sequelae after other viral infections.

SIGNIFICANCE STATEMENT

The explorative study investigates the predictive ability of a battery of pre-COVID risk factors potentially associated with the development of post-COVID pain. This article presents the profiles of predictors of interest in COVID-19 survivors with and without pre-COVID pain. The results will contribute to the understanding of patient profiles that might develop post-COVID pain conditions and provide a first step towards focused clinical predictive research.

Dietary polysaccharides from dragon fruit pomace, a co-product of the fruit processing industry, exhibit therapeutic potential in high-fat diet-induced metabolic disorders

The increasing prevalence of metabolic disorders, often associated with high-fat diets (HFD), highlights the need for new therapeutic approaches, especially from natural sources. Dragon fruit pomace, a by-product of the fruit processing industry, is rich in polysaccharides with potential health benefits. This study investigates the effects of dragon fruit pomace-derived polysaccharides (PDPS) in alleviating HFD-induced metabolic dysfunction. Treatment with PDPS in mice fed a high-fat diet led to significant decreases in body weight increase, abdominal fat accumulation, total cholesterol, triglycerides, and low-density lipoprotein cholesterol (LDL-C) concentrations, along with a notable elevation in high-density lipoprotein cholesterol (HDL-C) concentrations. PDPS also improved glucose tolerance and prevented fat accumulation in the liver and adipose tissue. Additionally, PDPS exhibited anti-inflammatory properties, evidenced by reduced levels of pro-inflammatory cytokines (TNF-α, IL-1β, and IL-6) in the liver. Gut microbiota analysis indicated a shift toward beneficial bacteria, such as Romboutsia, Lachnospiraceae_NK4A136_group, Coriobacteriaceae_UCG-002, and Blautia. These findings suggest that PDPS may mitigate HFD-induced metabolic issues by enhancing lipid metabolism, glycemic control, and gut health, positioning it as a promising, sustainable functional ingredient for dietary interventions aimed at managing metabolic disorders.

Prevalence, Risk Factors, and Impact of Long COVID Among Adults in South Korea

OBJECTIVES

This study aimed to identify the prevalence, risk factors, and impact of long COVID in a community-based representative sample of patients with COVID-19 aged 19-64 years.

METHODS

A total of 975 participants completed online or telephone surveys at 1 and 3 months post-diagnosis, covering persistent symptoms, daily activity limitations, vaccination status, and underlying diseases.

RESULTS

Long COVID, as defined by the WHO criteria, had a prevalence of 19.7-24.9% in females and 12.7% in males. Logistic regression revealed that the odds of having long COVID symptoms were higher among females compared to males (OR, 2.43; 95% CI, 1.53-3.87), and higher in those aged ≥ 30 years compared to those aged 19-29 years: 30-39 years (OR, 2.91; 95% CI, 1.59-5.33), 40-49 years (OR, 2.72; 95% CI, 1.51-4.89), and 50-64 years (OR, 1.96; 95% CI, 1.10-3.49). Additionally, patients with underlying diseases had higher odds of long COVID symptoms compared to those without underlying diseases (OR, 1.81; 95% CI, 1.24-2.64). Among those with long COVID, 54.2% experienced daily activity limitations, and 40.6% received treatment. Furthermore, lower income groups faced greater daily activity limitations but had similar treatment rates to higher income groups.

CONCLUSIONS

These findings emphasize the need for interest in and the development of programs to support these low-income populations.

Multisystem inflammatory syndrome in adults hospitalizations in the United States; evaluating patient characteristics, COVID-19 associations, and mortality

INTRODUCTION

Multisystem inflammatory syndrome in adults (MIS-A) is thought to be closely linked with COVID-19 infection. This study aims to elucidate the demographics and clinical characteristics of MIS-A, aiding in timely diagnosis and management.

METHODS

Utilizing the National Inpatient Sample (NIS) database (2021), patients were stratified into MIS-A and non-MIS-A groups. Baseline characteristics and comorbidities, the association with COVID-19, post-COVID-19 syndrome, and personal history of COVID-19, as well as impact on mortality were studied.

RESULTS

We identified 2,730 adults with MIS-A. MIS-A was linked with active COVID-19 infection (aOR = 27.436, p < 0.001), post-COVID-19 syndrome (aOR = 32.766, p < 0.001), personal history of COVID-19 (aOR = 2.963, p < 0.001), and an increased mortality (aOR = 3.743, p < 0.001).

CONCLUSIONS

Using data adjusted for confounding variables, MIS-A was found to be associated with active and past COVID-19, and a greater mortality rate when compared to non-MIS-A patients.

Changes in Circulating Adipokine Levels in COVID-19 Patients

Objective: The COVID-19 pandemic has posed significant global health challenges. Despite extensive research efforts, the inflammatory response triggered by SARS-CoV-2 remains to be further explored and understood. Our study aims to examine the changes in serum concentrations of pro-inflammatory adipokines-visfatin and leptin-in COVID-19 patients in relation to a healthy control group. Patients/Materials/Subjects and Methods: The study consisted of forty COVID-19 patients and twenty-four healthy patients in the control group. Two serum samples were collected: upon admission and on the seventh day of hospitalization. Concentrations of visfatin and leptin in the serum, alongside routine biochemical parameters, were measured using enzyme immunoassay or enzyme-linked immunosorbent assay kits. The Shapiro-Wilk test was used to assess normality. Differences between independent groups were compared using the Mann-Whitney U test and Kruskal-Wallis ANOVA. Correlations were evaluated with Spearman's rank correlation coefficient. Results: Our findings revealed significantly lower visfatin levels in COVID-19 patients compared to the control group upon admission (4.29 ng/mL, (3.0-6.88 ng/mL) vs. 37.16 ng/mL (24.74-50.12 ng/mL), p < 0.001 for visfatin 1 and 52.05 ng/mL, (31.2-69.66 ng/mL) vs. 37.16 ng/mL (24.74-50.12 ng/mL), p = 0.048 for visfatin 2). The visfatin level of COVID-19 patients returned to the normal levels, established in the control group. However, there was no significant difference in leptin levels between the two groups (p = 0.270 for leptin 1 and p = 0.129 for leptin 2). There was a positive correlation between BMI and leptin concentration (r = 0.66 and p = 0.00). Moreover, it was discovered that COVID-19 independently reduces visfatin levels during the first day of illness. Conclusions: The results of our research suggest that the onset of COVID-19 infection is correlated to visfatin levels. Association with leptin levels remains inconclusive. Further research is imperative to elucidate the intricate role of visfatin and leptin in SARS-CoV-2 infection and their potential as biomarkers for COVID-19 severity and prognosis.

Lysophosphatidylcholines Promote Influenza Virus Reproduction through the MAPK/JNK Pathway in PMA-Differentiated THP-1 Macrophages

Obesity and metabolic syndrome alter serum lipid profiles. They also increase vulnerability to viral infections and worsen the survival rate and symptoms after infection. How serum lipids affect influenza virus proliferation is unclear. Here, we investigated the effects of lysophosphatidylcholines on influenza A virus (IAV) proliferation. IAV particles in the culture medium were titrated using extraction-free quantitative PCR, and viral RNA and protein levels were assessed using real-time PCR and Western blot, respectively. RNA sequencing data were analyzed using PCA and heatmap analysis, and pathway analysis was performed using the KEGG mapper and PathIN tools. Statistical analysis was conducted using SPSS21.0. LPC treatment of THP-1 cells significantly increased IAV proliferation and IAV RNA and protein levels, and saturated LPC was more active in IAV RNA expression than unsaturated LPC was. The functional analysis of genes affected by LPCs showed that the expression of genes involved in IAV signaling, such as suppressor of cytokine signaling 3 (SOCS3), phosphoinositide-3-kinase regulatory subunit 3 (PI3K) and AKT serine/threonine kinase 3 (AKT3), Toll-like receptor 7 (TKR7), and interferon gamma receptor 1 (IFNGR1), was changed by LPC. Altered influenza A pathways were linked with MAPK and PI3K/AKT signaling. Treatment with inhibitors of MAPK or PI3K attenuated viral gene expression changes induced by LPCs. The present study shows that LPCs stimulated virus reproduction by modifying the cellular environment to one in which viruses proliferated better. This was mediated by the MAPK, JNK, and PI3K/AKT pathways. Further animal studies are needed to confirm the link between LPCs from serum or the respiratory system and IAV proliferation.

Temporal variations in the gut microbial diversity in response to high-fat diet and exercise

High-fat diet-induced obesity is a pandemic caused by an inactive lifestyle and increased consumption of Western diets and is a major risk factor for diabetes and cardiovascular diseases. In contrast, exercise can positively influence gut microbial diversity and is linked to a decreased inflammatory state. To understand the gut microbial variations associated with exercise and high-fat diet over time, we conducted a longitudinal study to examine the effect of covariates on gut microbial diversity and composition. Young mice were divided into four groups: Chow-diet (CHD), high-fat diet (HFD), high-fat diet + exercise (HFX), and exercise only (EXE) and underwent experimental intervention for 12 weeks. Fecal samples at week 0 and 12 were collected for DNA extraction, followed by 16S library preparation and sequencing. Data were analyzed using QIIME 2, R and MicrobiomeAnalyst. The Bacteroidetes-to-Firmicutes ratio decreased fivefold in the HFD and HFX groups compared to that in the CHD and EXE groups and increased in the EXE group over time. Alpha diversity was significantly increased in the EXE group longitudinally (p < 0.02), whereas diversity (Shannon, Faith's PD, and Fisher) and richness (ACE) was significantly reduced in the HFD (p < 0.005) and HFX (p < 0.03) groups over time. Beta diversity, based on the Jaccard, Bray-Curtis, and unweighted UniFrac distance metrics, was significant among the groups. Prevotella, Paraprevotella, Candidatus arthromitus, Lactobacillus salivarius, L. reuteri, Roseburia, Bacteroides uniformis, Sutterella, and Corynebacterium were differentially abundant in the chow-diet groups (CHD and EXE). Exercise significantly reduced the proportion of taxa characteristic of a high-fat diet, including Butyricimonas, Ruminococcus gnavus, and Mucispirillum schaedleri. Diet, age, and exercise significantly contributed to explaining the bacterial community structure and diversity in the gut microbiota. Modulating the gut microbiota and maintaining its stability can lead to targeted microbiome therapies to manage chronic and recurrent diseases and infections.

Implications of obesity and adiposopathy on respiratory infections; focus on emerging challenges

Obesity is characterized by excessive adipose tissue accumulation, which impacts physiological, metabolic, and immune functions. Several respiratory infections, including bacterial pneumonia, influenza, and coronavirus disease 2019, appear to be linked to unfavorable results in individuals with obesity. These may be attributed to the direct mechanical/physiological effects of excess body fat on the lungs’ function. Notably, adipose tissue dysfunction is associated with a low-grade chronic inflammatory status and hyperleptinemia, among other characteristics. These have all been linked to immune system dysfunction and weakened immune responses to these infections. A better understanding and clinical awareness of these risk factors are necessary for better disease outcomes.

Overview of the cardio-metabolic impact of the COVID-19 pandemic

Evidence has shown that cardiometabolic disorders (CMDs) are amongst the top contributors to COVID-19 infection morbidity and mortality. The reciprocal impact of COVID-19 infection and the most common CMDs, the risk factors for poor composite outcome among patients with one or several underlying diseases, the effect of common medical management on CMDs and their safety in the context of acute COVID-19 infection are reviewed. Later on, the changes brought by the COVID-19 pandemic quarantine on the general population's lifestyle (diet, exercise patterns) and metabolic health, acute cardiac complications of different COVID-19 vaccines and the effect of CMDs on the vaccine efficacy are discussed. Our review identified that the incidence of COVID-19 infection is higher among patients with underlying CMDs such as hypertension, diabetes, obesity and cardiovascular disease. Also, CMDs increase the risk of COVID-19 infection progression to severe disease phenotypes (e.g. hospital and/or ICU admission, use of mechanical ventilation). Lifestyle modification during COVID-19 era had a great impact on inducing and worsening of CMDs. Finally, the lower efficacy of COVID-19 vaccines was found in patients with metabolic disease.

Age, Sex and Previous Comorbidities as Risk Factors Not Associated with SARS-CoV-2 Infection for Long COVID-19: A Systematic Review and Meta-Analysis

Identification of predictors of long COVID-19 is essential for managing healthcare plans of patients. This systematic literature review and meta-analysis aimed to identify risk factors not associated with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection, but rather potentially predictive of the development of long COVID-19. MEDLINE, CINAHL, PubMed, EMBASE, and Web of Science databases, as well as medRxiv and bioRxiv preprint servers were screened through 15 September 2022. Peer-reviewed studies or preprints evaluating potential pre-SARS-CoV-2 infection risk factors for the development of long-lasting symptoms were included. The methodological quality was assessed using the Quality in Prognosis Studies (QUIPSs) tool. Random-effects meta-analyses with calculation of odds ratio (OR) were performed in those risk factors where a homogenous long COVID-19 definition was used. From 1978 studies identified, 37 peer-reviewed studies and one preprint were included. Eighteen articles evaluated age, sixteen articles evaluated sex, and twelve evaluated medical comorbidities as risk factors of long COVID-19. Overall, single studies reported that old age seems to be associated with long COVID-19 symptoms (n = 18); however, the meta-analysis did not reveal an association between old age and long COVID-19 (n = 3; OR 0.86, 95% CI 0.73 to 1.03, p = 0.17). Similarly, single studies revealed that female sex was associated with long COVID-19 symptoms (n = 16); which was confirmed in the meta-analysis (n = 7; OR 1.48, 95% CI 1.17 to 1.86, p = 0.01). Finally, medical comorbidities such as pulmonary disease (n = 4), diabetes (n = 1), obesity (n = 6), and organ transplantation (n = 1) were also identified as potential risk factors for long COVID-19. The risk of bias of most studies (71%, n = 27/38) was moderate or high. In conclusion, pooled evidence did not support an association between advancing age and long COVID-19 but supported that female sex is a risk factor for long COVID-19. Long COVID-19 was also associated with some previous medical comorbidities.