Obesity Is Associated with Changes in Laboratory Biomarkers in Chilean Patients Hospitalized with COVID-19

BACKGROUND AND AIMS

It is reported that patients with obesity are more frequently hospitalized for COVID-19, and evidence exists that obesity is a risk factor, regardless of other comorbidities. The objective of this study was to evaluate the association of obesity with changes in laboratory biomarkers in hospitalized Chilean patients.

MATERIALS AND METHODS

A total of 202 hospitalized patients (71 with obesity and 131 without obesity) with a diagnosis of COVID-19 were included in the study. Demographic, clinical, and laboratory (days 1, 3, 7, 15) data were obtained. We performed a statistical analysis, assuming significance with a value of p < 0.05.

RESULTS

Significant differences in chronic respiratory pathology are observed between patients with and without obesity. The inflammatory markers CPR, ferritin, NLR, and PLR are elevated during the evaluated period, while changes in leukocyte populations are present on day 1 (eosinophils) and day 3 (lymphocytes). Finally, a persistent elevation of D-dimer level is observed, presenting significant differences on day 7 between patients with and without obesity. Obesity had a positive correlation with admission to the critical patient unit, invasive mechanical ventilation, and length of hospital stay.

CONCLUSION

Patients with obesity hospitalized for COVID-19 present marked elevations of inflammatory and hemostasis parameters, with a correlation between obesity, changes in laboratory biomarkers, and the risk of adverse clinical outcomes also observed.

Surgical Morbidity in the Elderly Bariatric Patient: Does Age Matter?

BACKGROUND

Obesity is a global health problem that also affects older adults. In Chile, as in most of the developing countries, more than half of older adults are overweight or obese, and bariatric surgery may be riskier for this group. The aim of this study is to compare our experience in patients over 60 years of age with a control group to determine associated surgical morbidity and mortality.

METHODS

Case-control study of bariatric surgeries performed between 2006 and 2017 in our institution. Patients aged ≥ 60 years for the case group versus control group for patients ≤ 50 years selected randomly, matched by body mass index, type 2 diabetes, hypertension, dyslipidemia, surgical technique, and gender (ratio 1:2). Primary endpoint was surgical morbidity, 30-day readmission, and mortality.

RESULTS

Seventy-two patients in case group were matched with 144 patients in control group. Surgical complications rate was the same for both groups. No differences were observed in the conversion to open surgery rate or 30-day readmission rate. There was no mortality in this series.

CONCLUSION

In this case-control study, being elderly does not increase the risk of morbidity and mortality associated with bariatric surgery.

Spontaneous urinary chemiluminescence and diet. An intervention study in humans

Spontaneous urinary visible chemiluminiscence has been measured in samples from a diet intervention study in humans. For a month, two groups, each of 21 male volunteers, received either a Mediterranean-type diet or an occidental (high-fat) diet. Urinary chemiluminescence levels (in 10(3) cpm) were 8.5 +/- 3.1 and 6.0 +/- 2.0 for the high-fat and Mediterranean-type diets, respectively. The differences obtained were statistically significant. These results reflect differences in the oxidative stress associate to both diets and support the proposal that spontaneous urinary chemiluminiscence constitutes a complementary index of systemic oxidative stress.

Temporary sedation with midazolam for control of severe incident pain

Incident pain frequently complicates cancer-related pain. Its treatment is sometimes very difficult due to poor responsiveness to opioids. Two cases are presented in which a temporary or intermittent sedation with midazolam was successfully used to control excruciating incident pain.