Thyroid disease and hypothyroidism are associated with poor COVID-19 outcomes: A systematic review,meta-analysis,and meta-regression

Background and aimsCoronavirus disease (COVID-19) still becomes a global burden that affected people in different groups. The aim of this study was to evaluate the association between thyroid disease and the outcome of COVID-19 patients.MethodThis was a meta-analysis study from articles obtained through a systematic literature search to investigate the relationship between thyroid disease and COVID-19 outcomes. Composite poor outcomes comprised of severity, mortality, intensive care unit (ICU) admission, and hospitalization.ResultsA total of 31339 patients from 21 studies included in this study. Thyroid disorder was associated with increased composite poor outcome (risk ratio (RR) 1.87 [95% confidence interval (CI) 1.53, 2.27], p < 0.001; I2 = 84%, p < 0.01), this included higher disease severity (RR 1.92 [1.40, 2.63], p < 0.05; I2 = 86%, p < 0.01), ICU admission (RR 1.61 [1.12, 2.32], p > 0.05; I2 = 32%, p < 0.05), mortality (RR 2.43 [1.44, 4.13], p < 0.05; I2 = 83%, p < 0.01), and hospitalization (RR 1.28 [1.17, 1.39], p < 0.05; I2 = 0%, p < 0.96). Meta-regression analysis indicated that age (p = 0.002) was a significant influence that affects the association. Also, the presence of unspecified thyroid disease (RR 1.91 [1.38, 2.65], p < 0.05; I2 = 81%, p < 0.01) and hypothyroidism (RR 1.90 [1.45, 2.55], p < 0.05; I2 = 85%, p < 0.01) during admission were associated with poor outcomes.ConclusionThyroid abnormalities increased the risk of COVID-19 composite poor outcomes and were influenced by the patient's age. Abnormal thyroid and hypothyroidism, but not hyperthyroidism, were associated with poor COVID-19 outcomes.     

Association between dairy product consumption and hyperuricemia in an elderly population with metabolic syndrome

Background and aimsThe prevalence of hyperuricemia has increased substantially in recent decades. It has been suggested that it is an independent risk factor for weight gain, hypertension, hypertriglyceridemia, metabolic syndrome (MetS), and cardiovascular disease. Results from epidemiological studies conducted in different study populations have suggested that high consumption of dairy products is associated with a lower risk of developing hyperuricemia. However, this association is still unclear. The aim of the present study is to explore the association of the consumption of total dairy products and their subtypes with the risk of hyperuricemia in an elderly Mediterranean population with MetS.Methods and resultsBaseline cross-sectional analyses were conducted on 6329 men/women (mean age 65 years) with overweight/obesity and MetS from the PREDIMED-Plus cohort. Dairy consumption was assessed using a food frequency questionnaire. Multivariable-adjusted Cox regressions were fitted to analyze the association of quartiles of consumption of total dairy products and their subtypes with the prevalence of hyperuricemia. Participants in the upper quartile of the consumption of total dairy products (multiadjusted prevalence ratio (PR) = 0.84; 95% CI: 0.75–0.94; P-trend 0.02), low-fat dairy products (PR = 0.79; 95% CI: 0.70–0.89; P-trend <0.001), total milk (PR = 0.81; 95% CI: 0.73–0.90; P-trend<0.001), low-fat milk (PR = 0.80; 95% CI: 0.72–0.89; P-trend<0.001, respectively), low-fat yogurt (PR = 0.89; 95% CI: 0.80–0.98; P-trend 0.051), and cheese (PR = 0.86; 95% CI: 0.77–0.96; P-trend 0.003) presented a lower prevalence of hyperuricemia. Whole-fat dairy, fermented dairy, and yogurt consumption were not associated with hyperuricemia.ConclusionsHigh consumption of total dairy products, total milk, low-fat dairy products, low-fat milk, low-fat yogurt, and cheese is associated with a lower risk of hyperuricemia.     

The association between curry-rice consumption and hypertension,type 2 diabetes,and depression: The findings from KNHANES 2012–2016

Background and aimsWe aim to evaluate the association between curry-rice consumption, cardiovascular diseases (CVDs), type 2 diabetes (T2DB), arthritis, and depression.Methods17,625 participants aged ≥18 years were recruited to obtain data on sociodemographic characteristics, lifestyle, medical history, current medications, family history, and food consumption. The association between curry-rice consumption, CVDs, T2DB, arthritis, and depression was examined using multivariable-adjusted analyses.ResultsIn the logistic model, risks of elevated triglyceride (OR 0.89; 95% CI, 0.82–0.97, p = 0.006), elevated HbA1c (OR 0.81; 95% CI, 0.73–0.91, p < 0.001), and elevated glucose (OR 0.86; 95% CI, 0.79–0.94, p < 0.001) were significantly lower in the high curry-rice consumption group than in the low curry-rice consumption group. Risk of hypertension (OR 0.88; 95% CI, 0.78–0.98, p = 0.044), T2DB (OR, 0.82; 95% CI, 0.68–0.98, p < 0.001), and depression (OR 0.82; 95% CI, 0.70–0.97, p = 0.026) was significantly lower among the high curry-rice consumption group than in the low curry-rice consumption group. These findings were consistent with the results of the analysis when curry-rice consumption was treated as a continuous variable.ConclusionsThe potential health benefits resulting from the intake of curry-rice via an ordinary diet could protect the public from the burden of non-communicable diseases (NCDs) and mental health. These results highlight an ongoing need to understand the role of curry-rice in NCDs and mental health.     

Impact of the vitamin D deficiency on COVID-19 infection and mortality in Asian countries

Background and aimsCOVID-19 is a pandemic that has affected beyond 100 million and caused nearly 3 million deaths globally. Vitamin D is a known risk factor for COVID-19. Therefore, we aimed to investigate the association of prevalence of vitamin D deficiency and mean vitamin D level with COVID-19 infection and mortality in Asia, predicting with other confounding factors such as median age, obesity, and diabetes.MethodsCOVID-19 infections and mortalities among the Asian countries were retrieved from the Worldometer website. Information on prevalence of vitamin D deficiency and mean vitamin D values in each Asian country was retrieved through literature searching on PubMed® and Google scholar. The associations between COVID-19 infections and mortalities with prevalence of vitamin D deficiency and mean vitamin D level were explored with correlation coefficients. As a predictive analysis, multiple linear regression was carried out with all confounders.ResultsPositive correlations were observed for prevalence of vitamin D deficiency with COVID-19 infections (r = 0.55; p = 0.01; R² = 0.31) and mortalities (r = 0.50; p = 0.01; R² = 0.25). Moreover, the associations for the COVID-19 infections and mortalities improved to r = 0.76 (p = 0.002; R² = 0.58) and r = 0.65 (p = 0.03; R² = 0.42), respectively, after predicting with confounding factors. Similarly, mean vitamin D level had a significant negative correlation with COVID-19 infections (r = ?0.77; p = 0.04; R² = 0.59) and mortalities (r = ?0.80; p = 0.03; R² = 0.63) when combining with confounders.ConclusionPrevalence of vitamin D deficiency is significantly positively associated whereas the mean vitamin D level is significantly negatively associated with both infection and mortality rate of COVID-19 among Asian countries upon predicting with all confounders.     

Quality of life and associations with health-related behaviours among older adults with increased cardiovascular risk

Background and aimsA better understanding of the relationship between cardiovascular disease risk factors and quality of life (QoL) in older age is needed to inform development of risk reduction strategies. This cross-sectional study investigated the association of QoL with health-related behaviours in older adults at risk of heart failure.Methods and resultsOlder adults (N = 328) at risk of heart failure residing in Melbourne, Australia, provided data on QoL and health-related behaviours including physical activity, diet, smoking and alcohol consumption. Multiple linear regression modelling was used to examine associations between health-related behaviours, QoL and its constituent domains. After adjustment for age, gender, body mass index and comorbidities, current smoking was found to have a negative association with the mental component score (MCS) of QoL (β = ?0.174, p ≤ 0.01), with a positive association seen between MCS and physical activity (β = 0.130, p = 0.01). Current alcohol use had a positive association with the physical component score (PCS) (β = 0.120, p = 0.02) and saturated fat intake consumption had a negative association with the physical functioning domain of QoL (β = ?0.105, p = 0.03) but was not associated with either PCS or MCS.ConclusionEngagement of older adults at increased cardiovascular risk with behavioural risk factor modification using QoL as a driver of change may offer new opportunities to promote healthy ageing. Development of such strategies should consider that for some behaviours which are cardiovascular risk factors (alcohol intake, in particular), the positive association to QoL is complicated and needs further deliberation.     

Consumption of sweetened beverages is associated with the incidence of type 2 diabetes in Brazilian adults (CUME project)

Background and aimTo evaluate the association between the energy consumption of sweetened beverages (SBs) adjusted for daily energy intake and the incidence of type 2 diabetes.Methods and resultsThis was a prospective study with 2480 type 2 diabetes mellitus (T2DM)-free Cohort of Universities of Minas Gerais (CUME) participants at baseline and 2–4 years of follow-up. A longitudinal analysis was performed with generalized equation estimation to verify the effect of SB consumption, adjusted for sociodemographic and lifestyle variables, on the incidence of T2DM. The incidence of T2DM was 2.78%. The median calorie intake of daily SB consumption adjusted for energy was 47.7 kcal/day. Participants with the highest consumption of SBs (≥47.7 kcal/day) were 63% (odds ratio [OR] = 1.63; p value-0.049) more likely to acquire T2DM over time compared to the lowest consumption (<47.7 kcal/day).ConclusionsHigher energy consumption from SBs favored a higher incidence of T2DM among CUME participants. The results reinforce the need for marketing restrictions on these foods and taxation to reduce the consumption of these beverages to prevent T2DM and other chronic noncommunicable diseases.     

The impact of COVID-19 on Diabetic Ketoacidosis patients

Background and aimDescribe the prevalence/outcomes of Diabetic Ketoacidosis (DKA) patients comparing pre- (March–April 2019) and pandemic (March–April 2020) periods.MethodsRetrospective cohort of admitted pandemic DKA/COVID-19+ patients comparing prevalence/outcomes to pre-pandemic DKA patients that takes place in Eleven hospitals of New York City Health & Hospitals. Our included participants during the pandemic period were admitted COVID-19+ patients (>18 years) and during the pre-pandemic period were admissions (>18 years) selected through the medical record. We excluded transfers during both periods. The intervention was COVID-19+ by PCR testing. The main outcome measured was mortality during the index hospitalization and secondary outcomes were demographics, medical histories and triage vital signs, and laboratory tests. Definition of DKA: Beta-Hydroxybutyrate (BHBA) (>0.4 mmol/L) and bicarbonate (<15 mmol/L) or pH (<7.3).ResultsDemographics and past medical histories were similar during the pre-pandemic (n = 6938) vs. pandemic (n = 7962) periods. DKA prevalence was greater during pandemic (3.14%, 2.66–3.68) vs. pre-pandemic period (0.72%, 0.54–0.95) (p > 0.001). DKA/COVID-19+ mortality rates were greater (46.3% (38.4–54.3) vs. pre-pandemic period (18%, 8.6–31.4) (p < 0.001). Surviving vs. non-surviving DKA/COVID-19+ patients had more severe DKA with lower bicarbonates by 2.7 mmol/L (1.0–4.5) (p < 0.001) and higher both Anion Gaps by 3.0 mmol/L (0.2–6.3) and BHBA by 2.1 mmol/L (1.2–3.1) (p < 0.001).ConclusionsCOVID-19 increased the prevalence of DKA with higher mortality rates secondary to COVID-19 severity, not DKA. We suggest DKA screening all COVID-19+ patients and prioritizing ICU DKA/COVID-19+ with low oxygen saturation, blood pressures, or renal insufficiency.     

Type 1 diabetes outpatient care and treatment effectiveness during COVID-19: A single-center cohort study

PurposeCOVID-19 has brought many challenges for providing quality healthcare for type 1 diabetes (T1DM). We evaluated the impact of the COVID-19 pandemic on the medical care, glycemic control, and selected outcomes in T1DM patients.MethodsWe retrospectively analyzed medical records from 357 T1DM adults enrolled in the Program of Comprehensive Outpatient Specialist Care at the University Hospital in Krakow, and assessed differences in patient data from before the COVID-19 period (March 2019–February 2020) and after it started COVID-19 (March 2020–February 2021).ResultsThe median HbA1c levels and the percentage of patients within the HbA1c target of <7 % (53 mmol/mol) were similar in both periods: before and after the beginning of the pandemic (6.86 % [51.5 mmol/mol], IQR 6.23–7.58 % [44.6–59.3 mmol/mol] vs. 6.9 % [51.9 mmol/mol], IQR 6.2–7.61 % [44.3–59.7 mmol/mol]; p = 0.50 and 56.3 % vs. 57.1 %, p = 0.42, respectively). However, we observed a rise in BMI and body weight (median 24.25, IQR 21.97–27.05 vs. 24.82, IQR 22.17–27.87 and median weight 71.0 IQR 61–82 vs. 72.55, IQR 55–85; p < 0.001 for both comparisons). There was no reduction in the numbers of total diabetes-related visits (median 4, IQR 4–5 vs. 5, IQR 4–5; p = 0.065), but the frequency of other specialist consultations decreased (2, IQR 0–2 vs. 1, IQR 0–2). During the pandemic, telehealth visits constituted of 1191 out of 1609 (71.6 %) total visits.ConclusionsIn this single-center observation, the COVID-19 pandemic did not have a negative impact on glycemic control in T1DM patients, but the patients' weight did increase. Telemedicine proved to be a valuable tool for T1DM care.     

Diabetes mellitus is associated with increased mortality and severity of disease in COVID-19 pneumonia – A systematic review,meta-analysis,and meta-regression

Background and aimsDiabetes Mellitus (DM) is chronic conditions with devastating multi-systemic complication and may be associated with severe form of Coronavirus Disease 2019 (COVID-19). We conducted a systematic review and meta-analysis in order to investigate the association between DM and poor outcome in patients with COVID-19 pneumonia.MethodsSystematic literature search was performed from several electronic databases on subjects that assess DM and outcome in COVID-19 pneumonia. The outcome of interest was composite poor outcome, including mortality, severe COVID-19, acute respiratory distress syndrome (ARDS), need for intensive care unit (ICU) care, and disease progression.ResultsThere were a total of 6452 patients from 30 studies. Meta-analysis showed that DM was associated with composite poor outcome (RR 2.38 [1.88, 3.03], p < 0.001; I²: 62%) and its subgroup which comprised of mortality (RR 2.12 [1.44, 3.11], p < 0.001; I²: 72%), severe COVID-19 (RR 2.45 [1.79, 3.35], p < 0.001; I²: 45%), ARDS (RR 4.64 [1.86, 11.58], p = 0.001; I²: 9%), and disease progression (RR 3.31 [1.08, 10.14], p = 0.04; I²: 0%). Meta-regression showed that the association with composite poor outcome was influenced by age (p = 0.003) and hypertension (p < 0.001). Subgroup analysis showed that the association was weaker in studies with median age ≥55 years-old (RR 1.92) compared to <55 years-old (RR 3.48), and in prevalence of hypertension ≥25% (RR 1.93) compared to <25% (RR 3.06). Subgroup analysis on median age <55 years-old and prevalence of hypertension <25% showed strong association (RR 3.33)ConclusionDM was associated with mortality, severe COVID-19, ARDS, and disease progression in patients with COVID-19.     

Relationship between lifestyle changes due to the COVID-19 pandemic and depression: Nationwide population-based research using Community Health Survey data in South Korea

AimsThis study evaluated the association between depression and lifestyle changes due to the COVID-19 pandemic and evaluated this association in patients with chronic diseases.MethodsData were obtained from the 2020 Community Health Survey in South Korea. This study included 212,806 participants and perceived changes in life patterns (sleep, food, and exercise) after the COVID-19 outbreak were measured. People with hypertension or diabetes were categorized as patients with chronic diseases and depression was defined as a score of ≥10 on the Patient Health Questionnaire-9.ResultsCompared with before the COVID-19 pandemic, increased or decreased sleep, the consumption of instant food, and decreased physical activity were associated with increased depression. Compared with the general population, patients with chronic diseases showed increased depression, with or without medication. Additionally, among patients with chronic diseases not taking medication, increased physical activity was associated with reduced depression, whereas reduced physical activity was associated with increased depression in both younger and older groups.ConclusionsThis study found that unhealthy lifestyle changes during the COVID-19 pandemic were associated with increased depression. Maintaining a certain lifestyle is important for mental health. Chronic disease patients need appropriate disease management, including physical activity.     

Impact of COVID-19 outbreak on lifestyle behaviour: A review of studies published in India

Background and aimsThe entire globe is undergoing an unprecedented challenge of COVID-19 which has affected the lifestyle behaviour of individuals. The present review is an attempt to summarize the effect of pandemic COVID-19 on lifestyle behaviour among the Indian population.MethodsA review was carried out to summarize the effect of pandemic COVID-19 on lifestyle behaviour focusing on changes in dietary or eating behaviour, stress, sleep pattern, and level of physical activity among the Indian population. Literature searches were conducted in PubMed and Google Scholar from inception till October 2020 to identify all relevant studies.ResultsA total of 11 studies (n = 5957, age group 18–70 years, comprising both genders) consisting of 1 hospital and 10 community based, were included in the present review. A change in lifestyle behaviour was observed due to COVID-19. Psychosocial or any kind of mental stress among the participants was found to be prevalent. Weight gain and decline in physical activity were also observed. Not only sleep quantity but sleep quality was also found to be affected due to COVID-19.ConclusionThe present review indicates the need for lifestyle behaviour programmes via using the platform of E-media and also for the dissemination of health education.     

Dipeptidyl peptidase-4 (DPP-4) inhibitor and mortality in coronavirus disease 2019 (COVID-19) – A systematic review,meta-analysis,and meta-regression

Background and aimsThis study aims to synthesize evidence on dipeptidyl peptidase-4 (DPP-4) inhibitor and mortality in COVID-19 patients and factors affecting it.MethodsWe performed a systematic literature search from PubMed, Scopus, and Embase databases from inception of databases up until 7 March 2021. Studies that met all of the following criteria were included: 1) observational studies or randomized controlled trials that report COVID-19 patients, 2) reporting DPP-4 inhibitor use, 3) mortality, and 4) mortality based on DPP-4 inhibitor use. The exposure was DPP-4 inhibitor, defined as DPP-4 inhibitor use that started prior to COVID-19 hospitalization. The control group was patients with no exposure to DPP-4 inhibitor. The outcome was mortality. The pooled effect estimate was reported as risk ratio (RR).ResultsThere were 4,477 patients from 9 studies in this systematic review and meta-analysis. 31% of (15%, 46%) the patients use DPP-4 inhibitor. Mortality occurs in 23% (15%, 31%) of the patients. DPP-4 inhibitor was associated with lower mortality in patients with COVID-19 (RR 0.76 [0.60, 0.97], p = 0.030, I2: 44.5%, p = 0.072). Meta-regression analysis showed that the association between DPP-4 inhibitor and mortality was significantly affected by metformin (RR 1.02 [1.00, 1.04], p = 0.048) and angiotensin converting enzyme inhibitor or angiotensin receptor blocker (ACEI/ARB) use (RR 1.04 [1.01, 1.07], p = 0.006), but not age (p = 0.759), sex (reference: male, p = 0.148), and hypertension (p = 0.218).ConclusionDPP-4 inhibitor use was associated with lower mortality in COVID-19 patients, and the association was weaker in patients who were also taking metformin and/or ACE inhibitors.     

The use of renin angiotensin system inhibitor on mortality in patients with coronavirus disease 2019 (COVID-19): A systematic review and meta-analysis

Backgroundand Aims; To investigate the association between use of angiotensin-converting enzyme inhibitor (ACEI)/angiotensin-receptor blocker (ARB) and outcomes of hypertensive COVID-19 patients, a systematic review and meta-analysis were performed.MethodsWe systematically searched PubMed, EuropePMC, ProQuest, and Cochrane Central Databases using the terms “(COVID-19 OR SARS-CoV-2) AND (angiotensin converting enzyme OR angiotensin receptor blocker)”. The primary and second outcomes were mortality (non-survivor) and severe COVID-19, respectively.ResultsTotally, 7410 patients were included from 15 studies. Pooled analysis showed that the use of ACEI/ARB was not associated with mortality (OR 0.73 [0.38, 1.40], p = 0.34; I²: 81%) and severity (OR 1.03 [0.73, 1.45], p = 0.87; I²: 65%). Pooled adjusted OR showed no risk/benefit associated with ACEI/ARB use in terms of mortality (OR 0.83 [0.54, 1.27], p = 0.38; I²: 0%). Subgroup analysis showed that the use of ARB was associated with reduced mortality (OR 0.51 [0.29, 0.90], p = 0.02; I²: 22%) but not ACEI subgroup (OR 0.68 [0.39, 1.17], p = 0.16; I²: 0%). Meta-regression showed that the association between ACEI/ARB use and mortality in patients with COVID-19 do not varies by gender (p = 0.104). GRADE showed a very low certainty of evidence for effect of ACEI/ARB on mortality and severity. The certainty of evidence was very low for both ACEI and ARB subgroups.ConclusionAdministration of a renin angiotensin system (RAS) inhibitor, was not associated with increased mortality or severity of COVID-19 in patients with hypertension. Specifically, ARB and not ACEI use, was associated with lower mortality.     

Assessment of food environment at work and its association with cardiometabolic health among employed adults in Delhi,India

Background and aimsUnhealthy food environment at work is believed to be playing a role in the burgeoning obesity, cardiometabolic risk, diabetes and cardiovascular diseases in India. Therefore, food environment assessment at work is crucial to understand the effect of food environment and to find its association with cardiometabolic risk among adults in Delhi, India.MethodologyMix-methods study to find association between worksite food environment on the food choices, dietary behavior, and cardio-metabolic health of 455 apparently healthy adults (both males and females) aged 25–55 years was done in urban India.ResultsUnhealthy food environment, poor eating pattern and sedentary lifestyle at work resulted in clustering of CMR factors among the study participants. Work environment assessment revealed that worksites with canteens had higher overall CHEW score for all its domains (Physical, nutritional, and information environment), in comparison to worksites without or no canteens. Four out of ten apparently healthy adults had metabolic syndrome indicating poor cardiometabolic health. The odds of CMR in subjects with access to canteen (unhealthy food) were estimated to be 0.74 (CI: 0.51 to 1.07; p = 0.11) times the odds of CMR in subjects without canteen (limited access to food). Females (β:0.34; 95% CI:0.23, 0.44; p = 0.00) had high CMR factors in comparison to males. Overall cardiometabolic risk factors increased with age (β:0.01; 95% CI:0.01,0.01; p = 0.00).ConclusionFindings of the present study urge the need for dietary and lifestyle intervention along with longitudinal studies to further disentangle the association of the food and work environment on the prevalence of CMR among adults.     

Statin and outcomes of coronavirus disease 2019 (COVID-19): A systematic review,meta-analysis,and meta-regression

AimsOne of the comorbidities associated with severe outcome and mortality of COVID-19 is dyslipidemia. Statin is one of the drugs which is most commonly used for the treatment of dyslipidemic patients. This study aims to analyze the association between statin use and composite poor outcomes of COVID-19.Data synthesisWe systematically searched the PubMed and Europe PMC database using specific keywords related to our aims until November 25th, 2020. All articles published on COVID-19 and statin were retrieved. Statistical analysis was done using Review Manager 5.4 and Comprehensive Meta-Analysis 3 software.ResultsA total of 35 studies with a total of 11, 930, 583 patients were included in our analysis. Our meta-analysis showed that statin use did not improve the composite poor outcomes of COVID-19 [OR 1.08 (95% CI 0.86–1.35), p = 0.50, I² = 98%, random-effect modelling]. Meta-regression showed that the association with composite poor outcomes of COVID-19 was influenced by age (p = 0.010), gender (p = 0.045), and cardiovascular disease (p = 0.012). Subgroup analysis showed that the association was weaker in studies with median age ≥60 years-old (OR 0.94) compared to <60 years-old (OR 1.43), and in the prevalence of cardiovascular disease ≥25% (RR 0.94) compared to <25% (RR 1.24).ConclusionStatin use did not improve the composite poor outcomes of COVID-19. Patients with dyslipidemia should continue taking statin drugs despite COVID-19 infection status, given its beneficial effects on cardiovascular outcomes.     

The prognostic values of thyroid disorders in predicting COVID-19 composite poor outcomes: A systematic review and meta-analysis

Background and aimsIn this meta-analysis, we aimed to evaluate the prognostic properties of thyroid disorder during admission on poor prognosis and factors that may influence the relationship in patients with COVID-19.MethodsA systematic literature search of PubMed, EBSCO, and CENTRAL was conducted from inception to August 27, 2021. The main exposure was unspecified and specified thyroid disorders–hypothyroidism or hypothyroidism. The outcome of interest was the COVID-19 composite poor outcome that comprises of severity, mortality, ICU admission, and hospitalization.ResultsThere were 24,734 patients from 20 studies. Meta-analysis showed that thyroid disorder was associated with composite poor outcome (OR 2.87 (95% CI 2.04–4.04), p < 0.001; I² = 62.4%, p < 0.001). Meta regression showed that age (p = 0.047) and hypertension (p = 0.01), but not gender (p = 0.15), DM (p = 0.10), CAD/CVD (p = 0.38), obesity (p = 0.84), and COPD (p = 0.07) affected the association. Subgroup analysis showed that thyroid disorder increased risk of severe COVID-19 (OR 5.13 (95% CI 3.22–8.17), p < 0.05; I² = 0%, p = 0.70) and mortality (OR 2.78 (95%CI 1.31–5.90), p < 0.05; I² = 80%, p < 0.01). Pooled diagnostic analysis of thyroid disorder yielded a sensitivity of 0.22 (0.13–0.35), specificity of 0.92 (0.87–0.95), and AUC of 0.72. The probability of poor outcome was 38% in patients with thyroid disorder and 15% in patients without thyroid abnormality.ConclusionOn-admission thyroid disorder was associated with poor prognosis in COVID-19 patients.     

Burden of diabetes mellitus and its impact on COVID-19 patients: A meta-analysis of real-world evidence

Background & aimsCoronavirus disease 2019 (COVID-19) spreads rapidly and within no time, it has been declared a pandemic by the World Health Organization. Evidence suggests diabetes to be a risk factor for the progression and poor prognosis of COVID-19. Therefore, we aimed to understand the pooled prevalence of diabetes in patients infected with COVID-19. We also aimed to compute the risk of mortality and ICU admissions in COVID-19 patients with and without diabetes.MethodsA comprehensive literature search was performed in PubMed to identify the articles reporting the diabetes prevalence and risk of mortality or ICU admission in COVID-19 patients. The primary outcome was to compute the pooled prevalence of diabetes in COVID-19 patients. Secondary outcomes included risk of mortality and ICU admissions in COVID-19 patients with diabetes compared to patients without diabetes.ResultsThis meta-analysis was based on a total of 23007 patients from 43 studies. The pooled prevalence of diabetes in patients infected with COVID-19 was found to be 15% (95% CI: 12%–18%), p = <0.0001. Mortality risk was found to be significantly higher in COVID-19 patients with diabetes as compared to COVID-19 patients without diabetes with a pooled risk ratio of 1.61 (95% CI: 1.16–2.25%), p = 0.005. Likewise, risk of ICU admission rate was significantly higher in COVID-19 patients with diabetes as compared to COVID-19 patients without diabetes with a pooled risk ratio of 1.88 (1.20%–2.93%), p = 0.006.ConclusionThis meta-analysis found a high prevalence of diabetes and higher mortality and ICU admission risk in COVID-19 patients with diabetes.     

The impact of obesity and dyslipidemia on Remdesivir effectiveness in hospitalized patients with SARS-CoV-2-related pneumonia: An observational study

Background and aimsRemdesivir (GS-5734), an inhibitor of the viral RNA-dependent, RNA polymerase was early identified as a promising therapeutic candidate against COVID-19. Our aim was to evaluate the impact of several metabolic parameters on Remdesivir effectiveness among hospitalized COVID-19 patients.Methods and resultsWe conducted an observational study on patients with SARS-CoV-2-related pneumonia admitted between May 2020 and September 2021 to the COVID-19 Units of Internal Medicine, Pneumology and Intensive Care of Garibaldi Hospital, Catania, Italy, and treated with Remdesivir. The “Ordinal Scale For Clinical Improvement” was used to assess patients’ clinical improvement within 28 days of hospitalization. Short-term mortality rate was also evaluated.A total of 142 patients with SARS-CoV-2-related pneumonia were studied. The prevalence of obesity (20.7% vs. 41.9%, p = 0.03), the average BMI (27.1 ± 4.4 vs. 31.1 ± 6.1, p < 0.01) and the mean LDL-C levels (78 ± 19 mg/dl vs. 103 ± 18 mg/dl, p = 0.03) were significantly lower in early-improved (EI) compared to not-improved (NI) individuals. Obesity was negatively associated to clinical improvement after Remdesivir (OR 0.48, 95%CI 0.17–0.97, p = 0.04). Both obesity (OR 2.82, 95% CI 1.05–7.71, p = 0.04) and dyslipidemia (OR 2.78, 95%CI 1.17–7.16, p = 0.03) were significantly related to patients’ mortality. Dyslipidemic subjects experienced a slower clinical improvement than non-dyslipidemic ones (Long-Rank p = 0.04).ConclusionOur study showed that unfavorable metabolic conditions such as obesity and dyslipidemia could predict a worse clinical response to Remdesivir as well as the mortality in hospitalized COVID-19 patients. Further prospective and larger-scale studies are needed to confirm these preliminary findings.     

Malnutrition by GLIM criteria in chronic pancreatitis: Prevalence,predictors, and its impact on quality of life

IntroductionMalnutrition in chronic pancreatitis (CP) has prognostic value and there is limited data on the prevalence, predictors of malnutrition in CP and its effect on Quality of life (QoL).MethodsA retrospective study was conducted in patients with CP to assess the prevalence of malnutrition as per the Global Leadership Initiative on Malnutrition (GLIM) criteria. Multivariable-adjusted regression was used to identify independent predictors of both malnutrition and global QoL.ResultsA total of 297 patients were included and the most common etiology of CP was idiopathic (75%) and alcohol (25%). The prevalence of malnutrition was 46.4% as per GLIM criteria. On univariate analysis, the risk of malnutrition was significantly higher in alcoholic etiology (p = 0.001), current alcohol consumption (p = 0.001), smokers (p < 0.001), those having higher cumulative days of pain in last 6 months (p < 0.001) and lower daily calorie intake (p = 0.019). On multivariate analysis, malnutrition was independently associated with current alcohol consumption (Odds ratio: 3.22, p = 0.017), current smokers (OR: 2.23, p = 0.042) and those having higher cumulative days of abdominal pain (OR: 1.01, p < 0.001), while higher daily calorie intake (per 100 kcal) (OR:0.94, p = 0.023) has reduced risk of malnutrition. Malnutrition (p = 0.015) and higher cumulative days of abdominal pain (p < 0.001) were independently associated with lower global QoL in patients with CP.ConclusionMalnutrition is frequent in patients with CP; and current alcohol consumption, smoking and higher cumulative days of abdominal pain independently predicts risk of developing malnutrition. Patients with malnutrition and higher cumulative days of pain has poorer quality of life.