COVID-19 is currently considered an inflammatory disease affecting the entire organism. In severe forms, an augmented inflammatory response leads to the fulminant “cytokine storm”, which may result in severe multisystemic end-organ damage. Apart from the acute inflammatory response, it seems that chronic inflammation also plays a major role in the clinical evolution of COVID-19 patients. Pre-existing inflammatory conditions, such as those associated with chronic coronary diseases, type 2 diabetes mellitus or obesity, may be associated with worse clinical outcomes in the context of COVID-19 disease. These comorbidities are reported as powerful predictors of poor outcomes and death following COVID-19 disease. Moreover, in the context of chronic coronary syndrome, the cytokine storm triggered by SARS-CoV-2 infection may favor vulnerabilization and rupture of a silent atheromatous plaque, with consequent acute coronary syndrome, leading to a sudden deterioration of the clinical condition of the patient. This review aims to present the current status of knowledge regarding the link between COVID-19 mortality, systemic inflammation and several major diseases associated with poor outcomes, such as cardiovascular diseases, diabetes and obesity.
Introduction: The psoriatic patients have an increased number of associated comorbidities. Of these, cardiovascular diseases present the highest incidence and severity. The understanding of the cardiovascular risk in patients with psoriatic arthritis was supported from the rheumatoid arthritis studies that suggested that patients with psoriatic arthritis have a risk of cardiovascular diseases similar to patients presenting rheumatoid arthritis. The presence of the metabolic syndrome further increases the risk of cardiovascular disease. The purpose of this study was to determine the prevalence of metabolic syndrome and its components in two groups of patients: those presenting psoriatic arthritis and those with rheumatoid arthritis.
Material and method: The study included two groups of patients: group one - 40 patients with psoriatic arthritis defined by Moll and Wright criteria, respectively the group two - 51 patients with rheumatoid arthritis defined by American College of Rheumatology (ACR) criteria. The metabolic syndrome was defined according to the consensus definition (incorporating IDF and American Heart Association/National Heart, Lung and Blood Institute -AHA/NHLBI definitions).
Results: We enrolled in the study 91 patients having a mean age of 57.7±10.4SD (54.7±10.2 SD psoriatic arthritis, 60.01±10.0 SD rheumatoid arthritis). The mean disease duration (years) was 4.12±4.1SD for psoriatic arthritis and 6.7±7.8SD for rheumatoid arthritis. The prevalence of the metabolic syndrome was 67.5% in the group with psoriatic arthritis and 37.2% in patients with rheumatoid arthritis. The psoriatic patients had a higher prevalence of impared fasting glucose (52.5% vs 27.4%, p=0.018), and elevated trygliceride values as compared with those presenting rheumatoid arthritis (25% vs 11% p=0.0004).
Conclusions: The prevalence of metabolic syndrome is increased in patients with psoriatic arthritis as compared to patients with rheumatoid arthritis.
Our study aimed to emphasize the high rates of maternal smoking during pregnancy and its importance in LBW outcomes in Romanian pregnant women. Moreover, the study highlights disparities in smoking status observed in ethnic minorities and those living in poverty.
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