BackgroundPublished data regarding the impact of obesity on COVID-19 outcomes are inconsistent. However, in most studies, body composition was assessed using body mass index (BMI) alone, thus neglecting the presence and distribution of adipose tissue. Therefore, we aimed to investigate the impact of body and visceral fat on COVID-19 outcomes.MethodsObservational, prospective cohort study included 216 consecutive COVID-19 patients hospitalized at University Clinical Center Kragujevac (Serbia) from October to December 2021. Body composition was assessed using the BMI, body fat percentage (%BF), and visceral fat (VF) via bioelectrical impedance analysis (BIA). In addition to anthropometric measurements, variables in the research were socio-demographic and medical history data, as well as admission inflammatory biomarkers. Primary end-points were fatal outcomes and intensive care unit (ICU) admission.ResultsThe overall prevalence of obesity was 39.3% according to BMI and 50.9% according to % BF, while 38.4% of patients had very high VF levels. After adjusting odds ratio values for cofounding variables and obesity-related conditions, all three anthropometric parameters were significant predictors of primary end-points. However, we note that % BF and VF, compared to BMI, were stronger predictors of both mortality (aOR 3.353, aOR 3.05, and aOR 2.387, respectively) and ICU admission [adjusted odds ratio (aOR) 7.141, aOR 3.424, and aOR 3.133, respectively].ConclusionObesity is linked with COVID-19 mortality and ICU admission, with BIA measurements being stronger predictors of outcome compared to BMI use alone.

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Introduction. Coronary artery spasm (CAS) is defined as a transient vasoconstriction of an epicardial coronary artery with a total or subtotal vessel occlusion, causing myocardial ischemia. Although the overall incidence of CAS during coronary angiography is estimated to be between 0.3% and 1%, CAS remains an underdiagnosed and undertreated cause of acute cardiac events. Case outline. In this article, we report a case of a 62-year-old male presenting with cardiac arrest and repeated ST-segment elevations during chest pain episodes, caused by initially unrecognized CAS. Although percutaneous coronary intervention (PCI) is generally not recommended for the treatment of CAS, due to clinical manifestations and the presence of underlying flow-limiting stenosis, we decided to perform PCI of the left anterior descending coronary artery. During the two-year-follow up period, the patient reported no chest pains nor exercise limitations at regular outpatient controls. Conclusion. Coronary artery spasms should be considered an unrecognized cause of refractory angina, acute coronary syndrome, malignant arrhythmia, and even cardiac arrest. Although medical therapy is the first option for CAS treatment, PCI could be a safe and effective approach in selected patients.

Obesity is a global health problem associated with numerous pathological conditions. Unhealthy eating habits and the lack of regular physical activity are considered the most common cause of disordered nutritional status. The aim of the research was to determine the nutritional status in student population and the predictors which determine this condition. The cross-sectional study was conducted on 262 students of the Faculty of Medical Sciences in Kragujevac (130 males and 132 females). Body weight and height, body mass index (BMI) and visceral fat (VF) were measured. Each respondent completed a specially designed questionnaire considering sociodemographic data, eating habits and physical activity. The majority of students have normal BMI values (75.6%), 5.3% were classified as underweight, 14.9% as over-weight and 4.3% as obese. Normal VF values were found in 93.1% of subjects, while high in 5.7% and very high in 1.1%. A statistically significant difference in BMI and VF values was found between male and female gender (24.41 vs. 21.05, Sig = 0.000 and 5.47 vs. 3.07, Sig = 0.000, respectively), as well as between students of the first 4 and the last 2 years of study (Sig = 0.019 and 0.000 respectively). Unhealthy eating habits, such as the consumption of sweets, snacks, fast foods and white bread, and the absence of regular physical activity were statistically more present in overweight/obese respondents. Given the significant presence of pre-obesity/obesity in the examined population, corrective measures should be taken in this population in order to avoid a major health problem in the future.