Patients with acute respiratory distress syndrome due to infection with the novel coronavirus SARS-COV2 are currently considered at high risk of developing thromboembolic complications in both venous and arterial vessels. The use of anticoagulants for preventive or curative purposes should be considered to reduce the risk of thromboembolic events. We report a case of a patient with severe COVID-19 acute respiratory distress syndrome who consecutively developed a right femoral deep vein thrombosis related to the femoral central line and acute ischemia of the left upper limb related to a radial arterial line. He was under a therapeutic dose of low molecular weight heparin twice a day three days before. The femoral vein was free of thrombosis while the central line was placed under a duplex ultrasound. Thromboembolic events can occur in patients with severe COVID-19 despite therapeutic anticoagulants. Close monitoring of vascular access with duplex ultrasound may be required.

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Animal studies show that CD36, a fatty acid translocase, is involved in fat detection and preference, but these findings have not been reported in humans. The objective of this study was to determine whether human genetic variation in 5 common CD36 polymorphisms is associated with oral fat perception of Italian salad dressings, self-reported acceptance of high-fat foods and obesity in African-American adults (n = 317). Ratings of perceived oiliness, fat content, and creaminess were assessed on a 170-mm visual analogue scale (VAS) in response to salad dressings that were 5%, 35%, and 55% fat-by-weight content. Acceptance of added fats and oils and high-fat foods was self-reported and anthropometric measures were taken in the laboratory. DNA was isolated from saliva and genotyped at 5 CD36 polymorphisms. Three polymorphisms, rs1761667, rs3840546, and rs1527483 were associated with the outcomes. Participants with the A/A genotype at rs1761667 reported greater perceived creaminess, regardless of the fat concentration of the salad dressings (P < 0.01) and higher mean acceptance of added fats and oils (P = 0.02) compared to those with other genotypes at this site. Individuals who had C/T or T/T genotypes at rs1527483 also perceived greater fat content in the salad dressings, independent of fat concentration (P = 0.03). BMI and waist circumference were higher in participants who were homozygous for a deletion (D/D) at rs3840546, compared to I/D or D/D individuals (P < 0.001), but only 2 D/D individuals were tested, so this finding needs replication. This is the first study to demonstrate an association between common variants in CD36 and fat ingestive behaviors in humans.

AbstractCoronavirus disease 2019 (COVID-19), currently a worldwide pandemic, is a viral illness caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The suspected contribution of thrombotic events to morbidity and mortality in COVID-19 patients has prompted a search for novel potential options for preventing COVID-19-associated thrombotic disease. In this article by the Global COVID-19 Thrombosis Collaborative Group, we describe novel dosing approaches for commonly used antithrombotic agents (especially heparin-based regimens) and the potential use of less widely used antithrombotic drugs in the absence of confirmed thrombosis. Although these therapies may have direct antithrombotic effects, other mechanisms of action, including anti-inflammatory or antiviral effects, have been postulated. Based on survey results from this group of authors, we suggest research priorities for specific agents and subgroups of patients with COVID-19. Further, we review other agents, including immunomodulators, that may have antithrombotic properties. It is our hope that the present document will encourage and stimulate future prospective studies and randomized trials to study the safety, efficacy, and optimal use of these agents for prevention or management of thrombosis in COVID-19.

Objective Eating behavior traits measured in early life predict eating behavior and weight trajectories later in development, and may be associated with certain parental feeding behaviors. Our goal was to investigate the relationship between a range of feeding behaviors, and preschoolers’ appetitive traits. Method Four hundred thirty-nine parents of UK 3–5 year olds completed scales measuring authoritarian vs. authoritative forms of limiting (Restriction vs. Monitoring) and promoting (Pressuring vs. Prompting) intake, as well as Emotional and Instrumental Feeding. Parents also completed scales measuring child Food responsiveness and Satiety responsiveness. Child BMI z-scores were calculated based on measured heights and weights. Results Parental Restriction was significantly associated with greater child Food responsiveness (p <.001), but parental Monitoring was not. Parental Pressuring was significantly associated with greater child Satiety responsiveness (p <.001), while parental Prompting was not. Parental Instrumental and Emotional feeding were both associated with greater child Food responsiveness (p <.001). All relationships were independent of child BMI z-score. Discussion Prospective data are needed to determine whether the parent–child feeding relationships identified here promote, or protect against, the development of eating pathology in children. However, our results suggest that cross-sectional associations depend on the style (e.g., authoritarian vs. authoritative), as well as the type of feeding behavior measured.

We come into the world with enduring predispositions towards food, which interact with environmental factors to influence our eating behaviors and weight trajectories. But our fates are not sealed – by learning more about this process we can identify ways to intervene. To advance this goal this we need to be able to assess appetitive traits such as food cue responsiveness and satiety sensitivity at different developmental stages. Assessment methods might include behavioral measures (e.g. eating behavior tests, psychometric questionnaires), but also biomarkers such as brain responses to food cues measured using fMRI. Evidence from infants, children and adolescents suggests that these indices of appetite differ not only with body weight, but also with familial obesity risk as assessed by parent weight, which reflects both genetic and environmental influences, and may provide a useful predictor of obesity development. Behavioral and neural approaches have great potential to inform each other: examining eating behavior can help us identify meaningful appetitive endophenotypes whose neural bases can be probed, while increasing knowledge of the shared neurobiology underlying appetite, obesity, and related behaviors and disorders may ultimately lead to innovative generalized interventions. Another challenge will be to combine comprehensive behavioral and neural assessments of appetitive traits with measures of relevant genetic and environmental factors within long-term prospective studies. This approach may help to identify the biobehavioral precursors of obesity, and lay the foundations for targeted neurobehavioral interventions that can interrupt the pathway to excess weight.

Variations in fat preference and intake across humans are poorly understood in part because of difficulties in studying this behavior. The objective of this study was to develop a simple procedure to assess fat discrimination, the ability to accurately perceive differences in the fat content of foods, and assess the associations between this phenotype and fat ingestive behaviors and adiposity. African-American adults (n=317) were tested for fat discrimination using 7 forced choice same/different tests with Italian salad dressings that ranged in fat-by-weight content from 5–55%. Performance on this procedure was determined by tallying the number of trials in which a participant correctly identified the pair of samples as “same” or “different” across all test pairs (ranging from 1–7). Individuals who received the lowest scores on this task (≤3 out of 7 correct) were classified as fat non-discriminators (n=33) and those who received the highest scores (7 out of 7 correct) were classified as fat discriminators (n=59). These 2 groups were compared for the primary outcome variables: reported food intake, preferences, and adiposity. After adjusting for BMI, sex, age, and dietary restraint and disinhibition, fat non-discriminators reported greater consumption of both added fats and reduced fat foods (p<0.05 for both). Fat non-discriminators also had greater abdominal adiposity compared to fat discriminators (p<0.05). Test-retest scores performed in a subset of participants (n=40) showed moderate reliability of the fat discrimination test (rho=0.53;p<0.01). If these results are replicated, fat discrimination may serve as clinical research tool to identify participants who are at risk for obesity and other chronic diseases due to increased fat intake.

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