BackgroundCoronavirus disease (COVID-19) has rapidly spread worldwide. However, the effects of asthma, asthma medication, and asthma severity on the clinical outcomes of COVID-19 have not yet been established.MethodsThe study included 7590 de-identified patients, who were confirmed to have COVID-19 using the severe acute respiratory syndrome-coronavirus-2 RNA–polymerase chain reaction tests conducted up to 15th May 2020; and we used the linked-medical claims data provided by the Health Insurance Review and Assessment Service. Asthma and asthma severity (step suggested by GINA) was defined using the diagnostic code and history of asthma medication usage.ResultsAmong 7590 COVID-19 patients, 218 (2.9%) had underlying asthma. The total medical cost associated with COVID-19 patients with underlying asthma was significantly higher than that of other patients. Mortality rate for COVID-19 patients with underlying asthma (7.8%) was significantly higher than that of other patients (2.8%; p<0.001). However, asthma was not an independent risk factor for the clinical outcomes of COVID-19 after adjustment. Asthma medication use and asthma severity also did not affect the clinical outcomes of COVID-19. However, use of oral short-acting β2-agonists (SABA) was an independent factor to increase the total medical cost burden. Patients with step 5 asthma showed significant prolonged admission duration than those with step 1 asthma in both univariate and multivariate analysis.ConclusionsAsthma led to poor outcomes of COVID-19; however, underlying asthma, use of asthma medication, and asthma severity were not independent factors for poor clinical outcomes of COVID-19, generally.
INTRODUCTION:
The use of statins in nonalcoholic fatty liver disease (NAFLD) may reduce cardiovascular morbidity, although their effect on NAFLD itself is not well known. We aimed to investigate the role of statins on the development of de novo NAFLD and progression of significant liver fibrosis.
METHODS:
This study included 11,593,409 subjects from the National Health Information Database of the Republic of Korea entered in 2010 and followed up until 2016. NAFLD was diagnosed by calculating fatty liver index (FLI), and significant liver fibrosis was evaluated using the BARD score. Controls were randomly selected at a ratio of 1:5 from individuals who were at risk of becoming the case subjects at the time of selection.
RESULTS:
Among 5,339,901 subjects that had a FLI < 30 and included in the non-NAFLD cohort, 164,856 subjects eventually had NAFLD developed. The use of statin was associated with a reduced risk of NAFLD development (adjusted odds ratio [AOR] 0.66; 95% confidence interval [CI] 0.65–0.67) and was independent of associated diabetes mellitus (DM) (with DM: AOR 0.44; 95% CI 0.41–0.46, without DM: AOR 0.71; 95% CI 0.69–0.72). From 712,262 subjects with a FLI > 60 and selected in the NAFLD cohort, 111,257 subjects showed a BARD score ≥ 2 and were defined as liver fibrosis cases. The use of statins reduced the risk of significant liver fibrosis (AOR 0.43; 95% CI 0.42–0.44), independent of DM (with DM: AOR 0.31; 95% CI 0.31–0.32, without DM: AOR 0.52; 95% CI 0.51–0.52).
DISCUSSION:
In this large population-based study, statin use decreased the risk of NAFLD occurrence and the risk of liver fibrosis once NAFLD developed.
Self-reported OA was not associated with mortality. RKOA was associated with higher CVD, diabetes and renal mortality, especially in people with early onset of the disease or with obesity.
Determining the ideal ratio of macronutrients for increasing life expectancy remains a high priority in nutrition research. We aim to investigate the association between carbohydrate, fat, and protein intake and all-cause mortality in Koreans. This cohort study investigated 42,192 participants from the Korea National Health and Nutrition Examination Survey (KNHANES) linked with causes of death data (2007–2015). Hazard ratios (HRs) were calculated using the multivariable Cox proportional regression model after adjusting for confounders. We documented 2110 deaths during the follow-up period. Time to exceed 1% of the all-cause mortality rate was longest in participants with 50–60% carbohydrate, 30–40% fat, and 20–30% protein intake. Adjusted hazard ratio (HR) with 95% confidence intervals (CIs) was 1.313 (1.031–1.672, p = 0.0272) for <50% carbohydrate intake, 1.322 (1.116–1.567, p = 0.0013) for ≥60% carbohydrate intake, 1.439 (1.018–2.035, p = 0.0394) for <30% fat intake, and 3.255 (1.767–5.997, p = 0.0002) for ≥40% fat intake. There was no significant association between protein intake proportion and all-cause mortality. We found a U-shaped association between all-cause mortality and carbohydrate intake as well as fat intake, with minimal risk observed at 50–60% carbohydrate and 30–40% fat intake. Our findings suggest current Korean dietary guidelines should be revised to prolong life expectancy.
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