“…The full-text screening of these studies led to the exclusion of 17 studies that did not meet the inclusion criteria. We thereby identified a total of five articles from the PubMed search that were appropriate for discussing the continuation of diet therapy for patients with epilepsy during the COVID-19 pandemic [11] , [12] , [13] , [14] , [15] . Fig.…”
Section: Resultsmentioning
confidence: 99%
“… Five patients were able to continue cKD in the following unique ways:Follow-up of cKD with video visits.Initiation of cKD by outpatient with telemedicine.Initiation of cKD by short admission and phone education.Initiation of MAD as a temporary alternative to cKD by telemedicine and e-mail.Follow-up of MAD with telemedicine. Ferraris et al, 2020 [15] Letter -(Approximately 20 visits with cKD or MAD) Italy 2/10 (As a case series) March–May, 2020 - One patient had more difficulty in continuing cKD, but this patient already had poor compliance history prior to the COVID-19 pandemic. Telemedicine was conducted without major problems.…”
“…The full-text screening of these studies led to the exclusion of 17 studies that did not meet the inclusion criteria. We thereby identified a total of five articles from the PubMed search that were appropriate for discussing the continuation of diet therapy for patients with epilepsy during the COVID-19 pandemic [11] , [12] , [13] , [14] , [15] . Fig.…”
Section: Resultsmentioning
confidence: 99%
“… Five patients were able to continue cKD in the following unique ways:Follow-up of cKD with video visits.Initiation of cKD by outpatient with telemedicine.Initiation of cKD by short admission and phone education.Initiation of MAD as a temporary alternative to cKD by telemedicine and e-mail.Follow-up of MAD with telemedicine. Ferraris et al, 2020 [15] Letter -(Approximately 20 visits with cKD or MAD) Italy 2/10 (As a case series) March–May, 2020 - One patient had more difficulty in continuing cKD, but this patient already had poor compliance history prior to the COVID-19 pandemic. Telemedicine was conducted without major problems.…”
“…In addition, it is a challenging issue to maintain KDTs during the ongoing COVID-19 pandemic, and the use of telemedicine [ 35 ], e-health applications [ 36 ], and E-mail [ 37 ] can help the dietary management. We will develop a Taiwanese KetoApp, which, through the application of connectivity alteration at six months of KDTs, will help us choose the appropriate candidates for the KD program more precisely and facilitate the continuation of KD management.…”
Ketogenic diet therapies (KDTs) are widely used treatments for epilepsy, but the factors influencing their responsiveness remain unknown. This study aimed to explore the predictors or associated factors for KDTs effectiveness by evaluating the subtle changes in brain functional connectivity (FC) before and after KDTs. Segments of interictal sleep electroencephalography (EEG) were acquired before and after six months of KDTs. Analyses of FC were based on network-based statistics and graph theory, with a focus on different frequency bands. Seventeen responders and 14 non-responders were enrolled. After six months of KDTs, the responders exhibited a significant functional connectivity strength decrease compared with the non-responders; reductions in global efficiency, clustering coefficient, and nodal strength in the beta frequency band for a consecutive range of weighted proportional thresholds were observed in the responders. The alteration of betweenness centrality was significantly and positively correlated with seizure reduction rate in alpha, beta, and theta frequency bands in weighted adjacency matrices with densities of 90%. We conclude that KDTs tended to modify minor-to-moderate-intensity brain connections; the reduction of global connectivity and the increment of betweenness centrality after six months of KDTs were associated with better KD effectiveness.
“…The authors and the other members of the International Ketogenic Diet Study Group, pediatric consensus group, reported no issues regarding the maintenance of ketosis and seizure control in their group, and raised no questions about the safety of the ketogenic diet in case of respiratory infection. A similar approach in similar setting was used by Ferraris et al [ 57 ] and no major issues were reported, but they did not specify if any of their patients was infected by COVID-19.…”
Section: Covid-19 Lockdown and Kdsmentioning
confidence: 99%
“…These may be due to the impaired respiratory mechanics, increased airway resistance and impaired gas exchange [ 25 , 28 , 54 ], as well as obesity-related comorbidities [ 63 ], which appear to be directly related to the onset of complications and severe course of COVID-19. In particular, OSAS [ 38 ], metabolic syndrome, hypertension, Non-Alcoholic Fatty Liver Disease (NAFLD) and diabetes or insulin resistance have all shown to affect COVID-19 outcome negatively [ 55 , 56 , 57 , 58 ]. Finally, it should not be overlooked that obesity is associated with low chronic inflammation within a state of immunological dysfunction that can lead to increased risk of allergies [ 64 ] or ineffective response against infections [ 35 ] and vaccines [ 65 ].…”
Section: Conclusion and Future Perspectivementioning
Severe obesity is associated with an increased risk of admission to intensive care units and need for invasive mechanical ventilation in patients with COVID-19. The association of obesity and COVID-19 prognosis may be related to many different factors, such as chronic systemic inflammation, the predisposition to severe respiratory conditions and viral infections. The ketogenic diet is an approach that can be extremely effective in reducing body weight and visceral fat in the short term, preserving the lean mass and reducing systemic inflammation. Therefore, it is a precious preventive measure for severely obese people and may be considered as an adjuvant therapy for patients with respiratory compromise.
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