COVID-19, anorexia nervosa and obese patients with an eating disorder - some considerations for practitioners and researchers

Ostojic, Mladena Simeunovic; Maas, Joyce; Bodde, Nynke M.G.

doi:10.1186/s40337-021-00369-w

Cited by 7 publications

(7 citation statements)

References 43 publications

(60 reference statements)

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“…Generally, both underweight and obesity can increase viral infection risk in a U-shaped relation with body mass index (BMI) [ 50 ]. As symptoms and laboratory findings during COVID-19 infections are similar to those found in patients with an ED (especially AN), detection and surveillance of COVID-19 infections in those with an ED may be complicated [ 51 , 52 ]. However, it has been hypothesized that AN patients are less prone to viral infections than individuals with malnutrition [ 52 ].…”

Section: Risk and Resilience Factorsmentioning

confidence: 99%

“…As symptoms and laboratory findings during COVID-19 infections are similar to those found in patients with an ED (especially AN), detection and surveillance of COVID-19 infections in those with an ED may be complicated [ 51 , 52 ]. However, it has been hypothesized that AN patients are less prone to viral infections than individuals with malnutrition [ 52 ]. In one small observational study, having AN did not increase the risk of severe COVID-19 infection [ 53 ].…”

Section: Risk and Resilience Factorsmentioning

confidence: 99%

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Review of the unprecedented impact of the COVID-19 pandemic on the occurrence of eating disorders

Meier

Hoeken

Hoek

2022

Current Opinion in Psychiatry

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Purpose of reviewTo review the recent literature on the impact of the coronavirus disease-2019 (COVID-19) pandemic on incidence and severity of symptoms of eating disorders (EDs).Recent findingsA worrying increase of EDs in- and outpatients has been reported since the COVID-19 pandemic began in 2019/2020. Restrictions implemented during the pandemic to protect populations against COVID-19 increased the risk for onset and for worsening of EDs by disrupting eating and exercise routines, social isolation, lack of support, and limited access to healthcare. Substantial increases since the start of the pandemic have been reported for overall incidence (15%), hospital admissions (48%) and emergency department visits (11%) for EDs, with even higher increases among women and children or adolescents with an ED. During the pandemic, ED patients reported increased severity of ED-specific symptoms and increased anxiety, depression and suicidal ideations and -attempts. Treatments shifted largely toward online methods for continuity of care, despite concerns about the quality of care provided and difficulties in self-monitoring. Our review provides preliminary evidence for a similar effectiveness of online treatment to prepandemic face-to-face treatment. In-person assessment remains essential for detecting EDs and for those requiring medical admission.SummaryAlthough the ongoing COVID-2019 pandemic affected mental health globally, research shows that it particularly affected individuals with an ED diagnosis or at risk for an ED, especially women, children and adolescents, and those with anorexia nervosa.

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Section: Risk and Resilience Factorsmentioning

confidence: 99%

Section: Risk and Resilience Factorsmentioning

confidence: 99%

Review of the unprecedented impact of the COVID-19 pandemic on the occurrence of eating disorders

Meier

Hoeken

Hoek

2022

Current Opinion in Psychiatry

View full text Add to dashboard Cite

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“…Downregulation of the citrate cycle during virus shedding could be due to the high energy consumption caused by the virus [21]. For example, COVID-19 health care practitioners account for energy expenditure increases of up to 10% during asymptomatic viral infections [34]. Such a decrease in the citrate cycle metabolism would cause an imbalance of the anti-oxidization mechanism and inflammatory damage [35].…”

Section: Untargeted Metabolomics and Lipidomics Of Nasal Wash Samplesmentioning

confidence: 99%

Metabolic Profiling from an Asymptomatic Ferret Model of SARS-CoV-2 Infection

et al. 2021

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Coronavirus disease (COVID-19) is a contagious respiratory disease that is causing significant global morbidity and mortality. Understanding the impact of the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection on the host metabolism is still in its infancy but of great importance. Herein, we investigated the metabolic response during viral shedding and post-shedding in an asymptomatic SARS-CoV-2 ferret model (n = 6) challenged with two SARS-CoV-2 isolates. Virological and metabolic analyses were performed on (minimally invasive) collected oral swabs, rectal swabs, and nasal washes. Fragments of SARS-CoV-2 RNA were only found in the nasal wash samples in four of the six ferrets, and in the samples collected 3 to 9 days post-infection (referred to as viral shedding). Central carbon metabolism metabolites were analyzed during viral shedding and post-shedding periods using a dynamic Multiple Reaction Monitoring (dMRM) database and method. Subsequent untargeted metabolomics and lipidomics of the same samples were performed using a Liquid Chromatography Quadrupole Time-of-Flight Mass Spectrometry (LC-QToF-MS) methodology, building upon the identified differentiated central carbon metabolism metabolites. Multivariate analysis of the acquired data identified 29 significant metabolites and three lipids that were subjected to pathway enrichment and impact analysis. The presence of viral shedding coincided with the challenge dose administered and significant changes in the citric acid cycle, purine metabolism, and pentose phosphate pathways, amongst others, in the host nasal wash samples. An elevated immune response in the host was also observed between the two isolates studied. These results support other metabolomic-based findings in clinical observational studies and indicate the utility of metabolomics applied to ferrets for further COVID-19 research that advances early diagnosis of asymptomatic and mild clinical COVID-19 infections, in addition to assessing the effectiveness of new or repurposed drug therapies.

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“…Although anorexia has not been commonly linked to severe COVID-19 in the past, our finding suggests that loss of appetite could be a serious indicator of mortality among Veteran COVID-19 patients. 32 This link can be potentially explained by the poor nutritional and immune status of patients experiencing anorexia, which results in their inability to thwart severe viral infections. This is one of the first studies to identify anorexia as a risk factor for mortality due to COVID-19.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Death, Survival, Need for Intubation, and Need for Oxygen Support Among Admitted COVID-19 Patients of the Veterans Affairs Greater Los Angeles Healthcare System

Yang

et al. 2022

Military Medicine

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Introduction While risk factors for severe COVID-19 infections have been well explored among the public, population-specific studies for the U.S. Veteran community are limited in the literature. By performing a comprehensive analysis of the demographics, comorbidities, and symptomatology of a population of COVID-19 positive Veterans Affairs (VA) patients, we aim to uncover predictors of death, survival, need for intubation, and need for nasal cannula oxygen support among this understudied community. Materials and Methods A retrospective review was conducted of 124 COVID-19 Veteran patients who were admitted from March to October 2020 to the VA Greater Los Angeles Healthcare System (IRB#2020-000272). Chi-square and Fisher’s exact tests were employed to assess differences in baseline demographic and clinical variables between Veterans who survived COVID-19 versus those who succumbed to COVID-19 illness. Multivariate logistic regression and Cox regression analyses were employed to assess predictors of outcome variables, including death, survival, need for intubation, and need for oxygen support (via nasal cannula). Covariates included a wide range of demographic, comorbidity-related, symptom-related, and summary index variables. Results Our study population consisted of primarily senior (average age was 73) Caucasian and African American (52.5% and 40.7%, respectively) Veterans. Bivariate analyses indicated that need for intubation was significantly associated with mortality (P = 0.002). Multivariate analyses revealed that age (P < 0.001, adjusted odds ratio (OR) = 1.16), dyspnea (P = 0.015, OR = 7.73), anorexia (P = 0.022, OR = 16.55), initial disease severity as classified by WHO (P = 0.031, OR = 4.55), and having more than one of the three most common comorbidities (hypertension, diabetes, and cardiac disease) and symptoms (cough, fever, and dyspnea) among our sample (P = 0.009; OR = 19.07) were independent predictors of death. Furthermore, age (P < 0.001, hazard ratio (HR) = 1.14), cerebrovascular disease (P = 0.022, HR = 3.76), dyspnea (P < 0.001, HR = 7.71), anorexia (P < 0.001, HR = 16.75), and initial disease severity as classified by WHO (P = 0.025, HR = 3.30) were independent predictors of poor survival. Finally, dyspnea reliably predicted need for intubation (P = 0.019; OR = 29.65). Conclusions Several independent predictors of death, survival, and need for intubation were identified. These risk factors may provide guidelines for risk-stratifying Veterans upon admission to VA hospitals. Additional investigations of COVID-19 prognosis should be conducted on the larger U.S. Veteran population to confirm our findings and add to the current body of literature.

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COVID-19, anorexia nervosa and obese patients with an eating disorder - some considerations for practitioners and researchers

Cited by 7 publications

References 43 publications

Review of the unprecedented impact of the COVID-19 pandemic on the occurrence of eating disorders

Review of the unprecedented impact of the COVID-19 pandemic on the occurrence of eating disorders

Metabolic Profiling from an Asymptomatic Ferret Model of SARS-CoV-2 Infection

Predictors of Death, Survival, Need for Intubation, and Need for Oxygen Support Among Admitted COVID-19 Patients of the Veterans Affairs Greater Los Angeles Healthcare System

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