Inflammation and vascular dysfunction: The negative synergistic combination of diabetes and COVID‐19

Bolla, Andrea Mario; Loretelli, Cristian; Montefusco, Laura; Finzi, Giovanna; Abdi, Reza; Nasr, Moufida Ben; Lunati, Maria Elena; Pastore, Ida; Bonventre, Joseph V.; Nebuloni, Manuela; Rusconi, Stefano; Santus, Pierachille; Zuccotti, Gianvincenzo; Galli, Massimo; D’Addio, Francesca; Fiorina, Paolo

doi:10.1002/dmrr.3565

Cited by 10 publications

(13 citation statements)

References 194 publications

(283 reference statements)

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“…This trend of patient background was similar to that in previous reports 20 . Previously, reports also described the strong confounding of diabetes regarding cardiovascular damage and COVID‐19 severity 30,31 . However, having a cardiovascular disease was not a significant risk factor of critical outcomes in each group.…”

Section: Discussionsupporting

confidence: 89%

“…20 Previously, reports also described the strong confounding of diabetes regarding cardiovascular damage and COVID-19 severity. 30,31 However, having a cardiovascular disease was not a significant risk factor of critical however, the lower prevalence of cardiovascular disease in our cohort, compared with Western studies, might be the reason. Additionally, the prevalence of severe COVID-19 was higher among these patients than in those without diabetes.…”

Section: Factors Related To Covid-19 Severity In the Non-diabetes Pre...contrasting

confidence: 63%

“… 20 Previously, reports also described the strong confounding of diabetes regarding cardiovascular damage and COVID‐19 severity. 30 , 31 However, having a cardiovascular disease was not a significant risk factor of critical outcomes in each group. The reason for this discrepancy is unknown; however, the lower prevalence of cardiovascular disease in our cohort, compared with Western studies, might be the reason.…”

Section: Discussionmentioning

confidence: 82%

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Clinical significance of prediabetes, undiagnosed diabetes and diagnosed diabetes on critical outcomes in COVID‐19: Integrative analysis from the JapanCOVID‐19 task force

Fukushima

Chubachi

Namkoong

et al. 2022

Diabetes Obesity Metabolism

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Aim Diabetes mellitus (DM) is a known risk factor for severe coronavirus disease 2019 (COVID‐19), but the clinical impact of undiagnosed diabetes and prediabetes in COVID‐19 are unclear particularly in Japan. We clarify the difference in clinical characteristics, including age, sex, body mass index and co‐morbidities, laboratory findings and critical outcomes, in a large Japanese COVID‐19 cohort without diabetes, with prediabetes, undiagnosed diabetes and diagnosed diabetes, and to identify associated risk factors. Materials and Methods This multicentre, retrospective cohort study used the Japan COVID‐19 Task Force database, which included data on 2430 hospitalized COVID‐19 patients from over 70 hospitals from February 2020 to October 2021. The prevalence of prediabetes, undiagnosed diabetes and diagnosed diabetes were estimated based on HbA1c levels or a clinical diabetes history. Critical outcomes were defined as the use of high‐flow oxygen, invasive positive‐pressure ventilation or extracorporeal membrane oxygenation, or death during hospitalization. Results Prediabetes, undiagnosed diabetes and diagnosed diabetes were observed in 40.9%, 10.0% and 23.0%, respectively. Similar to diagnosed diabetes, prediabetes and undiagnosed diabetes were risk factors for critical COVID‐19 outcomes (adjusted odds ratio [aOR] [95% CI]: 2.13 [1.31‐3.48] and 4.00 [2.19‐7.28], respectively). HbA1c was associated with COVID‐19 severity in prediabetes patients (aOR [95% CI]: 11.2 [3.49‐36.3]), but not other groups. Conclusions We documented the clinical characteristics and outcomes of Japanese COVID‐19 patients according to HbA1c levels or diabetes co‐morbidity. As well as undiagnosed and diagnosed diabetes, physicians should be aware of prediabetes related to COVID‐19 severity.

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Section: Discussionsupporting

confidence: 89%

Section: Factors Related To Covid-19 Severity In the Non-diabetes Pre...contrasting

confidence: 63%

Section: Discussionmentioning

confidence: 82%

See 1 more Smart Citation

Clinical significance of prediabetes, undiagnosed diabetes and diagnosed diabetes on critical outcomes in COVID‐19: Integrative analysis from the JapanCOVID‐19 task force

Fukushima

Chubachi

Namkoong

et al. 2022

Diabetes Obesity Metabolism

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“…Aggravating affects of the ARDs on cardiovascular comorbidities, diabetes onset, and chronic liver and kidney diseases have long been debating. [11,12] Older age and type 2 diabetes (T2D), hypertension, liver and kidney diseases were signi cantly associated with an increased likelihood of mortality. [13] NCDs are also leading cause of mortality/morbidity in the world.…”

Section: Introductionmentioning

confidence: 99%

Weight loss treatment of COVID-19 in patients with NCDs: a pilot prospective clinical trial

Oshakbayev

Durmanova

Zhankalova

et al. 2023

Preprint

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Background COVID-19 in comorbidity with non-communicable chronic diseases (NCDs) complicate the diagnosis, treatment, prognosis, and increase mortality rate. Objective. To evaluate the effects of the weight loss treatment on clinic/laboratory inflammation and metabolic profile, reactive oxygen species (ROS) body composition in patients with COVID-19 in comorbidity with NCDs. Design: A 6-week open, pilot prospective clinical trial. Setting: The study included 72 adult patients with COVID and influenza in comorbidity with type 2 diabetes (T2D), hypertension, and NASH. Interventions: The treatment involved a fast-weight-loss-method (Analimentary detoxication, ANADETO) including calorie restriction to 50–100 kcal/day, salt intake to 5–6 gr/day, hot water drinking 1000–1500 ml/day, walking > 2,000 steps/day, and sexual self-restraint. Main outcome measures: Primary endpoints: Clinic/infectious/inflammation tests for COVID/Influenza; weight loss during 14 days. Secondary endpoints: fasting blood glucose, HbA1c, blood insulin; systolic/diastolic BP; blood lipids; ALT/AST, chest-CT-scan. Results The patients weight lost from baseline (-9,14 − 12,4%; P < 0.001); COVID and Influenza were a negative in > 96.3% patients at the 14 days. Systolic/diastolic BP normalized (P < 0.0001), glucose/lipids metabolism (P < 0.0001); ALT/AST normalized (P < 0.0001), platelets increased from baseline (P < 0.0001), chest-CT (P < 0.0001) at 6-week follow-up. The previous antidiabetic, antihypertensive, anti-inflammatory and hepatoprotective, and other symptomatic medications were adequately decreased in 2–5 days to completely stopping by 5–8 days treatment. Conclusions The non-pharmacological treatment including fast weight loss is clinical/laboratory benefit in treatment of patients with COVID-19 and Influenza in comorbidity with T2D, hypertension, and NASH. Trial Registration: ClinicalTrials.gov NCT05635539 (12/01/2022): https://clinicaltrials.gov/ct2/show/NCT05635539?term=NCT05635539&draw=2&rank=1 .

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“…Aggravating affects of the ARDs on cardiovascular comorbidities, diabetes onset, and chronic liver and kidney diseases have long been debating. (11,12) Older age and type 2 diabetes (T2D), hypertension, liver and kidney diseases were significantly associated with an increased likelihood of mortality. (13) NCDs are also leading cause of mortality and morbidity in the world.…”

Section: Introductionmentioning

confidence: 99%

Weight loss in patients with COVID-19 and Influenza in comorbidity with NCDs: a pilot prospective clinical trial

Oshakbayev

Durmanova

Idrisov

et al. 2022

Preprint

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Background COVID and Influenza with non-communicable chronic diseases (NCDs) complicate the diagnosis, treatment, prognosis, and increase mortality rate. The aim: to evaluate the effects of the fast weight loss on clinic and laboratory inflammation profile, metabolic profile, reactive oxygen species (ROS) and body composition in patients with COVID and Influenza in comorbidity with NCDs. Methods A 6-week open, pilot prospective clinical trial including 62 adult patients with COVID (n=27) and influenza (n=35) in comorbidity with T2D, hypertension, and NASH. Overweight in 33 patients (53.2%) with BMI 28.14±0.39 kg/m2, and 29 patients without overweight with BMI 23.37 ± 0.38 kg/m2. T2D in 26 (41.9%); Hypertension in 38 (61.3%) (incl. 12 patients with T2D); NASH in 51 patients (82.2%) (incl. 8 patients with NASH, T2D and Hypertension; 6 patients with NASH and T2D; 18 patients with NASH and Hypertension; 19 patients with only NASH). Primary endpoints Clinic/infectious/inflammation tests for COVID and Influenza; weight loss during 14 days. Secondary endpoints: fasting blood glucose, HbA1c, blood insulin; systolic/diastolic BP; blood lipids; ALT, AST, chest CT-scan. Results The patients with overweight lost -12,4% from baseline or BMI= -4.2 kg/m2, and patients without overweight lost -9,14% from baseline or BMI= -2.2 kg/m2 (-9.7±0.7 kg vs. -6.4±0.6 kg, respectively; P<0.001) at 14-day of the treatment. Weight loss in both groups was due to reduction of fat mass (P<0.0001). Sputum production increased in 1.0-1.5 liter/day on 2-3 days, decreased in 7-9 days. Body temperature normalized in 6-9 days. On 3-5 days, in most patients their urine became turbid/muddy/intensively colored. Urine microscopy showed organic and non-organic salts, and leukocyturia (20-35/sight). White blood cells, lymphocytes, NLR normalized at 14 days (P<0.0001). Total-fibrinogen, C-reactive-protein, and Erythrocyte-sedimentation-rate, ROS normalized at 14-day of treatment (P<0.0001). COVID and Influenza were a negative in >96.3% patients at 14-day. Systolic/diastolic BP decreased (161.3±1.31/101.6±0.85 vs. 118.3±0.46/80.89±0.66, P<0.0001), glucose and lipids metabolism in patients with T2D (n=26) (P<0.0001); ALT and AST in patients with NASH (n=51) were significantly normalized (from baseline 134.3±5.4 and 166.5±5.5 U/L, respectively, and at 14-day to 78.4±4.2 and 92.4±4.9 U/L, respectively (P<0.0001)), platelets increased from baseline (186.5±4.6, ×109/L) at 14-day of treatment (238.5±5.8, ×109/L) (P<0.0001), and at 6-week follow-up (278.3±6.9, ×109/L) (P<0.0001). The mean score of chest-CT for the patients (n=44) was 13.12±0.38 from baseline, and at 14-day the score was 1.72±0.12 (P<0.0001). ROS level normalized at 14-day treatment and 6-week follow-up from baseline (P<0.0001). The previous antidiabetic, antihypertensive, antiinflammatory and hepatoprotective, and other symptomatic medications were adequately decreased in 2-5 days to completely stopping by 5-8 days treatment. Conclusions The fast weight loss is clinical/laboratory benefit in treatment of patients with COVID-19 and Influenza in comorbidity with T2D, hypertension, and NASH.

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Inflammation and vascular dysfunction: The negative synergistic combination of diabetes and COVID‐19

Cited by 10 publications

References 194 publications

Clinical significance of prediabetes, undiagnosed diabetes and diagnosed diabetes on critical outcomes in COVID‐19: Integrative analysis from the JapanCOVID‐19 task force

Clinical significance of prediabetes, undiagnosed diabetes and diagnosed diabetes on critical outcomes in COVID‐19: Integrative analysis from the JapanCOVID‐19 task force

Weight loss treatment of COVID-19 in patients with NCDs: a pilot prospective clinical trial

Weight loss in patients with COVID-19 and Influenza in comorbidity with NCDs: a pilot prospective clinical trial

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