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The Influence of Obesity and Weight Loss on the Bioregulation of Innate/Inflammatory Responses: Macrophages and Immunometabolism.
Gálvez, I, Navarro, MC, Martín-Cordero, L, Otero, E, Hinchado, MD, Ortega, E
Nutrients. 2022;(3)
Abstract
Obesity is characterized by low-grade inflammation and more susceptibility to infection, particularly viral infections, as clearly demonstrated in COVID-19. In this context, immunometabolism and metabolic flexibility of macrophages play an important role. Since inflammation is an inherent part of the innate response, strategies for decreasing the inflammatory response must avoid immunocompromise the innate defenses against pathogen challenges. The concept "bioregulation of inflammatory/innate responses" was coined in the context of the effects of exercise on these responses, implying a reduction in excessive inflammatory response, together with the preservation or stimulation of the innate response, with good transitions between pro- and anti-inflammatory macrophages adapted to each individual's inflammatory set-point in inflammatory diseases, particularly in obesity. The question now is whether these responses can be obtained in the context of weight loss by dietary interventions (low-fat diet or abandonment of the high-fat diet) in the absence of exercise, which can be especially relevant for obese individuals with difficulties exercising such as those suffering from persistent COVID-19. Results from recent studies are controversial and do not point to a clear anti-inflammatory effect of these dietary interventions, particularly in the adipose tissue. Further research focusing on the innate response is also necessary.
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COVID-19 in perinatal period: questions and consequences.
Tunçel, D, Bilgin, LK, İnce, Z, Çoban, A
The Turkish journal of pediatrics. 2022;(1):1-9
Abstract
BACKGROUND The effect of COVID-19 infection on newborn babies is not yet clear. Babies born to pregnant women with suspected or proven COVID-19 or babies who had contact with infected people are considered to be at risk. In this review, intrauterine problems that may be caused by COVID-19 infection, delivery room approach, postnatal follow-up, precautions and controversies regarding breastfeeding and vaccination are discussed. METHODS The articles published between March 2020 and June 2021 were searched in Pubmed, Cochrane Library and Google Scholar databases using the keywords COVID-19 and newborn, perinatal period, vertical transmission, pregnancy, breast milk and vaccines. The updated information and recommendations are presented. CONCLUSIONS Our knowledge of the perinatal and neonatal effects of COVID-19 infection changes rapidly. Therefore, close follow-up of the mother-infant dyads is important. Larger epidemiological and clinical cohort studies are needed to better understand the possible implications and long-term outcomes of COVID-19 infection and also maternal vaccination in newborn infants.
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Impact of COVID-19 on the Destiny of Bariatric Patients.
Gualtieri, P, Marchetti, M, Renzo, LD, De Santis, GL, Palma, R, Colica, C, Frank, G, De Lorenzo, A, Di Lorenzo, N
Nutrients. 2022;(1)
Abstract
Obese patients reported worse outcomes of COVID-19 related to prothrombotic and low-grade inflammation status. During the SARS-CoV-2 outbreak, all non-elective surgeries were postponed, including bariatric surgery (BS). This umbrella review wants to underline obesity as a condition provoking low-grade chronic inflammation, and increasing severe COVID-19 risk; to relaunch the prioritization of BS. The literature search was conducted in March 2022 via Pubmed (MEDLINE) and focused on reviews, systematic reviews, and meta-analyses published in peer-reviewed journals. Terms "bariatric surgery" OR "obesity surgery" OR "metabolic surgery" were analyzed with "COVID-19" OR "SARS-CoV-2" using the AND modifier. Only 13 studies of the 406 screened met the objective. The procrastination of BS over the past two years determined a delay in obesity treatment and severe consequences. The COVID-19 pandemic has had a huge impact on economic costs. Although BS has high costs, a lifetime cost advantage over conventional weight loss methods was demonstrated. As the pandemic continues, health policies must recognize obesity as a disease-predisposing factor for SARS-CoV-2 infection, considering COVID-19 as a new comorbidity mitigable by BS. Care pathways for obese patients in COVID/post-COVID era should be revitalized and the concept of elective surgery attributed to BS should be reformulated.
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Role of probiotics and prebiotics in mitigation of different diseases.
Manzoor, S, Wani, SM, Ahmad Mir, S, Rizwan, D
Nutrition (Burbank, Los Angeles County, Calif.). 2022;:111602
Abstract
Probiotics and their food sources, prebiotics, are known to have qualities that help with gastrointestinal issues along with overall improvement in health and well-being. Pro- and prebiotics play a key role in neuroimmune processes. Their beneficial effects on health are linked to interactions of the gastrointestinal tract, immune system, and neurologic systems. The interaction between the microflora-gut-brain axis has a profound effect on brain function, thereby influencing the overall well-being of an individual. Nutritionists, researchers, regulatory bodies (World Health Organization/Food and Agriculture Organization), pharmaceutical, and food manufacturers are currently engaged in enhancing the potential of nutrition in health maintenance and disease prevention. Nutrition has the potential to increase psychological well-being and could be used much as are psychiatric drugs. Probiotics and prebiotics have evolved as promising therapeutic techniques to treat several disease conditions associated with the gastrointestinal tract. The aim of this review was to provide useful information about the use of probiotics and prebiotics in mitigation of various diseases such as COVID-19, congenital heart disease, diarrhea, inflammatory bowel disease, hypertension, genitourinary tract infection, colon cancer, immune system defense, mineral absorption, allergic disorders, and atopic dermatitis.
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A state-of-the-art review on fucoidan as an antiviral agent to combat viral infections.
Pradhan, B, Nayak, R, Patra, S, Bhuyan, PP, Behera, PK, Mandal, AK, Behera, C, Ki, JS, Adhikary, SP, MubarakAli, D, et al
Carbohydrate polymers. 2022;:119551
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Abstract
As a significant public health hazard with several drug side effects during medical treatment, searching for novel therapeutic natural medicines is promising. Sulfated polysaccharides from algae, such as fucoidan, have been discovered to have a variety of medical applications, including antibacterial and immunomodulatory properties. The review emphasized on the utilization of fucoidan as an antiviral agent against viral infections by inhibiting their attachment and replication. Moreover, it can also trigger immune response against viral infection in humans. This review suggested to be use the fucoidan for the potential protective remedy against COVID-19 and addressing the antiviral activities of sulfated polysaccharide, fucoidan derived from marine algae that could be used as an anti-COVID19 drug in near future.
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Acute kidney injury and electrolyte disorders in COVID-19.
Nogueira, GM, Silva, NLOR, Moura, AF, Duarte Silveira, MA, Moura-Neto, JA
World journal of virology. 2022;(5):283-292
Abstract
Acute kidney injury (AKI) and electrolyte disorders are important complications of hospitalized coronavirus disease 2019 (COVID-19) patients. AKI is thought to occur due to multiple pathophysiological mechanisms, such as multiple organ dysfunction (mainly cardiac and respiratory), direct viral entry in the renal tubules, and cytokine release syndrome. AKI is present in approximately one in every ten hospitalized COVID-19 patients. The incidence rates of AKI increase in patients who are admitted to the intensive care unit (ICU), with levels higher than 50%. Additionally, renal replacement therapy (RRT) is used in 7% of all AKI cases, but in nearly 20% of patients admitted to an ICU. COVID-19 patients with AKI are considered moderate-to-severe cases and are managed with multiple interdisciplinary conducts. AKI acts as a risk factor for mortality in severe acute respiratory syndrome coronavirus 2 infection, especially when RRT is needed. Electrolyte disorders are also common manifestations in hospitalized COVID-19 patients, mainly hyponatremia, hypokalemia, and hypocalcemia. Hyponatremia occurs due to a combination of syndrome of inappropriate secretion of antidiuretic hormone and gastrointestinal fluid loss from vomiting and diarrhea. When it comes to hypokalemia, its mechanism is not fully understood but may derive from hyperaldosteronism due to renin angiotensin aldosterone system overstimulation and gastrointestinal fluid loss as well. The clinical features of hypokalemia in COVID-19 are similar to those in other conditions. Hypocalcemia is the most common electrolyte disorder in COVID-19 and seems to occur because of vitamin D deficiency and parathyroid imbalance. It is also highly associated with longer hospital and ICU stay.
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Barriers to optimal care and strategies to promote safe and optimal management of sick young infants during the COVID-19 pandemic: A multi-country formative research study.
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Journal of global health. 2022;:05023
Abstract
BACKGROUND Essential health and nutrition services for pregnant women, newborns, and children, particularly in low- and middle-income countries (LMICs), are disrupted by the COVID-19 pandemic. This formative research was conducted at five LMICs to understand the pandemic's impact on barriers to and mitigation for strategies of care-seeking and managing possible serious bacterial infection (PSBI) in young infants. METHODS We used a convergent parallel mixed-method design to explore the possible factors influencing PSBI management, barriers, and facilitators at three levels: 1) national and local policy, 2) the health systems, public and private facilities, and 3) community and caregivers. We ascertained trends in service provision and utilisation across pre-lockdown, lockdown, and post-lockdown periods by examining facility records and community health worker registers. RESULTS The pandemic aggravated pre-existing challenges in the identification of young infants with PSBI; care-seeking, referral, and treatment due to several factors at the policy level (limited staff and resource reallocation), health facility level (staff quarantine, sub-optimal treatment in facilities, limited duration of service availability, lack of clear guidelines on the management of sick young infants, and inadequate supplies of protective kits and essential medicines) and at the community level (travel restrictions, lack of transportation, and fear of contracting the infection in hospitals). Care-seeking shifted to faith healers, traditional and informal private sources, or home remedies. However, caregivers were willing to admit their sick young infants to the hospital if advised by doctors. A review of facility records showed low attendance (<50%) of sick young infants in the OPD/emergencies during lockdowns in Bangladesh, India (both sites) and Pakistan, but it gradually increased as lockdowns eased. Stakeholders suggested aspirational and pragmatic mitigation strategies. CONCLUSIONS We obtained useful insights on health system preparedness during catastrophes and strategies to strengthen services and improve utilisation regarding PSBI management. The current pandemic provides an opportunity for implementing various mitigation strategies at the policy, health system, and community levels to improve preparedness.
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Vitamin D regulation of immune function during covid-19.
Bikle, DD
Reviews in endocrine & metabolic disorders. 2022;(2):279-285
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Abstract
Covid-19 has to date infected a confirmed 275 million people with 5.4 million, now dead, with the count rising every day. Although the virus, SARS-CoV2, causing Covid-19 infects many cells in the body, its infection of the upper and lower respiratory tract (upper airway epithelia and pulmonary alveolar pneumocytes and macrophages) causing what is now called a cytokine storm in the lungs is the major cause of morbidity and mortality. This results from a dysregulation of the innate immune system with an outpouring of proinflammatory cytokines and chemokines leading to abnormal activation of the adaptive immune pathway. Airway epithelia constitutively expresses CYP27B1, the enzyme producing the active vitamin D metabolite, 1,25(OH)2D, and the vitamin D receptor (VDR) for which 1,25(OH)2D is the ligand. Pulmonary alveolar macrophages, on the other hand, are induced to express both CYP27B1 and VDR by various pathogens including viruses and cytokines released from infected epithelia and other immune cells. Although not demonstrated for corona viruses like SARS-CoV2, for other viruses and other respiratory pathogens activation of innate immunity leading to increased local 1,25(OH)2D production has been shown to enhance viral neutralization and clearance while modulating the subsequent proinflammatory response. Whether such will be the case for SARS-CoV2 remains to be seen, but is currently being proposed and investigated. This mini review will discuss some of the mechanisms by which vitamin D may help reduce morbidity and mortality in this devastating pandemic.
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Mental Health amid COVID-19 Pandemic: Appropriate Coping Strategies.
Ayenigbara, IO
Psychiatria Danubina. 2022;(2):325-333
Abstract
COVID-19 is a global public health crisis, and is turning to be a major mental health problem. This review provides a broad overview of mental health situations during COVID-19 pandemic in Africa and globally, while some preventive methods to improve mental health conditions during the pandemic were provided. In the Africa context, various government authorities must ensure the provision and accessibility to mental health care services such as routine preventive information, mental health counseling and self help measures, and social supports such as palliatives, basic needs and special financial assistance to the public during the pandemic. Generally, coping strategies such as personal care-based measures (adequate nutrition, personal hygiene, adequate sleep and rest) activity-based measures (regular physical exercise, learning new tasks and engaging in novel adventures and mindfulness meditation) and behavioral-based measures (avoidance of psychoactive substances, taking breaks from COVID-19-related information, social connectedness and showing supports to others, setting achievable targets, help seeking measures and psychiatrist's visitations, adherence to all COVID-19 preventive measures and uptake of the COVID-19 vaccines) are all viable preventive methods against mental health conditions during the pandemic globally. It is recommended that researchers should conduct more studies on the impacts of COVID-19 on mental health status in Africa populations to ensure a valid basis for proper interventions during and post pandemic era. Also, African countries should seek supports and routine guidance from appropriate international health organizations to ensure an updated and frequent mental health care delivery to the public.
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Therapeutic strategies to fight COVID-19: Which is the status artis?
Scavone, C, Mascolo, A, Rafaniello, C, Sportiello, L, Trama, U, Zoccoli, A, Bernardi, FF, Racagni, G, Berrino, L, Castaldo, G, et al
British journal of pharmacology. 2022;(10):2128-2148
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COVID-19 is a complex disease, and many difficulties are faced today especially in the proper choice of pharmacological treatments. The role of antiviral agents for COVID-19 is still being investigated and evidence for immunomodulatory and anti-inflammatory drugs is quite conflicting, whereas the use of corticosteroids is supported by robust evidence. The use of heparins in hospitalized critically ill patients is preferred over other anticoagulants. There are conflicting data on the use of convalescent plasma and vitamin D. According to the World Health Organization (WHO), many vaccines are in Phase III clinical trials, and some of them have already received marketing approval in European countries and in the United States. In conclusion, drug repurposing has represented the main approach recently used in the treatment of patients with COVID-19. At this moment, analysis of efficacy and safety data of drugs and vaccines used in real-life context is strongly needed. LINKED ARTICLES This article is part of a themed issue on The second wave: are we any closer to efficacious pharmacotherapy for COVID 19? (BJP 75th Anniversary). To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v179.10/issuetoc.