Background The spread of COVID-19 depends on a lot of social and economic factors. The aim: to study the influence of country’s gross domestic product, population prevalence of overweight/ obesity, NCD mortality, and vaccination on COVID-19 morbidity and mortality rates. Methods A cross-sectional study with two phases: correlation-regression interrelations in 1) all world countries; 2) all world non-island countries. The study includes the following data from 218 world countries: COVID-19 morbidity/mortality rates, GDP per capita, the prevalence of overweight/ obesity, NCD mortality among adults (both sexes), people fully vaccinated against COVID-19. Results An average percentage of the prevalence of overweight among adults in world countries by 2019 was 47.31±15.99%, obesity 18.34±9.64%, while the prevalence by 2016 were 39% and 13%, respectively. Overweight and obesity among adults during three years grew by 21.2% and 40.8%, respectively. Data from the world countries provide significant correlations (p<0.0001) between COVID-19 morbidity, and: GDP (r=0.517), overweight (r=0.54), obesity (r=0.528), NCD mortality (r=0.537); COVID-19 mortality, and: GDP (r=0.344), overweight (r=0.514), obesity (r=0.489), NCD mortality (r=0.611); GDP, and: overweight (r=0.507), obesity (r=0.523), NCD mortality (r=0.35), fully vaccinated people (r=0.754). An increase in fully vaccinated people, from 3% to 30% of world population, decreases new confirmed COVID-19 cases, although the dependence was not significant (p=0.07). Data from non-island world countries provides more highly significant correlations (p<0.0001) between COVID-19 morbidity, and: GDP (r=0.616), overweight (r=0.581), obesity (r=0.583); COVID-19 mortality, and: GDP (r=0.43), overweight (r=0.556), obesity (r=0.539); GDP, and: overweight (r=0.601), obesity (r=0.633). The differences of correlation coefficients between data of 176 world countries and data of 143 world non-island countries were not significant (Z-scores<1.29; p>0.05). Conclusion The study provides evidence of a significant impact of overweight/obesity prevalence on the increase in COVID-19 morbidity/mortality. Countries with higher GDP have a high overweight/obesity prevalence and possibility to get vaccinated.

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.

Background Behavioral habits and parental rearing during physical and sexual growth of men can influence to their penis size. Aim To assess the erect penis size in adult Kazakh males and study the influence of their physiological events and behavioral habits during their body growth on their penis size. Methods A cross-sectional survey pilot study with the intention-to-treat. The study included 282 adult Kazakh fertility males aged 23-35 years. Interventions: paper-based survey administration; erect penis length and girth measurement. Two-tailed Student’s t-test, Pearson correlation, and multivariate tests of the MANOVA/MANCOVA were used. The Ethics Committee of the National Research oncology center approved the study. Outcomes In Kazakh men a mean age 29.6±4.4 years; body height 171.56±6.64 cm; BMI 24.53±3.40 kg/m2; erect penis length 13.41±1.04 cm and girth 11.62±0.91 cm. Results There was a significant correlation between erect penis length and girth (P<0.0001). The frequency of erection in 54.7% males was 5-6 times a day. The frequency of masturbation or coitus with ejaculation in 42.2% males was two times per month. 40.9% males abstained to masturbation or coitus in one of two cases. The frequency of nocturnal sperm emission was in 39.1% males one time per month. Frequencies of erection, masturbation/coitus, abstinence to masturbation/coitus, and nocturnal emission have a statistically significant effect (P<0.01) on both erect penis length and girth in Kazakh males in their body growth. Conclusions Sexual abstinence to coitus and masturbation during childhood has a positive increasing affect on the penis size in adulthood. The more males in childhood abstains from ejaculation, the larger their penis size in adulthood. A long-lasting extended erection during body growth has a positive effect on penis enlargement.

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