Body Composition Findings by Computed Tomography in SARS-CoV-2 Patients: Increased Risk of Muscle Wasting in Obesity

Gualtieri, Paola; Falcone, Cristina; Romano, Lorenzo; Macheda, Sebastiano; Correale, Pierpaolo; Arciello, Pietro; Polimeni, Nicola; Lorenzo, Antonino De

doi:10.3390/ijms21134670

Cited by 62 publications

(104 citation statements)

References 48 publications

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“…Initial data analysis was performed in the CFX96 Manager software prior, followed by export to the Seegene viewer software. The SARS-CoV-2 results were automatically categorised by the 'Seegene viewer' software as '2019-nCoV detected', 'negative' or 'invalid' based on predefined parameters (Allplex 2019-nCoV assay IFU) [36].…”

Section: Patient Population and Treatmentmentioning

confidence: 99%

“…Fifty-two patients with similar clinical/radiological features were hospitalized in the Grand Metropolitan Hospital starting on March 10 th , 2020 and were considered as the historical control of the study. Forty-nine of the latter patients, who required oxygenation with Ventimask (41 cases) or CPAP with helmet (8 cases), were hosted in the Infectious Diseases/Covid19Operative Unit while 3 further patients requiring mechanic ventilation, were hosted in the Covid19 Resuscitation Unit [36]. The latter patients had received specific treatment with HC, AZM, LMWH (40 cases) and Tocilizumab (12 cases) and none of them received adenosine.…”

Section: Patients Populationmentioning

confidence: 99%

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Therapeutic effects of adenosine in high flow 21% oxygen aereosol in patients with Covid19-pneumonia

Correale¹,

Caracciolo²,

Bilotta

et al. 2020

PLoS ONE

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Background SARS-Cov2 infection may trigger lung inflammation and acute-respiratory-distress-syndrome (ARDS) that requires active ventilation and may have fatal outcome. Considering the severity of the disease and the lack of active treatments, 14 patients with Covid-19 and severe lung inflammation received inhaled adenosine in the attempt to therapeutically compensate for the oxygen-related loss of the endogenous adenosine!A2A adenosine receptor (A2AR)-mediated mitigation of the lung-destructing inflammatory damage. This off label-treatment was based on preclinical studies in mice with LPS-induced ARDS, where inhaled adenosine/A2AR agonists protected oxygenated lungs from the deadly inflammatory damage. The treatment was allowed, considering that adenosine has several clinical applications. Patients and treatment Fourteen consecutively enrolled patients with Covid19-related interstitial pneumonitis and PaO 2 /FiO 2 ratio<300 received off-label-treatment with 9 mg inhaled adenosine every 12 hours in the first 24 hours and subsequently, every 24 days for the next 4 days. Fifty-two patients with analogue features and hospitalized between February and April 2020, who did not receive adenosine, were considered as a historical control group. Patients monitoring also included hemodynamic/hematochemical studies, CTscans, and SARS-CoV2-tests.

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Section: Patient Population and Treatmentmentioning

confidence: 99%

Section: Patients Populationmentioning

confidence: 99%

Therapeutic effects of adenosine in high flow 21% oxygen aereosol in patients with Covid19-pneumonia

Correale¹,

Caracciolo²,

Bilotta

et al. 2020

PLoS ONE

Self Cite

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show abstract

“…1 Nutritional status was found to be associated with the novel Coronavirus disease 2019 (COVID-19) severity, and malnutrition might play a role in this regard, but this aspect was investigated in a limited number of studies. [2][3][4] Previous studies have shown that malnutrition represents an independent risk factor for the prognosis of various infectious diseases including pneumonia. 5 Nutritional risk screening tools are useful in the everyday clinical practice to promptly detect potential or evident malnutrition.…”

Section: Introductionmentioning

confidence: 99%

Nutritional Risk Screening and Body Composition in COVID‐19 Patients Hospitalized in an Internal Medicine Ward

Giorno¹,

Quarenghi²,

Stefanelli³

et al. 2020

IJGM

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Background Malnutrition in patients hospitalized in internal medicine wards is highly prevalent and represents a prognostic factor of worse outcomes. Previous evidence suggested the prognostic role of the nutritional status in patients affected by the coronavirus disease 2019 (COVID-19). We aim to investigate the nutritional risk in patients with COVID-19 hospitalized in an internal medicine ward and their clinical outcomes using the Nutritional Risk Screening 2002 (NRS-2002) and parameters derived from bioelectrical impedance analysis (BIA). Methods Retrospective analysis of patients with COVID-19 aimed at exploring: 1) the prevalence of nutritional risk with NRS-2002 and BIA; 2) the relationship between NRS-2002, BIA parameters and selected outcomes: length of hospital stay (LOS); death and need of intensive care unit (ICU); prolonged LOS; and loss of appetite. Results Data of 90 patients were analyzed. Patients at nutritional risk were 92% with NRS-2002, with BIA-derived parameters: 88% by phase angle; 86% by body cell mass; 84% by fat-free mass and 84% by fat mass (p-value ≤0.001). In ROC analysis, NRS had the maximum sensitivity in predicting the risk of death and need of ICU and a prolonged hospitalization showing moderate-low specificity; phase angle showed a good predictive power in terms of AUC. NRS-2002 was significantly associated with LOS (β 12.62, SE 5.79). In a multivariate analysis, blood glucose level and the early warning score are independent predictors of death and need of ICU (OR 2.79, p ≤0.001; 1.59, p-0.029, respectively). Conclusion Present findings confirm the clinical utility of NRS-2002 to assess nutritional risk in patients with COVID-19 at hospital admission and in predicting LOS, and that bioimpedance does not seem to add further predictive value. An early detection of nutritional risk has to be systematically included in the management of COVID-19 patients hospitalized in internal medicine wards.

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“…Factors concurrent to the COVID-19 cytokine storm are several. These include obesity and its comorbidities [ 102 , 103 , 104 , 105 ], a pathological condition that can no longer be overlooked given the cost of human lives paid.…”

Section: Resultsmentioning

confidence: 99%

Can Adenosine Fight COVID-19 Acute Respiratory Distress Syndrome?

Falcone

Caracciolo

Correale

et al. 2020

JCM

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Coronavirus disease 2019 (COVID-19) patients can develop interstitial pneumonia, which, in turn, can evolve into acute respiratory distress syndrome (ARDS). This is accompanied by an inflammatory cytokine storm. severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) has proteins capable of promoting the cytokine storm, especially in patients with comorbidities, including obesity. Since currently no resolutive therapy for ARDS has been found and given the scientific literature regarding the use of adenosine, its application has been hypothesized. Through its receptors, adenosine is able to inhibit the acute inflammatory process, increase the protection capacity of the epithelial barrier, and reduce the damage due to an overactivation of the immune system, such as that occurring in cytokine storms. These features are known in ischemia/reperfusion models and could also be exploited in acute lung injury with hypoxia. Considering these hypotheses, a COVID-19 patient with unresponsive respiratory failure was treated with adenosine for compassionate use. The results showed a rapid improvement of clinical conditions, with negativity of SARS-CoV2 detection.

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Body Composition Findings by Computed Tomography in SARS-CoV-2 Patients: Increased Risk of Muscle Wasting in Obesity

Cited by 62 publications

References 48 publications

Therapeutic effects of adenosine in high flow 21% oxygen aereosol in patients with Covid19-pneumonia

Therapeutic effects of adenosine in high flow 21% oxygen aereosol in patients with Covid19-pneumonia

Nutritional Risk Screening and Body Composition in COVID‐19 Patients Hospitalized in an Internal Medicine Ward

Can Adenosine Fight COVID-19 Acute Respiratory Distress Syndrome?

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