Obesity in people with diabetes in COVID-19 times: Important considerations and precautions to be taken

Alberti, Adriano; Schuelter‐Trevisol, Fabiana; Iser, Betine Pinto Moehlecke; Traebert, Eliane; Freiberger, Viviane; Ventura, Luisa; Rezin, Gislaine Tezza; Silva, Bruna Becker da; Dallacosta, Fabiana Meneghetti; Grigollo, Leoberto Ricardo; Dias, Paula; Fin, Gracielle; Jesus, Josiane Aparecida de; Pertille, Fabiane; Rossoni, Carina; Soares, Ben Hur; Júnior, Rudy José Nodari; Comim, Clarissa M.

doi:10.12998/wjcc.v9.i20.5358

Cited by 8 publications

(7 citation statements)

References 96 publications

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“…Currently, published research demonstrates how comorbidities, including diabetes and obesity, can lead to increased COVID-19 severity (50)(51)(52)(53). Correlation measures of neuroinflammatory markers such as PVS count and white matter volume with BMI and potentially glucose levels may be indicative of increased likelihood of neurologic sequelae from COVID-19.…”

Section: Discussionmentioning

confidence: 99%

Semi-automated Segmentation and Quantification of Perivascular Spaces at 7 Tesla in COVID-19

et al. 2022

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While COVID-19 is primarily considered a respiratory disease, it has been shown to affect the central nervous system. Mounting evidence shows that COVID-19 is associated with neurological complications as well as effects thought to be related to neuroinflammatory processes. Due to the novelty of COVID-19, there is a need to better understand the possible long-term effects it may have on patients, particularly linkage to neuroinflammatory processes. Perivascular spaces (PVS) are small fluid-filled spaces in the brain that appear on MRI scans near blood vessels and are believed to play a role in modulation of the immune response, leukocyte trafficking, and glymphatic drainage. Some studies have suggested that increased number or presence of PVS could be considered a marker of increased blood-brain barrier permeability or dysfunction and may be involved in or precede cascades leading to neuroinflammatory processes. Due to their size, PVS are better detected on MRI at ultrahigh magnetic field strengths such as 7 Tesla, with improved sensitivity and resolution to quantify both concentration and size. As such, the objective of this prospective study was to leverage a semi-automated detection tool to identify and quantify differences in perivascular spaces between a group of 10 COVID-19 patients and a similar subset of controls to determine whether PVS might be biomarkers of COVID-19-mediated neuroinflammation. Results demonstrate a detectable difference in neuroinflammatory measures in the patient group compared to controls. PVS count and white matter volume were significantly different in the patient group compared to controls, yet there was no significant association between PVS count and symptom measures. Our findings suggest that the PVS count may be a viable marker for neuroinflammation in COVID-19, and other diseases which may be linked to neuroinflammatory processes.

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Section: Discussionmentioning

confidence: 99%

Semi-automated Segmentation and Quantification of Perivascular Spaces at 7 Tesla in COVID-19

et al. 2022

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“…Patients with COVID-19 have an aggressive inflammatory response, especially in severe forms, with the release of pro-inflammatory cytokines in cytokine storm; cytokine storm plays an important role in severe lung damage, multiple organ dysfunction syndromes, admission to the intensive care unit, and mortality [ 12 ]. The chronic inflammatory state in patients with type 2 diabetes and obesity facilitates the cytokine storm [ 13 ]. Type 2 diabetes and obesity can be associated with complications in patients with SARS-CoV2 viral infection [ 14 , 15 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

Antidiabetic Treatment before Hospitalization and Admission Parameters in Patients with Type 2 Diabetes, Obesity, and SARS-CoV-2 Viral Infection

Restea

Mureşan

Voicu

et al. 2023

JPM

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Background: SARS-CoV-2 viral infection is a current and important topic for patients with comorbidities of type 2 diabetes and obesity, associated with increased risk of mortality and morbidity. This study aims to analyze, compare and describe admission parameters in patients with type 2 diabetes, obesity, and SARS-CoV-2 infection based on whether they received insulin therapy before hospital admission. Methods: Our study enrolled patients diagnosed with type 2 diabetes, obesity, and SARS-CoV-2 viral infection, 81 patients without insulin treatment before hospital admission, and 81 patients with insulin at “Gavril Curteanu” Municipal Clinical Hospital of Oradea, Romania, between August 2020 and March 2022. RT-PCR/rapid antigen tests were used for detecting SARS-CoV-2 viral infection. Results: The severe form of COVID-19 was found in 66% of all patients (65% in the group without insulin and 67% in the group with insulin). Oxygen saturation at the time of hospital admission was greater or equal to 90% in 62% of all patients. The most associated comorbidities we founded in this study were: hypertension in 75% of all patients (grade two hypertension 63% in the group without insulin and 64% in the group with insulin), ischemic heart disease in 35% of patients (25% in the group without insulin and 44% in the group with insulin, n = 0.008), heart failure in 9.3% of all patients (8.6% in the group without insulin and 10% in the group with insulin). CRP and procalcitonin are increased in both groups at hospital admission, with a slightly higher trend in the group with insulin therapy before hospital admission. We found that 56% of patients in the group with insulin treatment were with uncontrolled diabetes on admission. Only 10% of patients required a change in antidiabetic treatment with insulin therapy at discharge. In our study, 89% of all patients did not require short-term home oxygen therapy at discharge. Conclusions: Antidiabetic therapy taken before hospital admission did not protect patients against cytokine storm in COVID-19, but is very important in the pathophysiological stage of comorbidities. Paraclinical parameters at hospitalization showed differences in correlation with oral antidiabetic treatment like metformin or insulin therapy. Changing the antidiabetic treatment for a small percentage of patients in the group who had not been receiving insulin therapy before discharge was necessary. It is necessary for future studies to see all changes involved in antidiabetic treatment in patients with diabetes type 2 and obesity after SARS-CoV2 viral infection and its long-term evolution.

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“…Obesity and diabetes are risk factors for increasing the severity of COVID-19. 31,32 In T2DM patients, obesity is associated with poor early prognosis in COVID-19 patients. Albahrani et al 33 prove that obesity was identified as an independent risk factor for the risk of decreased oxygen saturation in COVID-19 patients.…”

Section: Discussionmentioning

confidence: 99%

The Impact of COVID-19 Severity on TNF-α and IFN-γ in T2DM Patients' PBMC Monocytes

Wahyurini,

Tahapary,

Wibowo

2024

J Indon Med Assoc

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Introduction: Monocytes are very sensitive to changes in the metabolic environment, including hyperglycemia, such as type 2 diabetes mellitus (T2DM). T2DM is characterized by chronic low-grade inflammation and becomes one COVID-19 comorbid. TNF-α and IFN-γ are cytokines often linked to inflammation, the severity of COVID-19, and long COVID-19. This study aims to analyze the relationship between COVID-19 severity and TNF-α and IFN-γ in T2DM one month post-infection.Methods: This research is an experimental study at the Integrated Laboratory Faculty of Medicine, Universitas Indonesia, for four months. The total samples are 44 cryotubes of PBMC (18 T2DM and 26 Non-T2DM) from the CARAMEL study (COVID-19, Aging, and Cardiometabolic Risk Factors). PBMCs were stimulated with inactivated whole virions SARS-CoV-2 and incubated for 24 hours. Monocyte subsets and intracellular cytokines are detected by flow cytometry.Results: Research showed that IFN-γ in the T2DM group was higher in all subsets. There was no significant difference between the T2DM and non-T2DM groups. Based on the history of the severity of COVID-19, MedFI IFN-γ classic and intermediate monocytes differed significantly between the COVID-19 severity groups (p = 0.049 and p = 0.022). Further research is needed to analyze the risk factors involved.Conclusion: MedFI of classic and intermediate monocyte IFN-γ differed significantly between the severity of COVID-19. There were no significant differences between the T2DM and non-T2DM groups. The history of the severity of COVID-19 is significantly related to long COVID-19.

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Obesity in people with diabetes in COVID-19 times: Important considerations and precautions to be taken

Cited by 8 publications

References 96 publications

Semi-automated Segmentation and Quantification of Perivascular Spaces at 7 Tesla in COVID-19

Semi-automated Segmentation and Quantification of Perivascular Spaces at 7 Tesla in COVID-19

Antidiabetic Treatment before Hospitalization and Admission Parameters in Patients with Type 2 Diabetes, Obesity, and SARS-CoV-2 Viral Infection

The Impact of COVID-19 Severity on TNF-α and IFN-γ in T2DM Patients' PBMC Monocytes

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