Diabete et COVID-19 : les lecons de CORONADO Diabetes and COVID-19: Lessons from the CORONADO study
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SUBMITTER: Cariou B
PROVIDER: S-EPMC7832672 | biostudies-literature | 2020 Dec
REPOSITORIES: biostudies-literature
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Project description:Introduction Les impacts de la COVID-19 chez les patients souffrant de cancer sont débattus. Les conséquences de l’infection par le SRAS-CoV2 chez les patients souffrant de gliome ne sont pas rapportées. Objectifs Décrire les manifestations cliniques et les facteurs pronostiques de la COVID-19 chez les patients souffrant de gliome diffus Patients et méthodes Nous avons revu les dossiers médicaux de 41 patients suivis pour un gliome diffus et touchés par la COVID-19. Résultats La confusion était le symptôme neurologique les plus fréquent. Dix-sept patients sont décédés de la COVID-19. Bien que plusieurs facteurs (âge, fragilité, IMC élevé, comorbidités, CRP élevée, lymphopénie, thrombopénie, dose élevée de stéroïdes, cancer avancé, tumeur incontrôlée et chimiothérapie le mois précédent) semblaient avoir un impact pronostique défavorable, seuls le nombre de neutrophiles et l’admission en unité de soins intensifs étaient associés au décès (p < 0,05). Discussion La COVID-19 semble associée à un taux de mortalité élevé chez les patients souffrant de gliome diffus. Néanmoins, des études de plus grande envergure permettraient de mieux apprécier les interactions entre les facteurs pronostiques de la COVID-19 et ceux du gliome diffus. Conclusion Compte tenu du risque élevé de mortalité, les patients atteints de gliome diffus présentant un risque d’une COVID-19 sévère doivent être pris en charge avec des mesures préventives strictes et des traitements oncologiques adaptés. CocoNeuroSciences (NCT04362930).
| S-EPMC8036153 | biostudies-literature
Project description:Très rapidement après le début de la pandémie de la maladie à coronavirus 2019 (COVID-19), le diabète a été identifié comme facteur associé aux formes graves, et facteur pronostique. Depuis, de nombreuses études se sont intéressées à cette relation et ont pu préciser un certain nombre d’éléments : impact des comorbidités associées au diabète, phénotype des sujets diabétiques à risque de formes graves, impact de l’équilibre glycémique, impact de la COVID-19 sur le risque de diabète. Il persiste cependant un certain nombre de questions ou d’hypothèses, concernant notamment l’influence de traitements antidiabétiques sur le pronostic ou les mécanismes physiopathologiques impliqués dans les formes graves associées au diabète. Une mise à jour de l’ensemble de ces points est présentée dans cet article, mais les données de la littérature évoluent très vite…
| S-EPMC7733688 | biostudies-literature
Project description: Not available
| S-EPMC7204732 | biostudies-literature
Project description:Purpose of reviewIn France, in order to describe the phenotypic characteristics of patients with diabetes hospitalized for coronavirus disease-2019 (COVID-19) and to identify the prognostic factors in this specific population, the CORONADO (CORONAvirus and Diabetes Outcomes) study was launched. This review will summarize the key findings from the CORONADO study and put them in perspectives with others studies published on the subject.Recent findingsFor almost 2 years, the new SARS-CoV-2 (Severe Acute Respiratory Syndrome-CoronaVirus-2), which causes COVID-19, has spread all around the world leading to a pandemic. From the first epidemiological reports, diabetes mellitus has rapidly emerged as a major risk factor associated with severe forms of COVID-19 but few data were available about diabetes characteristics in hospitalized people with COVID-19. Between March 10 and April 10, 2020, 2951 patients were included in 68 centers throughout the national territory, including overseas territories. In the CORONADO study, the primary outcome was a composite endpoint combining invasive mechanical ventilation (IMV) and/or death within day 7 (D7). Secondary outcomes included death, IMV, intensive care unit (ICU) admission, and hospital discharge, all considered within D7 and day 28 (D28). The primary outcome occurred in 29.0% participants within D7 following hospital admission. Within D28, the end of the follow-up period, the mortality rate was 20.6%, while 50.2% of patients were discharged. In multivariable analysis, advanced age, microvascular complications, treatment with insulin or statin prior to admission, dyspnea on admission, as well as biological markers reflecting the severity of the infection (high levels of transaminases, leukocytes and CRP, and low platelet levels) were associated with an increased risk of death. Several exploratory analyses were performed to clarify the influence of some parameters such as weight status, sex, type of diabetes, and some routine drugs, including metformin or statins.
| S-EPMC8853410 | biostudies-literature
Project description:Aims/hypothesisCoronavirus disease-2019 (COVID-19) is a life-threatening infection caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) virus. Diabetes has rapidly emerged as a major comorbidity for COVID-19 severity. However, the phenotypic characteristics of diabetes in COVID-19 patients are unknown.MethodsWe conducted a nationwide multicentre observational study in people with diabetes hospitalised for COVID-19 in 53 French centres in the period 10-31 March 2020. The primary outcome combined tracheal intubation for mechanical ventilation and/or death within 7 days of admission. Age- and sex-adjusted multivariable logistic regressions were performed to assess the prognostic value of clinical and biological features with the endpoint. ORs are reported for a 1 SD increase after standardisation.ResultsThe current analysis focused on 1317 participants: 64.9% men, mean age 69.8 ± 13.0 years, median BMI 28.4 (25th-75th percentile: 25.0-32.7) kg/m2; with a predominance of type 2 diabetes (88.5%). Microvascular and macrovascular diabetic complications were found in 46.8% and 40.8% of cases, respectively. The primary outcome was encountered in 29.0% (95% CI 26.6, 31.5) of participants, while 10.6% (9.0, 12.4) died and 18.0% (16.0, 20.2) were discharged on day 7. In univariate analysis, characteristics prior to admission significantly associated with the primary outcome were sex, BMI and previous treatment with renin-angiotensin-aldosterone system (RAAS) blockers, but not age, type of diabetes, HbA1c, diabetic complications or glucose-lowering therapies. In multivariable analyses with covariates prior to admission, only BMI remained positively associated with the primary outcome (OR 1.28 [1.10, 1.47]). On admission, dyspnoea (OR 2.10 [1.31, 3.35]), as well as lymphocyte count (OR 0.67 [0.50, 0.88]), C-reactive protein (OR 1.93 [1.43, 2.59]) and AST (OR 2.23 [1.70, 2.93]) levels were independent predictors of the primary outcome. Finally, age (OR 2.48 [1.74, 3.53]), treated obstructive sleep apnoea (OR 2.80 [1.46, 5.38]), and microvascular (OR 2.14 [1.16, 3.94]) and macrovascular complications (OR 2.54 [1.44, 4.50]) were independently associated with the risk of death on day 7.Conclusions/interpretationsIn people with diabetes hospitalised for COVID-19, BMI, but not long-term glucose control, was positively and independently associated with tracheal intubation and/or death within 7 days.Trial registrationclinicaltrials.gov NCT04324736.
| S-EPMC7256180 | biostudies-literature
Project description:This review outlines the state of knowledge and research gaps in the area of determinants of healthy eating among children and youth. The article is structured around individual and collective determinants that affect healthy eating in children and youth. We defined healthy eating as “eating practices and behaviours that are consistent with improving, maintaining and/or enhancing health.” Relevant databases were searched for papers published between January 1992 and March 2003 that focussed on children or youth and reported at least one factor relevant to healthy eating. Among collective factors, familial factors and the nature of foods available in the physical environment, including at home, schools and in fast-food establishments, stand out as significant influences on healthy eating in children and youth. The media, particularly television, also have an enormous potential influence and can overshadow familial influences. Individual factors identified include knowledge, attitudes and food preferences; only the latter have been identified as a strong determinant of healthy eating in both children and adolescents. The results of the review identified a significant body of literature in the area of determinants of healthy eating in children and youth; however, very little of this research has taken place in Canada. Only a few determinants, such as economic factors and food security, the content of media nutritional messages, and the issue of flavours, neophobia and food preferences, have undergone some examination by Canadian researchers. Research priorities for Canada in the area of determinants of healthy eating and surveillance of eating behaviours are identified. Electronic Supplementary Material Supplementary material is available for this article at 10.1007/BF03405197 and is accessible for authorized users.
| S-EPMC6976047 | biostudies-literature
Project description: Not available
| S-EPMC7576421 | biostudies-literature
Project description:ObjectiveMale sex is one of the determinants of severe coronavirus diseas-e-2019 (COVID-19). We aimed to characterize sex differences in severe outcomes in adults with diabetes hospitalized for COVID-19.MethodsWe performed a sex-stratified analysis of clinical and biological features and outcomes (i.e. invasive mechanical ventilation (IMV), death, intensive care unit (ICU) admission and home discharge at day 7 (D7) or day 28 (D28)) in 2380 patients with diabetes hospitalized for COVID-19 and included in the nationwide CORONADO observational study (NCT04324736).ResultsThe study population was predominantly male (63.5%). After multiple adjustments, female sex was negatively associated with the primary outcome (IMV and/or death, OR: 0.66 (0.49-0.88)), death (OR: 0.49 (0.30-0.79)) and ICU admission (OR: 0.57 (0.43-0.77)) at D7 but only with ICU admission (OR: 0.58 (0.43-0.77)) at D28. Older age and a history of microvascular complications were predictors of death at D28 in both sexes, while chronic obstructive pulmonary disease (COPD) was predictive of death in women only. At admission, C-reactive protein (CRP), aspartate amino transferase (AST) and estimated glomerular filtration rate (eGFR), according to the CKD-EPI formula predicted death in both sexes. Lymphocytopenia was an independent predictor of death in women only, while thrombocytopenia and elevated plasma glucose concentration were predictors of death in men only.ConclusionsIn patients with diabetes admitted for COVID-19, female sex was associated with lower incidence of early severe outcomes, but did not influence the overall in-hospital mortality, suggesting that diabetes mitigates the female protection from COVID-19 severity. Sex-associated biological determinants may be useful to optimize COVID-19 prevention and management in women and men.
| S-EPMC9494335 | biostudies-literature
Project description: Not available
| S-EPMC10069926 | biostudies-literature
Project description:Introduction Depuis mars 2021, plusieurs publications ont rapporté des manifestations cutanées associées à l’infection COVID-19. Bien que non spécifiques, ces manifestations ont été massivement relayées par les revues scientifiques, les médias et les réseaux sociaux. L’objectif de ce travail était de déterminer si la prévalence et les caractéristiques de ces manifestations peu spécifiques avaient varié pour la même période entre 2019 et 2020. Matériel et méthodes Étude comparative rétrospective sur la prévalence de ces manifestations dermatologiques vues aux urgences dermatologiques du 01 mars au 30 avril 2020 en comparaison avec la même période de l’année 2019. Les manifestations incluses étaient : les urticaires, les pityriasis rosé de Gibert, les exanthèmes maculopapuleux, les rashs vésiculeux, les syndromes main-pied-bouche, les dysidroses atypiques et les pseudo-engelures. Les manifestations induites par les médicaments ont été exclues. Les tests statistiques utilisés étaient le test du Chi2 ou le test de Fisher. Résultats Entre mars et avril 2020, 877 observations ont été enregistrées vs 2874 au cours de la même période en 2019. L’âge moyen était de 41,6 ans (DS = 16,5) vs 40,8 (DS = 16,2) respectivement en 2020 et 2019. Le sex-ratio était de 0,33 en 2020 et 0,25 en 2019. La plupart des manifestations cutanées du COVID-19 étaient similaires à une atteinte cutanée survenant dans les infections virales courantes. Aucune augmentation de la prévalence des visites « non programmées » pour manifestations cutanées associées au COVID-19 chez les patients pris en charge au service de dermatologie n’a été notée : 8 % en 2019 et 7 % en 2020, p = 0,25. La prévalence des engelures était plus importante en mars/avril 2020 vs 2019. Discussion La plupart des séries publiées de signes cutanés associés au COVID-19 n’ont pas confirmé la présence directe du virus. L’association des lésions d’engelure au COVID-19 est controversée. Nous n’avons pas observé d’augmentation de la prévalence des tableaux d’éruptions cutanées décrites comme associés au COVID-19 en dehors des engelures.
| S-EPMC8603755 | biostudies-literature