Risk Of COVID-19 Severity Research Articles

Detection the Genetic Polymorphisms of the Programmed Cell Death Gene PD1.3 G/A (rs11568821) in Coronavirus Disease Patients

Abstract Background: Programmed cell death-1 protein (PD-1, Pcd1), a receptor from the CD28/CTLA-4 group, inhibits antigen receptor signaling by attracting protein tyrosine phosphatase in response to an interaction with any of the two ligands, PD-L1 or PD-L2. Human phenotypic variations can be attributed to both genetic and environmental influences. Objectives: Because SNPs (single nucleotide polymorphisms) are not absolute indicators of disease progression, in this work, the PD-1 gene polymorphism in coronavirus disease (COVID-19) patients was examined to assess the presence of SNPs in viral infections, in particular COVID-19 is the main goal of this investigation. Materials and Methods: Sixty confirmed COVID-19 patients were recruited to this study; 30 of them had severe COVID-19, whereas the other patients showed moderate sickness, who were admitted to the COVID-19 specialized ward in Salahuddin province, and all of them were over the age of 18 years. Also 30 healthy subjects were recruited for the purpose of the comparison. Blood was drawn from all the subjects for polymerase chain reaction (PCR) using the restriction fragment length (RFLP)-PCR for the assessment of the G/A SNP genotype of PD1.3 and ELISA test for the estimation of PD-1 and PD-L-1 serum level. Results: The examined PD-1 SNPs did not correlate with the incidence of COVID-19, according to a data analysis. Both the dominant and recessive models used in the research failed to detect a connection with the risk of COVID-19 severity. The PD1.3 genotypes frequency between the two groups did not show significant differences (P > 0.05). Only AG was substantially and mainly linked to COVID-19 susceptibility. This study compared the concentrations of immune check point inhibitors PD-1, PD-L-1 to find possible association with genotype frequency, and approved that PD-1 did not have any significant differences in the three groups of genotypes, whereas the difference was highly significant (0.048) in PDL-1 and AA genotype. Conclusion: Among all calculated haplotypes were unrelated to the disease’s prognosis (P > 0.05) concluded that the frequency of AA genotype in patients group decreed the expiation of PD-L-1, leads to immune inhibitions. Future research may clarify the relationship between some immune checkpoint molecule polymorphisms.

The gut microbiota patterns of patients with COVID-19: protocol for a case-control study

BackgroundSARS-CoV-2 caused an outbreak in late December 2019. It has been suggested that gut microbiota dysbiosis influences the severity, mortality, and quality of life of patients with COVID-19. So, identifying the gut microbiota pattern could be helpful to determine the prognosis of the disease, and maybe determine some potential treatment approaches. Our aim will be to compare gut microbiota patterns between patients with severe or non-severe COVID-19, and healthy controls.MethodsWe will include 183 samples: 122 samples from COVID-19 patients, including 61 severe patients and 61 non-severe patients, and 61 samples from healthy controls. Total bacterial DNA will be extracted from samples and 16 S rRNA gene will be amplified through two polymerase chain reaction (PCR) stages. Fecal samples will be analyzed using a targeted metabolomics technique. The differences in each RNA or DNA expression between patients with severe COVID-19, patients with non-severe COVID-19, and controls will be compared. Also, we will assess the relationships between each DNA or RNA and the risk of COVID-19 severity, sort of clinical manifestations, and comorbidities. Concurrent medication data will be collected and patients will also be grouped based on their drug history.ResultsWe hypothesize that the gut microbiota composition will be affected by the COVID-19 severity and there might be differences in terms of sex and age.ConclusionsThe results of our study could be the backbone for further trials which might lead to the development of prognostic factors and treatment options. Further studies can also consider the limitations of the study like potential confounders and selection and recall biases.

Medical Comorbidities and Risk Of COVID-19 Severity

Background: COVID-19 is a disease caused by SARS-CoV-2 that can cause respiratory infections. It may affect the sinuses, the upper airways of the nose and throat, or the lower airways of the trachea and lungs. Infections range from mild to deadly. Older people and people of all ages with medical comorbidities such as hypertension and diabetes may have a poorer prognosis and be at greater risk for hospital and intensive care unit admissions. Objectives: The present study aimed to determine the effects of preCOVID-19 comorbidities on the progression of disease severity and outcome in Iraqi patients. Method: This descriptive cross-sectional study was carried out on COVID- 19 patients using an online electronic questionnaire in Google form all over Iraq from September 2021 to July 2023. The total number of participants was 789, of whom approximately 282 were excluded, and the net was 507; they received an online questionnaire, The questionnaire literature review was completed after debuting in Arabic after a thor. This self-administered questionnaire consisted of 15 closedended questions and six open questions. Result: < 40 was the highest group affected by COVID-19, and those> 60 years were the most minor group involved. Females are affected more than males. Most of the cases were from the middle region of Iraq. 87.8% of participants have no smoking history. Fever, headache & fatigue were the most prevalent symptoms of patients. Past medical history of hypertension presented in 11.8% of patients, while diabetes mellitus represented 9%, asthma 5.5%, and cardiovascular diseases 4.9%. Other comorbidities were present in lower percentages. The history of hospitalization was positive in 37 patients with past medical comorbidities. Of those patients who were admitted to the hospital, 18 required Intensive care unit admission. Among them, 7 had hypertension, 4 had asthma & 3 had diabetes mellitus. Steroid treatment was given to 9% of patients with COVID-19. Conclusion: The need for hospitalization and Intensive care unit admission was higher among COVID-19 patients with comorbidities, especially hypertension, followed by diabetes, then asthma, and cardiovascular diseases.

Obesity, overweight, and severe prognosis in COVID-19 patients in Japan

IntroductionObesity (i.e., body mass index [BMI] of 30 kg/m2 or more) is one of the risk factors for severe COVID-19, but the findings may not be directly applicable to Asians, who have a different cutoff point for defining obesity. We thus examined the association between obesity/overweight (BMI of 25 kg/m2 or more and less than 30 kg/m2) and the risk of COVID-19 severity. MethodsThe study population included COVID-19 patients who had been enrolled in the registry of the Okayama City Public Health Center in Okayama, Japan, between March 2020 and June 2022. We included 27 820 patients who had information on BMI and prognosis, and we conducted Poisson regression analysis with robust error variance to estimate risk ratios (RRs) with 95% confidence intervals (CIs) for severe outcomes. ResultsObesity and overweight were associated with the increased risk of severe COVID-19 in all age categories. The RRs (95% CI) for COVID-19 induced respiratory failure compared to the normal weight category were 1.57 (1.31–1.88) for overweight and 2.45 (1.90–3.15) for obesity. ConclusionsBoth obesity and overweight were associated with increased risk of severe COVID-19. This study suggests the importance of the overweight category to predict the risk of severe COVID-19 in Asians.

Effects of Antidepressants on COVID-19 Outcomes: Retrospective Study on Large-Scale Electronic Health Record Data.

Antidepressants exert an anticholinergic effect in varying degrees, and various classes of antidepressants can produce a different effect on immune function. While the early use of antidepressants has a notional effect on COVID-19 outcomes, the relationship between the risk of COVID-19 severity and the use of antidepressants has not been properly investigated previously owing to the high costs involved with clinical trials. Large-scale observational data and recent advancements in statistical analysis provide ample opportunity to virtualize a clinical trial to discover the detrimental effects of the early use of antidepressants. We primarily aimed to investigate electronic health records for causal effect estimation and use the data for discovering the causal effects of early antidepressant use on COVID-19 outcomes. As a secondary aim, we developed methods for validating our causal effect estimation pipeline. We used the National COVID Cohort Collaborative (N3C), a database aggregating health history for over 12 million people in the United States, including over 5 million with a positive COVID-19 test. We selected 241,952 COVID-19-positive patients (age >13 years) with at least 1 year of medical history. The study included a 18,584-dimensional covariate vector for each person and 16 different antidepressants. We used propensity score weighting based on the logistic regression method to estimate causal effects on the entire data. Then, we used the Node2Vec embedding method to encode SNOMED-CT (Systematized Nomenclature of Medicine-Clinical Terms) medical codes and applied random forest regression to estimate causal effects. We used both methods to estimate causal effects of antidepressants on COVID-19 outcomes. We also selected few negatively effective conditions for COVID-19 outcomes and estimated their effects using our proposed methods to validate their efficacy. The average treatment effect (ATE) of using any one of the antidepressants was -0.076 (95% CI -0.082 to -0.069; P<.001) with the propensity score weighting method. For the method using SNOMED-CT medical embedding, the ATE of using any one of the antidepressants was -0.423 (95% CI -0.382 to -0.463; P<.001). We applied multiple causal inference methods with novel application of health embeddings to investigate the effects of antidepressants on COVID-19 outcomes. Additionally, we proposed a novel drug effect analysis-based evaluation technique to justify the efficacy of the proposed method. This study offers causal inference methods on large-scale electronic health record data to discover the effects of common antidepressants on COVID-19 hospitalization or a worse outcome. We found that common antidepressants may increase the risk of COVID-19 complications and uncovered a pattern where certain antidepressants were associated with a lower risk of hospitalization. While discovering the detrimental effects of these drugs on outcomes could guide preventive care, identification of beneficial effects would allow us to propose drug repurposing for COVID-19 treatment.

Clinical characteristics and severity of COVID-19 among Mexican adults.

Obesity, diabetes, hypertension and age have been pointed at as factors that influence on the progression of COVID-19; however, evidence for other conditions is inconclusive. To identify which clinical characteristics are related to COVID-19 severity and to determine whether age acts a modifier of the relationship between cardio-metabolic comorbidities (CMC) and COVID-19 progression. Data on ≥ 20-year-old confirmed cases (n = 159,017) were analyzed. Hospitalization, development of pneumonia, intubation requirement, intensive care unit admission and death were the dependent variables in Poisson regression models estimation, whereas the interaction between age and different CMCs were the independent variables. Having CMCs, as well as other comorbidities, was directly related to COVID-19 progression, whereas chronic obstructive pulmonary disease was only related to an increase in the risk of dying. The risk for COVID-19 severity was lower as age was more advanced. Asthma and smoking were not risk factors for the progression of COVID-19. In the Mexican population, the risk of COVID-19 progression associated with comorbidities was higher in young adults.

Is there an association between depression, anxiety disorders and COVID-19 severity and mortality? A multicenter retrospective cohort study conducted in 50 hospitals in Germany

BackgroundThe aim of this retrospective cohort study was to investigate associations between depression and anxiety disorder and the risk of COVID-19 severity and mortality in patients treated in large hospitals in Germany. MethodsThis retrospective study was based on anonymized electronic medical data from 50 public healthcare service hospitals across Germany. Multivariable logistic regression models were used to study associations between depression, anxiety and mechanical ventilation and mortality due to COVID adjusted for age, sex, time of COVID-19 diagnosis, and pre-defined co-diagnoses. ResultsOf 28,311 patients diagnosed with COVID-19, 1970 (6.9%) had a diagnosis of depression and 369 (1.3%) had a diagnosis of anxiety disorder prior to contracting COVID-19. While multivariable logistic regression models did not indicate any association between depression diagnosis and the risk of mechanical ventilation, depression was associated with a decreased risk of mortality (OR: 0.71; 95% CI: 0.53–0.94). There was no association between anxiety disorders and risk of mortality, but there was a strong positive association between anxiety disorders and the risk of mechanical ventilation (OR: 2.04; 95% CI: 1.35–3.10). ConclusionIn the present study, depression and anxiety disorder diagnoses were not associated with increased COVID-19 mortality. Anxiety disorder was strongly associated with an increased risk of mechanical ventilation. Further studies are needed to clarify how depression and anxiety disorders may influence COVID-19 severity and mortality.

Major risk factors associated with severe COVID-19 outcomes in patients with multiple myeloma: Report from the National COVID-19 Cohort Collaborative (N3C).

8008 Background: Patients with multiple myeloma (MM), an age-dependent neoplasm of antibody-producing plasma cells, have compromised immune systems due to multiple factors that may increase the risk of severe COVID-19. The NCATS’ National COVID Cohort Collaborative (N3C) is a centralized data resource representing the largest multi-center cohort of ̃12M COVID-19 cases and controls nationwide. In this study, we aim to analyze risk factors associated with COVID-19 severity and death in MM patients using the N3C database. Methods: Our cohort included MM patients within the N3C registry diagnosed with COVID-19 based on positive PCR or antigen tests or ICD-10–CM. The outcomes of interest include all-cause mortality (including discharge to hospice) during the index encounter, and clinical indicators of severity (hospitalization/ED visit, use of mechanical ventilation, or extracorporeal membrane oxygenation/ECMO). Results: As of 09/10/2021, the N3C registry included 690371 cancer patients, out of which 17791 were MM patients (4707 were COVID-19+). The mean age at diagnosis was 65.9yrs, 57.6% were &gt;65yo, 46.4% were females, and 21.8% were Blacks. 25.6% had a Charlson Comorbidity Index (CCI) score of ≥2. 55.6% required an inpatient or ED visit, and 3.65% required invasive ventilation. 11.4% developed acute kidney injury during hospitalization. Multivariate logistic regression analysis showed histories of pulmonary disease (OR 2.2; 95%CI: 1.7-2.8), renal disease (OR 1.8; 95%CI: 1.4-2.4), and black race (p&lt;0.001) were associated with higher risk of severity. Interestingly, smoking status was significantly associated with a lower risk of severity (OR 0.7; 95%CI: 0.5-0.9). Further, protective association was also observed between COVID-19 severity and blood or marrow transplant (BMT) (OR 0.52; 95%CI: 0.4-0.7), daratumumab therapy (OR 0.64; 95%CI: 0.42-0.99) and COVID-19 vaccination (OR 0.28; 95%CI: 0.18-0.44). IMiDs were associated increase in the risk of COVID-19 severity (OR 2.1; 95%CI: 1.6-2.7). 2.3% of N3C-myeloma COVID-19+ patients died within the first 10 days, while 4.95% died within 30 days of COVID-19 hospitalization. Overall, the survival probability was 90.5% across the course of the study. Multivariate cox proportional hazard model showed that CCI score ≥2 (HR 4.4; 95%CI: 2.2-8.8), hypertension (HR 1.6; 95%CI: 1.02-2.4), IMiD (HR 2.6; 95%CI: 1.8-3.8) and proteasome inhibitor (HR 1.6; 95%CI: 1.1-2.5) therapy were associated with worse survival. COVID-19 vaccination (HR 0.195; 95%CI: 0.09-0.45) and BMT (HR 0.65; 95%CI: 0.4-0.995) were associated with lower risk of death. Conclusions: We have identified previously unpublished potential risk factors for COVID-19 severity and death in MM as well as validated some published ones. To the best of our knowledge, this is the largest nationwide study on multiple myeloma patients with COVID-19.

The Impact of Deranged Glucose Metabolism and Diabetes in the Pathogenesis and Prognosis of the Novel SARS-CoV-2: A Systematic Review of Literature.

The novel coronavirus disease (COVID-19), declared a global pandemic by the World Health Organization (WHO) on March 11, 2020, and has constituted one of the most serious health challenges of the century, globally. The causative organism was initially named the 2019 novel coronavirus (2019 n CoV) but has subsequently been renamed Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). The pandemic has so far infected several millions and killed about a million people worldwide. Diabetes mellitus (DM) is one of the leading causes of morbidity worldwide. To examine the critical role diabetes plays in the pathogenesis and prognosis of COVID-19 and to assess the emerging therapies available to fight the pandemic. Authors conducted a systematic review of the literature to examine the role of diabetes as comorbidity in the pathogenesis and prognosis of COVID-19 by searching PubMed and Science Direct databases mainly for articles published since the outbreak of the pandemic. Both experimental and observational data from early 2020 suggested that most people with COVID-19 have comorbidities, the most dominant of which are diabetes, cardiovascular disease, and hypertension. Empirical evidence indicates that diabetic patients infected with the COVID-19 disease had the worst outcomes concerning morbidity and mortality. A combination of underlying chronic conditions such as hypertension, obesity, and cardiovascular diseases together with altered ACE receptor expression, immune dysregulation via cytokine storm, alveolar and endothelial dysfunction, increased systemic coagulation may put individuals with diabetes at risk for COVID-19 severity. More studies are needed to elucidate how glucose- lowering drugs may modulate the host immune response in diabetic individuals, especially following the administration of potential COVID-19 vaccines.

Complications of obesity in children and adolescents during covid-19 pandemic: A narrative review

Background: Obesity in children and adolescents has increased exponentially around the world. Furthermore, the COVID-19 pandemic has led to a higher pediatric obesity rate. The excess adipose tissue generates a dysregulation of adiponectin, ghrelin, and leptin, among others. Metabolic alterations can develop cardiovascular disease, dyslipidemias, arterial hypertension, type 2 diabetes mellitus, nonalcoholic fatty liver disease, sleep disorders, and higher risk of COVID-19 severity. Obesity has different therapeutic approaches such as behavioral weight loss programs, pharmacologic treatments, and surgical procedures. Therefore, timely diagnosis and treatment are important to decrease the mortality in obesity among pediatric population.

Estimating causal effects of atherogenic lipid-related traits on COVID-19 susceptibility and severity using a two-sample Mendelian randomization approach

BackgroundAs the number of COVID-19 deaths continues to rise worldwide, the identification of risk factors for the disease is an urgent issue, and it remains controversial whether atherogenic lipid-related traits including serum apolipoprotein B, low-density lipoprotein (LDL)-cholesterol, and triglyceride levels, are risk factors. The aim of this study was to estimate causal effects of lipid-related traits on COVID-19 risk in the European population using a two-sample Mendelian randomization (MR) approach.MethodsWe used summary statistics from a genome-wide association study (GWAS) that included 441,016 participants from the UK Biobank as the exposure dataset of lipid-related traits and from COVID-19 Host Genetics Initiative GWAS meta-analyses of European ancestry as the outcome dataset for COVID-19 susceptibility (32,494 cases and 1,316,207 controls), hospitalization (8316 cases and 1,549,095 controls), and severity (4792 cases and 1,054,664 controls). We performed two-sample MR analyses using the inverse variance weighted (IVW) method. As sensitivity analyses, the MR-Egger regression, weighted median, and weighted mode methods were conducted as were leave-one-out sensitivity analysis, the MR-PRESSO global test, PhenoScanner searches, and IVW multivariable MR analyses. A P value below 0.0055 with Bonferroni correction was considered statistically significant.ResultsThis MR study suggested that serum apolipoprotein B or LDL-cholesterol levels were not significantly associated with COVID-19 risk. On the other hand, we inferred that higher serum triglyceride levels were suggestively associated with higher risks of COVID-19 susceptibility (odds ratio [OR] per standard deviation increase in lifelong triglyceride levels, 1.065; 95% confidence interval [CI], 1.001–1.13; P = 0.045) and hospitalization (OR, 1.174; 95% CI, 1.04–1.33; P = 0.012), and were significantly associated with COVID-19 severity (OR, 1.274; 95% CI, 1.08–1.50; P = 0.004). Sensitivity and bidirectional MR analyses suggested that horizontal pleiotropy and reverse causation were unlikely.ConclusionsOur MR study indicates a causal effect of higher serum triglyceride levels on a greater risk of COVID-19 severity in the European population using the latest and largest GWAS datasets to date. However, as the underlying mechanisms remain unclear and our study might be still biased due to possible horizontal pleiotropy, further studies are warranted to validate our findings and investigate underlying mechanisms.

Impact of Immunosuppressant Agents on Post Liver Transplant Patients with COVID-19

Background: It seems that transplant recipients are at high risk for severe COVID-19, especially in the presence of comorbidities and immunosuppression. This study aimed to determine the effects of previous treatment with immunosuppressants and received dosage and the risk of COVID-19 severity and mortality in liver transplant recipients in various post-transplantation phases in the Iranian population. Methods: This was a cross-sectional study conducted among 24 patients in the post liver transplant course, who were referred to two transplant centers (Imam Reza and Montaseriyeh hospitals) affiliated to Mashhad University of Medical Sciences, Mashhad, Iran, during 2020-2021. The demographic and clinical characteristics of the patients were recorded in a checklist, and the relationships between various variables were analyzed. Results: The majority of the post liver transplant patients(96%) were in the late phase of post-transplantation, and 8.3% of the cases expired. COVID-19 severity and mortality did not show a significant relationship with previous treatment with immunosuppressants and received dosage (P&gt;0.05). In addition, there was no relationship between the symptoms of COVID-19 and immunosuppressant dosages, except for a headache. No significant correlation was found between immunosuppressants dosage and laboratory findings, and only prednisolone dosage was found to be correlated with heart rate (r=-0.62, P=0.03), BUN (r=-0.84, P=0.002), and D-dimer (r=-0.72, P=0.01). Conclusion: Severe SARS-CoV-2 infection was reported in the majority of liver transplant recipients. The severity of COVID-19 was not related to previous treatment with immunosuppressants and received dosage.

Combined association of obesity and other cardiometabolic diseases with severe COVID-19 outcomes: a nationwide cross-sectional study of 21 773 Brazilian adult and elderly inpatients

ObjectivesTo investigate the combined association of obesity, diabetes mellitus (DM) and cardiovascular disease (CVD) with severe COVID-19 outcomes in adult and elderly inpatients.DesignCross-sectional study based on registry data from Brazil’s...

Health Management Model: A Case Study for Success

Obesity is an important health issue in the current day and age. As it has been reported by many studies on the COVID-19 pandemic, individuals with excess weight and people with poor health are at a higher risk for COVID-19 severity. The purpose of this research is to give a model for losing weight by selecting a plant-based diet and by the progress measuring every day. The methodology is a case study with observations over three years. A case study is used to analyze the model and to teach in many disciplines in universities such as medicine, management, chiropractic, dentistry, psychology. Based on the findings of prior empirical studies, the subject made dietary and behavioral changes and was able to lose 45 kg (95 pounds) in approximately 18 months and maintain the proper weight for two years. The main conclusion is that by following this model including nutrition changes and regular measuring, people can reduce their weight to the normal level and keep it for a long period, hopefully, for the rest of life. This study shows how to change to plant-based food, avoid processed food, and measure the progress every day to adjust the behavior. Furthermore, the study shows that it is not a special diet but a long-term lifestyle. This study has limitations because a case study is not the same as a study with a randomized large sample. However, it contributes to the field of nutrition by showing that with a plant-based diet and a minor behavioral change, one can greatly improve his or her health by staying at a normal weight. This type of nutrition has a major social impact especially at this time of the COVID-19 pandemic because it affects particularly people in poor health conditions.

Retraction to: Intersectionality and Inequalities in Medical Risk for Severe COVID-19 in the Canadian Longitudinal Study on Aging.

Background and objectives Older populations with underlying medical conditions are at higher risk of COVID-19 severity and mortality once infected. Intersectional gerontology considers the compounding effects of multiple forms of social inequity. This study explores how racial-nativity status, family income, education level and the intersecting profile of these three social standings stratify differential patterns of chronic conditions among Canadians aged 45 years and older. Research design and methods Using the baseline Canadian Longitudinal Study on Aging (n = 29,748), multinomial logistic regression analyses were conducted to estimate multivariable-adjusted odds of having one and/or two (≤ 2) or multiple (≥3) medical conditions (i.e., diabetes, asthma, cancer, previous heart attack, cardiovascular disease, kidney disease, hypertension, chronic obstructive pulmonary disease, and obesity) based on socio-demographic characteristics. Results There were significant racial-nativity disparities and social-class gradients in multimorbidity. The odds of having ≥3 medical conditions were greater for Black immigrants (OR=1.79, 95% CI=1.13, 2.82), South Asian immigrants (OR=1.49, 95% CI=1.02, 2.19) and close to double for Aboriginal Canadians (OR=1.96, 95% CI=1.37, 2.80) relative to Canadian-born Whites. Black, South Asian and Aboriginal populations from disadvantaged socioeconomic backgrounds had the highest odds of having ≥3 medical conditions (OR=3.50, 95% CI=1.41, 8.70). Discussion and implications Despite a universal health system, marginalized older Canadians who are racialized foreign-born, less educated, and/or low-income have a higher prevalence of multimorbidity that are associated with COVID-19 severe illness and mortality. Upstream health policy and social care tackling intersecting structural inequities should be undertaken to prevent increasing multimorbidity among underserved aging populations.

Sickle Cell Disease (SCD) and COVID-19 – A Case Series

The ongoing pandemic of COVID-19 that started in the Hubei province of China in late December 2019, caused by severe acute respiratory syndrome corona virus-2 (SARS CoV-2). Globally millions affected by the disease so far. The risk of COVID-19 severity and its complications increases with age and other comorbidities. The course of SARS-CoV-2 infection or its related complications has yet to be established in patients with sickle cell disease (SCD), once more evidence is available. It is clear from the available data that the course of COVID-19 in patients with SCD is mild to moderate, seldom severe, and rarely fatal. Herein we report three known cases of SCD with confirmed COVID-19, in whom the course of the disease was mild to moderate and uncomplicated with uneventful recoveries.

We Need to Talk About Racism-In All of Its Forms-To Understand COVID-19 Disparities.

Purpose: Racism is an essential factor to understand racial health disparities in infection and mortality due to COVID-19 and must be thoroughly integrated into any successful public health response. But highlighting the effect of racism generally does not go far enough toward understanding racial/ethnic health disparities or advocating for change; we must interrogate the various forms of racism in the United States, including behaviors and practices that are not recognized by many as racism.Methods: In this article, we explore the prevalence and demographic distribution of various forms of racism in the United States and how these diverse racial ideologies are potentially associated with racialized responses to the COVID-19 crisis.Results: We find that among white Americans, more than a quarter express traditional racist attitudes, whereas more than half endorse more contemporary and implicit forms of racist ideology. Each of these types of racism helps us explain profound disparities related to COVID-19.Conclusions: Despite a robust literature documenting persistent patterns of racial disparities in the United States, a focus on the role that various forms of racism play in perpetuating these disparities is absent. These distinctions are essential to realizing health equity and countering disparities in COVID-19 and other health outcomes among people of color in the United States.

Sleep-wake cycle impairment adding on the risk for COVID-19 severity in people with diabetes.

In the present article, we explore the risks of circadian disruptions and impact on the sleep-wake cycle of individuals with diabetes during COVID-19 pandemic. The association between the duration and quality of sleep and the stability of glucose levels is well-established. Therefore, during the pandemic with changes and limitations in the exposure to cyclic cues that entrain the circadian rhythms, such as light-dark and social interactions, we hypothesize that the power and stability of circadian rhythms decrease if measures are not taken to intentionally create a routine that includes zeitgebers. Knowing that sleep-wake cycle disruptions impair melatonin production, immune system response and glucose metabolism, and that individuals with diabetes are at higher risk for poor prognosis when infected by SARS-CoV-2 (especially if their blood glucose is out of target), we recommend monitoring and advising these individuals towards strategies to maintain adequate sleep quality and duration as part of their preventive and protective measures during the new pandemic routine.