Is Obesity a Potential Risk factor for Poor Prognosis of COVID-19?

Meltem Agca,Eylem Tuncay,Elif Yıldırım,Reyhan Yıldız,Tülin Sevim,Dilek Ernam,Nermin Ozer Yılmaz,Nazlı Huma Teke,Simge Yavuz,Zuhal Karakurt,COVID-19 Team,Ipek Ozmen 대한감염학회 2021 Infection and Chemotherapy Vol.53 No.2

Background: Coronavirus disease 2019 (COVID-19) continues to cause major mortality and morbidity worldwide even after a year of its emergence. In its early days, hypertension, diabetes, and cardiovascular diseases were noted as poor prognostic factors, while obesity gained attention at a later stage. In the present study, unfavorable clinical outcomes (transfer to the intensive care unit, invasive mechanical ventilation, and mortality) were investigated in obese patients with COVID-19. Materials and Methods: In this retrospective study we analyzed patients with positive polymerase chain reaction test in tertiary care hospital between March-May 2020. They were divided into 3 groups according to body mass index (BMI) as normal, overweight, and obese (BMI: 18.5 - 24.99 kg/m2 , 25 - 29.99 kg/m2 , and ≥ 30 kg/m2 , respectively). We compared clinical features and laboratory findings of these groups and recorded adverse clinical outcomes. Multivariate logistic analysis was performed for unfavorable outcomes. Results: There were 99 patients (35%), 116 (41%), and 69 patients (24%) in the normal-weight, overweight, and obese group, respectively. Among all patients, 52 (18%) patients were transferred to the intensive care unit (ICU), 30 (11%) patients received invasive mechanical ventilation (IMV), and 22 patients (8%) died. Obese patients had minimum 1 more comorbidity than normal BMI patients (73% vs. 50%, P = 0.002), and a longer median (interquartile range [IQR]) duration of hospitalization (8 [5 - 12] vs. 6 [5 - 9]) days, P = 0.006). Obese participants had higher concentrations of serum C-reactive protein, procalcitonin, ferritin than nonobese patients (P <0.05 in all). In a multivariate analysis, obesity was associated with ICU admission (adjusted odds ratio [aOR]: 2.99, 95% confidence interval [CI]: 1.26 - 7.04, P = 0.012). Moreover, IMV requirement was associated with obesity (aOR: 8.73, 95% CI: 2.44 - 31.20, P = 0.001). Mortality occurred in 16%, 9%, and 1% of the obese group, overweight group, and normal-weight group, respectively (Chi-square trend analysis, P = 0.002). Conclusion: Obesity is a risk factor for adverse outcomes and caused increased mortality, hence requiring close follow-up.

Examining Knowledge, Skill, Stress, Satisfaction, and Self-Confidence Levels of Nursing Students in Three Different Simulation Modalities

Üzen Cura Şengül,Kocatepe Vildan,Yıldırım Dilek,Küçükakgün Hilalnur,Atay Selma,Ünver Vesile 한국간호과학회 2020 Asian Nursing Research Vol.14 No.3

Purpose: The aim of this study was to compare the effect of different simulation modalities on knowledge, skill, stress, satisfaction, and self-confidence levels of students receiving undergraduate education in three nursing schools. Method: This was an experimental study. Students applied the scenario of “Respiratory Sounds Assessment” which was prepared according to three different simulation modalities. In the study, the standardized patient, high-fidelity simulation, and partial task trainer were used as simulation modalities. Results: An increase was observed in postpractice knowledge levels of the three groups which had similar knowledge levels before the practice. Virtual Analog Scale stress levels of the students in the standardized patient group were higher than those of others. The students’ mean scores of satisfaction in learning were higher in the standardized patient group. The students in the partial task trainer group had lower scores of self-confidence in learning. Skill scores of the students were lower in the standardized patient practice than those in others. Conclusion: Simulation-based experiences give students the opportunity of experiencing situations they may experience in the actual practice beforehand. Therefore, this may increase their performance in real practices, as reality increases in the standardized patient group.

An Experimental Comparison of the Analgesic and Anti-Inflammatory Effects of Safflower Oil, Benzydamine HCl, and Naproxen Sodium

Ali Alaiye,Ercan Kaya,Mehmet Ozgur Pınarbaslı,Nusin Harmancı,Cafer Yıldırım,Dilek Burukoglu Donmez,Cemal Cingi 한국식품영양과학회 2020 Journal of medicinal food Vol.23 No.8

The study aims to establish how feasible a natural therapy option (safflower oil) is in the treatment of postoperative pain. Naproxen sodium has already been experimentally proven to be effective for this purpose. Accordingly, the analgesic and anti-inflammatory effects of safflower oil were compared with those obtained with benzydamine HCl and naproxen sodium. Forty-two, healthy, adult female rats of Wistar albino species were divided at random into six groups of seven rats. The intervention allocation was as follows: Group No. 1—physiological saline 0.9%; Group No. 2—safflower oil 100 mg/kg; Group No. 3—safflower oil 300 mg/kg; Group No. 4—benzydamine HCl 30 mg/kg; Group No. 5—benzydamine HCl 100 mg/kg; and Group No. 6—naproxen sodium 10 mg/kg. Following allocation of treatment, pain was induced experimentally and tested in various ways (hot plate test, tail-pinching test, and writhing test) and the efficacy of each treatment in providing peripheral and central analgesia was evaluated. The second stage consisted of providing different treatments to four groups (groups 7–10) of seven rats each, chosen at random. The allocations were as follows: Group No. 7—physiological saline 0.9%; Group No. 8—safflower oil 300 mg/kg; Group No. 9—benzydamine HCl 100 mg/kg; and Group No. 10—naproxen sodium 10 mg/kg. To create experimental inflammation, 2% formaldehyde was injected into the experimental animal's paw and the resulting edema was measured and recorded for a 10-day period. Edema inhibition was calculated as a percentage. The rats were sacrificed and the paw and stomach dissected for histopathological examination. The data were used for statistical analysis, using the Shapiro–Wilk, Kruskal–Wallis H test, and two-way analysis of variance. In the tail-pinching test, it was determined that a 300 mg/kg dose of safflower oil shows central spinal analgesic efficacy and this effect is close in magnitude to 10 mg/kg of the reference material, naproxen sodium. In the squirming test, it was observed that the 100 and 300 mg/kg doses of safflower oil had a peripheral analgesic effect when compared with the serum physiological (placebo) group. The peripheral efficacy of 300 mg/kg safflower oil was found to approximate that of 10 mg/kg naproxen sodium. In rats treated with benzydamine HCl 100 mg/kg, similar peripheral analgesic efficacy to naproxen sodium 10 mg/kg was noted. In the hot plate test, no difference in the analgesic efficacy between the various agents was found. The change in inhibition of edema between the 1st and 10th days was most marked in rats receiving naproxen sodium 10 mg/kg. A significant difference was determined in the safflower oil 300 mg/kg and benzydamine HCl 100 mg/kg groups (P < .001). Regarding histopathology findings in the rat paw, significant differences were seen in venous congestion between placebo and safflower oil 300 mg/kg and in inflammation between the control and benzydamine HCl 100 mg/kg groups. Regarding the histopathology findings in the rat stomach, significant differences were observed in venous congestion between placebo and safflower oil 300 mg/kg; in damage to the epithelium between placebo and safflower oil 300 mg/kg and between naproxen sodium 10 mg/kg and safflower oil; and in cell infiltration and development of edema between placebo and safflower oil 300 mg/kg. It is predicted that further research into safflower oil and benzydamine HCl will create opportunities to develop analgesic–anti-inflammatory therapeutics of a novel kind for the treatment of postoperative pain and inflammation.