Effects of mindfulness-based interventions on biomarkers in healthy and cancer populations: a systematic review

Background: Only a small number of articles have investigated the relationship between mindfulness-based interventions (MBIs) and biomarkers. The aim of this systematic review was to study the effect of MBIs on specific biomarkers (cytokines, neuropeptides and C-reactive protein (CRP)) in both healthy subjects and cancer patients. Methods: A search was conducted using PubMed, EMBASE, PsycINFO and the Cochrane library between 1980 and September 2016. Results: A total of 13 studies with 1110 participants were included. In the healthy population, MBIs had no effect on cytokines, but were found to increase the levels of the neuropeptide insulin-like growth factor 1 (IGF-1). With respect to neuropeptide Y, despite the absence of post-intervention differences, MBIs may enhance recovery from stress. With regard to CRP, MBIs could be effective in lower Body Mass Index (BMI) individuals. In cancer patients, MBIs seem to have some effect on cytokine levels, although it was not possible to determine which specific cytokines were affected. One possibility is that MBIs might aid recovery of the immune system, increasing the production of interleukin (IL)-4 and decreasing interferon gamma (IFN-gamma). Conclusions: MBIs may be involved in changes from a depressive/carcinogenic profile to a more normalized one. However, given the complexity and different contexts of the immune system, and the fact that this investigation is still in its preliminary stage, additional randomized controlled trials are needed to further establish the impact of MBI programmes on biomarkers in both clinical and non-clinical populations.Instituto de Salud Carlos III of the Spanish Ministry of Economy and CompetitivenessNetwork for Prevention and Health Promotion in primary Care from the Instituto de Salud Carlos III of the Ministry of Economy and Competitiveness (Spain)European Union ERDF fundsAragon Hlth Sci Inst IACS, Zaragoza, SpainShowa Univ, Dept Psychiat, Sch Med, Tokyo, JapanPrimary Care Prevent & Hlth Promot Res Network RE, Barcelona, SpainUniv Zaragoza, Miguel Servet Univ Hosp, Dept Psychiat, Zaragoza, SpainUniv Zaragoza, Fac Social & Human Sci, Dept Psychol & Sociol, Teruel, SpainFed Univ Sao Paulo UNIFESP, Dept Prevent Med, Mente Aberta Brazilian Ctr Mindfulness & Hlth Pro, Sao Paulo, BrazilHosp Israelita Albert Einstein, Sao Paulo, BrazilUniv Zaragoza, Fac Hlth Sci & Sports, Huesca, SpainUniv Balearic Isl, Res Inst Hlth Sci IUNICS, Palma De Mallorca, SpainFed Univ Sao Paulo UNIFESP, Dept Prevent Med, Mente Aberta Brazilian Ctr Mindfulness & Hlth Pro, Sao Paulo, BrazilInstituto de Salud Carlos III of the Spanish Ministry of Economy and Competitiveness: PI13/01637Network for Prevention and Health Promotion in primary Care from the Instituto de Salud Carlos III of the Ministry of Economy and Competitiveness (Spain): RD12/0005Web of Scienc

Early mobilisation in critically ill COVID-19 patients: a subanalysis of the ESICM-initiated UNITE-COVID observational study

Background Early mobilisation (EM) is an intervention that may improve the outcome of critically ill patients. There is limited data on EM in COVID-19 patients and its use during the first pandemic wave. Methods This is a pre-planned subanalysis of the ESICM UNITE-COVID, an international multicenter observational study involving critically ill COVID-19 patients in the ICU between February 15th and May 15th, 2020. We analysed variables associated with the initiation of EM (within 72 h of ICU admission) and explored the impact of EM on mortality, ICU and hospital length of stay, as well as discharge location. Statistical analyses were done using (generalised) linear mixed-effect models and ANOVAs. Results Mobilisation data from 4190 patients from 280 ICUs in 45 countries were analysed. 1114 (26.6%) of these patients received mobilisation within 72 h after ICU admission; 3076 (73.4%) did not. In our analysis of factors associated with EM, mechanical ventilation at admission (OR 0.29; 95% CI 0.25, 0.35; p = 0.001), higher age (OR 0.99; 95% CI 0.98, 1.00; p ≤ 0.001), pre-existing asthma (OR 0.84; 95% CI 0.73, 0.98; p = 0.028), and pre-existing kidney disease (OR 0.84; 95% CI 0.71, 0.99; p = 0.036) were negatively associated with the initiation of EM. EM was associated with a higher chance of being discharged home (OR 1.31; 95% CI 1.08, 1.58; p = 0.007) but was not associated with length of stay in ICU (adj. difference 0.91 days; 95% CI − 0.47, 1.37, p = 0.34) and hospital (adj. difference 1.4 days; 95% CI − 0.62, 2.35, p = 0.24) or mortality (OR 0.88; 95% CI 0.7, 1.09, p = 0.24) when adjusted for covariates. Conclusions Our findings demonstrate that a quarter of COVID-19 patients received EM. There was no association found between EM in COVID-19 patients' ICU and hospital length of stay or mortality. However, EM in COVID-19 patients was associated with increased odds of being discharged home rather than to a care facility. Trial registration ClinicalTrials.gov: NCT04836065 (retrospectively registered April 8th 2021)