Chronic Skin Disease and Levels of Physical Activity in 17,777 Spanish Adults: A Cross-Sectional Study

Background: To date there is limited literature on the prevalence of chronic skin conditions and levels of physical activity (PA) in Spain. Aim: The present study aims to (i) determine the prevalence of chronic skin disease and (ii) compare levels of PA in those with chronic skin disease to those without in a large representative sample of Spanish adults aged 15‐69 years. Methods: Data from the Spanish National Health Survey 2017 were analysed. Chronic skin disease was assessed using a yes‐no question. PA was measured using the short form of the International Physical Activity Questionnaire (IPAQ). Total PA metabolic equivalent of task (MET)‐minutes/week were calculated, and PA was included in the analyses as a continuous and a five‐category variable. Results: This cross‐sectional study included 17,777 participants [52.0% women; mean (standard deviation) age 45.8 (14.1) years]. There were 940 (5.3%) adults with chronic skin disease. After adjusting for several potential confounders, there was a negative association between chronic skin disease and PA [odds ratio (OR)=0.87, 95% CI=0.76–1.00]. The association was significant in men (OR=0.76, 95% CI=0.62‐0.93) but not in women (OR=0.97, 95% CI=0.81‐1.16). Conclusions: In this large representative sample of Spanish adults, the prevalence of chronic skin disease was low. Levels of PA in men with chronic skin conditions, but not in women, were lower than those without

The role of Vitamin D in the prevention of Coronavirus Disease 2019 infection and mortality

WHO declared SARS-CoV-2 a global pandemic. The present aim was to propose an hypothesis that there is a potential association between mean levels of vitamin D in various countries with cases and mortality caused by COVID-19. The mean levels of vitamin D for 20 European countries and morbidity and mortality caused by COVID-19 were acquired. Negative correlations between mean levels of vitamin D (average 56 mmol/L, STDEV 10.61) in each country and the number of COVID-19 cases/1 M (mean 295.95, STDEV 298.7, and mortality/1 M (mean 5.96, STDEV 15.13) were observed. Vitamin D levels are severely low in the aging population especially in Spain, Italy and Switzerland. This is also the most vulnerable group of the population in relation to COVID-19. It should be advisable to perform dedicated studies about vitamin D levels in COVID-19 patients with different degrees of disease severity

A paradigm shift in the role of NSAIDs in COVID-19: new pathological mechanisms and potential treatment targets

Objectives: The pathogeny of SARS-COV2 infection is currently not well defined. In this paper, we present a new perspective of how the SARS-CoV2 infection can lead to severe cases and potential pathways of preventing such cases. Methods: In the first part, we describe the role of cyclooxigenase 2 and in the second part, we describe the role of hypoxia inducible factor (HIF). Findings: We hypothesize that cyclooxigenase 2 and hypoxia inducible factor with subsequent inflammation and hypoxia can up-regulate each other in a vicious circle of feed-forward that can ultimately lead to “cytokine storm”. Conclusions: Breaking this cycle early potentially will have beneficial effects either by improving oxygenation (oxygen being given earlier in the course of the treatment) or by inhibiting COX-2. We also believe, that the use of COX-2 inhibitors early in the course of the disease can improve the outcome and clinical trial are urgently needed.

The impact of urinary incontinence on multiple health outcomes: an umbrella review of meta-analysis of observational studies

International audienceBackground and aim: We aimed to capture the breadth of health outcomes that have been associated with the presence of Urinary Incontinence (UI) and systematically assess the quality, strength, and credibility of these associations through an umbrella review and integrated meta-analyses. Methods: We assessed meta-analyses of observational studies based on random-effect summary effect sizes and their p-values, 95% prediction intervals, heterogeneity, small-study effects, and excess significance. We graded the evidence from convincing (Class I) to weak (Class IV). Results and discussion: From 3172 articles returned in search of the literature, 9 systematic reviews were included with a total of 41 outcomes. Overall, 37 out of the 41 outcomes reported nominally significant summary results (p < 0.05), with 22 associations surviving the application of a more stringent p-value (p < 10−6). UI was associated with worse scores than controls in female sexual function (Class II), while it was also associated with a higher prevalence of depression (odds ratio [OR] = 1.815; 95% confidence interval [CI]: 1.551–2.124), and anxiety (OR = 1.498; 95% CI: 1.273–1.762) (Class IV). UI was associated with poorer quality of life (QoL), higher rate of mortality (hazard ratio = 2.392; 95% CI: 2.053–2.787) an increase in falls, frailty, pressure ulcers, diabetes, arthritis, and fecal incontinence (Class IV). Conclusions: UI is associated with female sexual dysfunction, with highly suggestive evidence. However, the evidence of other adverse outcomes including depression, anxiety, poorer QoL, higher mortality, falls, pressure ulcers, diabetes, arthritis, fecal incontinence, and frailty is only weak. A multidimensional approach should be taken in managing UI in the clinical setting

The impact of urinary incontinence on multiple health outcomes: an umbrella review of meta-analysis of observational studies

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Factors associated with adverse COVID-19 outcomes in patients with psoriasis : insights from a global registry–based study

Background: The multimorbid burden and use of systemic immunosuppressants in people with psoriasis may confer greater risk of adverse outcomes of coronavirus disease 2019 (COVID-19), but the data are limited. Objective: Our aim was to characterize the course of COVID-19 in patients with psoriasis and identify factors associated with hospitalization. Methods: Clinicians reported patients with psoriasis with confirmed/suspected COVID-19 via an international registry, Psoriasis Patient Registry for Outcomes, Therapy and Epidemiology of COVID-19 Infection. Multiple logistic regression was used to assess the association between clinical and/or demographic characteristics and hospitalization. A separate patient-facing registry characterized risk-mitigating behaviors. Results: Of 374 clinician-reported patients from 25 countries, 71% were receiving a biologic, 18% were receiving a nonbiologic, and 10% were not receiving any systemic treatment for psoriasis. In all, 348 patients (93%) were fully recovered from COVID-19, 77 (21%) were hospitalized, and 9 (2%) died. Increased hospitalization risk was associated with older age (multivariable-adjusted odds ratio [OR] = 1.59 per 10 years; 95% CI = 1.19-2.13), male sex (OR = 2.51; 95% CI = 1.23-5.12), nonwhite ethnicity (OR = 3.15; 95% CI = 1.24-8.03), and comorbid chronic lung disease (OR = 3.87; 95% CI = 1.52-9.83). Hospitalization was more frequent in patients using nonbiologic systemic therapy than in those using biologics (OR = 2.84; 95% CI = 1.31-6.18). No significant differences were found between classes of biologics. Independent patient-reported data (n = 1626 across 48 countries) suggested lower levels of social isolation in individuals receiving nonbiologic systemic therapy than in those receiving biologics (OR = 0.68; 95% CI = 0.50-0.94). Conclusion: In this international case series of patients with moderate-to-severe psoriasis, biologic use was associated with lower risk of COVID-19-related hospitalization than with use of nonbiologic systemic therapies; however, further investigation is warranted on account of potential selection bias and unmeasured confounding. Established risk factors (being older, being male, being of nonwhite ethnicity, and having comorbidities) were associated with higher hospitalization rates