HealthDay News — People with severe mental illness (SMI) have higher risks for COVID-19 infection, hospitalization, and mortality, according to a study published online Dec. 7 in Molecular Psychiatry. Lamiece Hassan, Ph.D., from the University of Manchester in the United Kingdom, and colleagues investigated COVID-19-related infection, hospitalization, and mortality among people with SMI participating in the UK Biobank cohort study. The analysis included data from 447,296 participants (schizophrenia/psychosis: 1,925 patients; bipolar disease: 1,483 patients; and major depressive disorder: 41,448 patients; plus 402,440 with no SMI) that was linked to health care and death records. The researchers found higher odds of COVID-19 mortality among people with schizophrenia/psychosis (odds ratio [OR], 4.84), bipolar disease (OR, 3.76), and major depressive disorder (OR, 1.99) versus people with no SMI. Across all SMI groups, higher odds of infection and hospitalization were also seen, particularly among people with schizophrenia/psychosis (OR, 1.61 and 3.47, respectively) and bipolar disease (OR, 1.48 and 3.31, respectively). Mortality and hospitalization remained significantly higher among all SMI groups in fully adjusted models, while infection odds remained significantly higher only for major depressive disorder. “Only a proportion of these disparities were accounted for by preexisting demographic characteristics or comorbidities,” the authors write. “Vaccination and preventive measures should be prioritized in these particularly vulnerable groups.” Abstract/Full Text

Factors contributing significantly to the risk for peripheral arterial disease (PAD) among patients with type 2 diabetes include age ≥70 years, diabetes duration ≥5 years, history of coronary artery disease (CAD), hypertension, and increased low-density lipoprotein (LDL) level, according to research presented at the 30th Annual Scientific and Clinical Congress of the American Association of Clinical Endocrinologists (ENVISION 2021).

Investigators conducted a systematic and comprehensive review of the risk factors for PAD in populations with type 2 diabetes and assessed the pooled effect estimates. They conducted literature searches on PubMed/MEDLINE, EMBASE, and ProQuest through October 10, 2020, to identify risk factors including age, sex, duration of diabetes, hypertension, history of CAD or stroke, obesity, glycated hemoblogin (HbA1c) level, estimated glomerular filtration rate, dyslipidemia, smoking, and fibrinogen level.

The researchers included 10 studies in the qualitative synthesis and 9 studies in the meta-analysis. A total of 6 cohort studies included 71,450 patients, and 4 case-control studies included 2393 patients. All the included studies were of good quality with a low risk of bias.


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One study found a lower risk for PAD among patients who had HbA1c ≤7.4% (hazard ratio [HR] 0.67; CI 95%, 0.53-0.86) and blood pressure ≤145/85 mm Hg (HR 0.81; CI 95%, 0.66-0.99) during their first year of treatment. Another study found a higher risk of PAD in women (HR 1.86; CI 95%, 1.33-2.59; P <.001).

The pooled effect estimate (odds ratio [OR]) for the 2 studies that found age ≥70 years to be a risk factor for PAD was 3.44. The OR in 2 studies that found diabetes duration greater than 5 years as a risk factor for PAD was 1.81. The OR in 3 studies that found a history of CAD as a risk factor for PAD was 1.55. The OR in 8 studies that found hypertension as a risk factor for PAD was 1.43. In 2 studies that found increased LDL as a risk factor for PAD, the study authors reported a subtotal OR of 2.51.

Considering the numerous factors that contribute to the increased risk of developing PAD in the setting of type 2 diabetes, a multidisciplinary approach has the potential to improve outcomes in this population.

HealthDay News — In an effort to further lower lead levels in drinking water, the Biden administration on Thursday announced $2.9 billion in infrastructure bill funds for lead pipe removal and tighter lead limits. The new, tougher limits to be imposed by the Environmental Protection Agency (EPA) are expected to be finalized by 2024 and would require the replacement of remaining lead drinking water pipes as quickly as possible, the White House said in a statement announcing the new plan. “Over the past year, I have visited with and heard from communities in Chicago, Flint, Jackson, and many other areas that are impacted by lead in drinking water,” EPA Administrator Michael Regan said in an agency statement. “These conversations have underscored the need to proactively remove lead service lines, especially in low-income communities. The science on lead is settled — there is no safe level of exposure and it is time to remove this risk to support thriving people and vibrant communities.” In remarks made at the AFL-CIO Washington, D.C., headquarters on Thursday, Vice President Kamala Harris acknowledged the goal is lofty. “The challenge that we face is, without any question, great. Lead is built into our cities. It is laid under our roads and it is installed in our homes,” Harris said. Environmental advocates had mixed reactions to the 10-year plan. “The top priority must be to require removal of all lead pipes within the decade and to set a strict at-the-tap standard, which is the only way to prevent another generation of kids from drinking water through what is essentially a lead straw,” Erik Olson, senior strategic director of health at the Natural Resources Defense Council, told the Associated Press. “Good intentions won’t be enough to get the job done.” John Rumpler, senior attorney with Environment America, told the AP that the plans are “long overdue and an indispensable step toward securing safe water.” He also said the EPA should set a 10-year deadline to replace lead service lines, as New Jersey did in July. Associated Press Article

Reference

Rosana M, Saragih N, Soewondo P, et al. Risk factors of peripheral arterial disease in type 2 diabetes mellitus patients: a systematic review and meta-analysis. Presented at: 2021 AACE Virtual Annual Meeting, May 26-29, 2021.

This article originally appeared on Endocrinology Advisor