Gorman, Ellen K.

There is a context-dependent trade-off in body size of elite runners, such that smaller body sizes are observed among longer distance runners. However, it is unclear whether this trade-off in body size is observed in other Olympic sports, such as cycling and swimming. To understand the association between body size and athletic competition, we examined metrics of body size from male and female Olympic athletes competing in swimming, running, and cycling. We collected standard anthropometrics (height, mass, body mass index (BMI), and body surface area) of elite male and female athletes competing in the London 2012 Summer Olympics from a public repository. Anthropometric data were compared between sexes (male and female); between sports (swimming, running, and cycling); and between distances within sports (shorter and longer distance). Males were taller ( P < 0.001), heavier ( P < 0.001), and had a larger BMI ( P < 0.001) compared to females. Relative to athletes competing in longer distance events, athletes competing in shorter distance were generally taller (running: P < 0.001, swimming: P ≤ 0.014) and heavier (running: P < 0.001, swimming: P = 0.002 (males) and P = 0.148 (females), cycling: P < 0.001) for both males and females. Height was not different between shorter and longer distance cyclists. There was a trade-off between body size and distance for each of the three Olympics sports, such that smaller athletes were observed in longer distance events. Although there were large sex-based differences in body size, similar trade-offs in size and event were observed for both males and females. These data suggest that there is an optimal combination of skeletal muscle mass and body size to optimize movement economy that is generally preserved across different modes of human locomotion.

ABSTRACT Although severe coronavirus disease 2019 (COVID-19) and hospitalization associated with COVID-19 are generally preventable among healthy vaccine recipients, patients with immunosuppression have poor immunogenic responses to COVID-19 vaccines and remain at high risk of infection with SARS-CoV-2 and hospitalization. In addition, monoclonal antibody therapy is limited by the emergence of novel SARS-CoV-2 variants that have serially escaped neutralization. In this context, there is interest in understanding the clinical benefit associated with COVID-19 convalescent plasma collected from persons who have been both naturally infected with SARS-CoV-2 and vaccinated against SARS-CoV-2 (“vax-plasma”). Thus, we report the clinical outcome of 386 immunocompromised outpatients who were diagnosed with COVID-19 and who received contemporary COVID-19-specific therapeutics (standard-of-care group) and a subgroup who also received concomitant treatment with very high titer COVID-19 convalescent plasma (vax-plasma group) with a specific focus on hospitalization rates. The overall hospitalization rate was 2.2% (5 of 225 patients) in the vax-plasma group and 6.2% (10 of 161 patients) in the standard-of-care group, which corresponded to a relative risk reduction of 65% ( P = 0.046). Evidence of efficacy in nonvaccinated patients cannot be inferred from these data because 94% (361 of 386 patients) of patients were vaccinated. In vaccinated patients with immunosuppression and COVID-19, the addition of vax-plasma or very high titer COVID-19 convalescent plasma to COVID-19-specific therapies reduced the risk of disease progression leading to hospitalization. IMPORTANCE As SARS-CoV-2 evolves, new variants of concern (VOCs) have emerged that evade available anti-spike monoclonal antibodies, particularly among immunosuppressed patients. However, high-titer COVID-19 convalescent plasma continues to be effective against VOCs because of its broad-spectrum immunomodulatory properties. Thus, we report clinical outcomes of 386 immunocompromised outpatients who were treated with COVID-19-specific therapeutics and a subgroup also treated with vaccine-boosted convalescent plasma. We found that the administration of vaccine-boosted convalescent plasma was associated with a significantly decreased incidence of hospitalization among immunocompromised COVID-19 outpatients. Our data add to the contemporary data providing evidence to support the clinical utility of high-titer convalescent plasma as antibody replacement therapy in immunocompromised patients.

ImportancePatients who are immunocompromised have increased risk for morbidity and mortality associated with coronavirus disease 2019 (COVID-19) because they less frequently mount antibody responses to vaccines. Although neutralizing anti-spike monoclonal-antibody treatment has been widely used to treat COVID-19, evolutions of SARS-CoV-2 have been associated with monoclonal antibody-resistant SARS-CoV-2 variants and greater virulence and transmissibility of SARS-CoV-2. Thus, the therapeutic use of COVID-19 convalescent plasma has increased on the presumption that such plasma contains potentially therapeutic antibodies to SARS-CoV-2 that can be passively transferred to the plasma recipient.ObjectiveTo assess the growing number of reports of clinical experiences of patients with COVID-19 who are immunocompromised and treated with specific neutralizing antibodies via COVID-19 convalescent plasma transfusion.Data SourcesOn August 12, 2022, a systematic search was performed for clinical studies of COVID-19 convalescent plasma use in patients who are immunocompromised.Study SelectionRandomized clinical trials, matched cohort studies, and case report or series on COVID-19 convalescent plasma use in patients who are immunocompromised were included. The electronic search yielded 462 unique records, of which 199 were considered for full-text screening.Data Extraction and SynthesisThe study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Data were extracted by 3 independent reviewers in duplicate and pooled.Main Outcomes and MeauresThe prespecified end point was all-cause mortality after COVID-19 convalescent plasma transfusion; exploratory subgroup analyses were performed based on putative factors associated with the potential mortality benefit of convalescent plasma.ResultsThis systematic review and meta-analysis included 3 randomized clinical trials enrolling 1487 participants and 5 controlled studies. Additionally, 125 case series or reports enrolling 265 participants and 13 uncontrolled large case series enrolling 358 participants were included. Separate meta-analyses, using models both stratified and pooled by study type (ie, randomized clinical trials and matched cohort studies), demonstrated that transfusion of COVID-19 convalescent plasma was associated with a decrease in mortality compared with the control cohort for the amalgam of both randomized clinical trials and matched cohort studies (risk ratio [RR], 0.63 [95% CI, 0.50-0.79]).Conclusions and RelevanceThese findings suggest that transfusion of COVID-19 convalescent plasma is associated with mortality benefit for patients who are immunocompromised and have COVID-19.

Background During the menopause transition, women are at an increased risk of developing hypertension, which is a key marker of cardiovascular disease (CVD). Although historically hot flashes have been considered a quality‐of‐life issue, emerging data provides a link between hot flashes and risk of CVD. Poor renal function is suggested to be one of the key physiological contributors to increased risk of hypertension and CVD among women with hot flashes. Thus, the aim of this study was to characterize the relationship between hot flashes and renal function in peri‐ and post‐menopausal women using a retrospective chart review. We hypothesized that women with hot flashes would demonstrate reduced renal function compared to women without hot flashes. Methods We performed a chart review using serum creatinine and estimated glomerular filtration rate (eGFR) as proxies to assess renal function. Electronic health records for Mayo Clinic patients across multiple sites were abstracted for female patients who were diagnosed with peri‐ or post‐menopause between 2016 and 2020, between 45 and 55 years of age, and had available creatinine laboratory test results. Data regarding demographics, anthropometrics, systemic blood pressure, menopausal stage, occurrence of hot flashes, and comorbidities were extracted from electronic health records. Differences between women with and without hot flashes were evaluated using two‐tailed, independent samples t‐tests. We completed a univariate analysis of variance testing the main effects of menopausal status (peri‐ or post‐menopausal) and presence of hot flashes (yes or no). Given the potential modifying effects of menopause, analytical models were performed in duplicate with and without models separated by menopausal status (peri‐and post‐menopause). Results Data from 83 medical charts were assessed, including 57 women with hot flashes and 26 women without hot flashes. Without separating by menopausal status, there were no hot flash‐related differences in age (51 ± 3 vs. 51 ± 3 years, P = 0.64) or body mass index (30 ± 7 vs. 33 ± 11, P = 0.19) between women with and without hot flashes. Additionally, there were no hot flash‐related differences in metrics of blood pressure, including systolic (120 ± 13 vs. 125 ± 20, P = 0.19), diastolic (75 ± 11 vs. 77 ± 13, P = 0.54), and mean arterial pressure (90 ± 11 vs. 92 ± 14, P = 0.62). There were also no hot flash‐related differences in indicators of renal function, including creatinine (0.8 ± 0.1 vs. 0.8 ± 0.2, P = 0.65) and eGFR (88 ± 11 vs. 85 ± 16, P = 0.36). The clinical characteristics of the perimenopausal versus postmenopausal women are summarized in Table 1 by hot flash status . There were no main effects of hot flash or menopausal status on creatinine (menopausal stage: p=0.810, hot flash status: p=0.659, interaction effect: p=0.983) or eGFR (menopausal stage: p=0.508, hot flash status: p=0.405, interaction effect: p=0.834). Conclusions In this retrospective chart review of peri‐ and post‐menopausal women, there were no differences in systemic blood pressure or renal function between groups. Future investigations may include longitudinal markers of renal function and metrics describing frequency and severity of hot flashes.