The spread of COVID-19 depends on a lot of social and economic factors. The aim: to study the influence of country’s gross domestic product, population prevalence of overweight/ obesity, NCD mortality, and vaccination on COVID-19 morbidity and mortality rates. A cross-sectional study with two phases: correlation-regression interrelations in 1) all world countries; 2) all world non-island countries. The study includes the following data from 218 world countries: COVID-19 morbidity/mortality rates, GDP per capita, the prevalence of overweight/ obesity, NCD mortality among adults (both sexes), people fully vaccinated against COVID-19. An average percentage of the prevalence of overweight among adults in world countries by 2019 was 47.31 ± 15.99%, obesity 18.34 ± 9.64%, while the prevalence by 2016 were 39% and 13%, respectively. Overweight and obesity among adults during three years grew by 21.2% and 40.8%, respectively. Data from the world countries provide significant correlations (p < 0.0001) between COVID-19 morbidity, and: GDP (r = 0.517), overweight (r = 0.54), obesity (r = 0.528), NCD mortality (r = 0.537); COVID-19 mortality, and: GDP (r = 0.344), overweight (r = 0.514), obesity (r = 0.489), NCD mortality (r = 0.611); GDP, and: overweight (r = 0.507), obesity (r = 0.523), NCD mortality (r = 0.35), fully vaccinated people (r = 0.754). An increase in fully vaccinated people, from 3% to 30% of world population, decreases new confirmed COVID-19 cases, although the dependence was not significant (p = 0.07). Data from non-island world countries provides more highly significant correlations (p < 0.0001) between COVID-19 morbidity, and: GDP (r = 0.616), overweight (r = 0.581), obesity (r = 0.583); COVID-19 mortality, and: GDP (r = 0.43), overweight (r = 0.556), obesity (r = 0.539); GDP, and: overweight (r = 0.601), obesity (r = 0.633). The differences of correlation coefficients between data of 176 world countries and data of 143 world non-island countries were not significant (Z-scores 0.05). The study provides evidence of a significant impact of overweight/obesity prevalence on the increase in COVID-19 morbidity/mortality. Countries with higher GDP have a high overweight/obesity prevalence and possibility to get vaccinated.

The prevalence of type 2 diabetes is increasing in worldwide despite the development of new treatment methods. Aim of the study was to evaluate a weight loss method on body composition, glycemic, lipid and hormone profiles, blood pressure and reactive oxygen species in people with treated type 2 diabetes. A 24-week open, prospective, randomized, controlled clinical trial including 272 adult patients with treated type 2 diabetes was performed. The patients were divided in two groups: Main group consisted of 208 patients who followed a method including a calorie restriction diet and optimal physical activity; Control included 64 patients who received conventional drug treatment with weight loss. Main Outcome Measures were weight loss, fasting glucose and 2-hour oral glucose tolerance test (OGTT), HbA1c. Secondary endpoints were blood pressure, lipid and insulin blood levels. At 24 weeks, patients in Main weight lost between 8-18 kg (10–21%); their body mass index significantly decreased (-4.2 kg/m2) as well as their waist circumference (-13 cm) compared to Control. In Main weight loss was achieved fatty mass reduction. In Main fasting glucose and OGTT, HbA1c, blood pressure, reactive oxygen species decreased significantly, whereas hemoglobin levels and heel bone mineral density increased. In Main blood insulin levels decreased by 72.0%, cortisol levels decreased by 40.7%, while testosterone levels in men increased by 2.4 times from baseline. The application of the weight loss method led to a decrease in drug doses leading to their complete withdrawal. The results of this study show the beneficial role of a weight loss method in improving glycemic, lipid and hormone profiles, electrolyte and biochemical indices, blood pressure, reactive oxygen species and bone mineral density in patients with treated type 2 diabetes. ClinicalTrials.gov Identifier: NCT02503865 . Retrospectively registered November 2015.

Background: The coexistence of type two diabetes (T2D) and cardiovascular diseases (CVD) in patients with overweight increases the risk of macro-vascular complications. Some studies are controversial of the results of Ramadan fasting (RF) in patients T2D+CVD. Objective: To compare different RF (antique and modern) on anthropometric, glycemic, blood pressure (BP), lipids, heel bone mineral density (HBMD), and ejection fraction (EF) in patients with T2D+CVD. Methods: An open, 60-day, controlled, single-center, randomized clinical trial included 51 patients (29 women) with T2D+CVD: 26 in Main (antique RF); 25 in Controls (modern RF). Primary endpoints: weight loss, fasting blood glucose and, blood insulin, BP. Secondary endpoints: blood lipids, HBMD, and EF. Results: Patients in Main lost weight –8.02 kg ( P <0.0001), in Controls lost weight –2.67 kg ( P <0.025); BMI in Main significantly decreased ( P <0.0001), but in Controls did not significantly decrease ( P> 0.025). During a 30-day follow-up, Main did not regain weight and WC; but Controls regained weight and WC. In Main BP, all glycemic parameters (fasting glucose, immunoassay insulin, HOMA-IR), lipids (cholesterol, triglyceride, HDL), HBMD, and EF in patients with and without heart failure (HF) were significantly normalized at 30-day RF ( P 0.025). In Controls HBMD and EF in patients with HF did not change ( P >0.025). At 30-day follow-up, glycemic, BP, lipids, HBMD, and EF parameters did not significantly change in Main; but in Controls they worsened as weight regained. Conclusion: Both the RF methods allowed weight loss, but antique RF led to markedly weight loss and significant positive change in glycemic, BP, lipids, bone mineralization, and EF in patients with T2D+CVD; the antique RF allowed patients to stop taking medications. The duration of the positive results depended on the maintenance of the achieved weight loss on RF. Trial Registration: ClinicalTrials.gov NCT06410352 (05/08/2024): https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S000EG8K&selectaction=Edit&uid=U0006MBT&ts=139&cx=bhsvd1

Background: COVID and Influenza with non-communicable chronic diseases (NCDs) complicate the diagnosis, treatment, prognosis, and increase mortality rate. The aim: to evaluate the effects of the fast weight loss on clinic and laboratory inflammation profile, metabolic profile, reactive oxygen species (ROS) and body composition in patients with COVID and Influenza in comorbidity with NCDs. Methods: A 6-week open, pilot prospective clinical trial including 62 adult patients with COVID (n=27) and influenza (n=35) in comorbidity with T2D, hypertension, and NASH. Overweight in 33 patients (53.2%) with BMI 28.14±0.39 kg/m ² , and 29 patients without overweight with BMI 23.37 ± 0.38 kg/m ² . T2D in 26 (41.9%); Hypertension in 38 (61.3%) (incl. 12 patients with T2D); NASH in 51 patients (82.2%) (incl. 8 patients with NASH, T2D and Hypertension; 6 patients with NASH and T2D; 18 patients with NASH and Hypertension; 19 patients with only NASH). Primary endpoints: Clinic/infectious/inflammation tests for COVID and Influenza; weight loss during 14 days. Secondary endpoints: fasting blood glucose, HbA1c, blood insulin; systolic/diastolic BP; blood lipids; ALT, AST, chest CT-scan. Results: The patients with overweight lost -12,4% from baseline or BMI= -4.2 kg/m ² , and patients without overweight lost -9,14% from baseline or BMI= -2.2 kg/m ² (−9.7±0.7 kg vs. - 6.4±0.6 kg, respectively; P <0.001) at 14-day of the treatment. Weight loss in both groups was due to reduction of fat mass ( P <0.0001). Sputum production increased in 1.0-1.5 liter/day on 2-3 days, decreased in 7-9 days. Body temperature normalized in 6-9 days. On 3-5 days, in most patients their urine became turbid/muddy/intensively colored. Urine microscopy showed organic and non-organic salts, and leukocyturia (20-35/sight). White blood cells, lymphocytes, NLR normalized at 14 days (P<0.0001). Total-fibrinogen, C-reactive-protein, and Erythrocyte-sedimentation-rate, ROS normalized at 14-day of treatment ( P 96.3% patients at 14-day. Systolic/diastolic BP decreased (161.3±1.31/101.6±0.85 vs. 118.3±0.46/80.89±0.66, P <0.0001), glucose and lipids metabolism in patients with T2D (n=26) (P<0.0001); ALT and AST in patients with NASH (n=51) were significantly normalized (from baseline 134.3±5.4 and 166.5±5.5 U/L, respectively, and at 14-day to 78.4±4.2 and 92.4±4.9 U/L, respectively (P<0.0001)), platelets increased from baseline (186.5±4.6, ×10 ⁹ /L) at 14-day of treatment (238.5±5.8, ×10 ⁹ /L) ( P <0.0001), and at 6-week follow-up (278.3±6.9, ×10 ⁹ /L) ( P <0.0001). The mean score of chest-CT for the patients (n=44) was 13.12±0.38 from baseline, and at 14-day the score was 1.72±0.12 ( P <0.0001). ROS level normalized at 14-day treatment and 6-week follow-up from baseline ( P <0.0001). The previous antidiabetic, antihypertensive, anti-inflammatory and hepatoprotective, and other symptomatic medications were adequately decreased in 2-5 days to completely stopping by 5-8 days treatment. Conclusions: The fast weight loss is clinical/laboratory benefit in treatment of patients with COVID-19 and Influenza in comorbidity with T2D, hypertension, and NASH. Trial Registration: ClinicalTrials.gov NCT05635539 . Registered 1 December 2022.