Nutritional parameters and clinical outcomes of patients admited with COVID-19 in a university hospital
Palabras clave:
COVID-19, Nutritional assessment, Nutritional statusResumen
Objective
To evaluate the relationship between nutritional parameters and clinical factors and the outcome of patients diagnosed with COVID-19.
Method
This is a prospective longitudinal study involving patients with COVID-19 infection admitted to a University Hospital in Pernambuco. The sample consisted of individuals aged ≥20 years who tested positive for COVID-19 infection. Nutritional risk was assessed using the recommended screening procedure for this group and the nutritional status using the Body Mass Index. Demographic and clinical variables were transcribed from the medical records.
Results
There was a predominance of adult inpatients between 20 and 59 years of age (95% CI: 64.6-76.0); nutritional risk was observed in 91.6% of patients and overweight in 58.9% of patients. Age ≥60 years (p=0.03), presence of malignancies and inadequate nutrition (p<0.001) were independent risk factors for in-hospital death. It was also observed that only arterial hypertension (OR 2.34, 95% CI 1.32-4.13, p=0.003) and overweight (OR 1.84, 95% CI 1.05-3.21, p=0.032) were considered independent risk factors for admission of the patients in the Intensive Care Unit.
Conclusion
Although overweight is a risk factor for admission in the Intensive Care Unit, it was not possible to observe it as a factor for mortality, requiring further studies to determine the mechanisms that interfere in the association between obesity and mortality in those patients.
Citas
Silva GL, Kopruszynski CP. Assistência nutricional e dietoterápica em pacientes hospitalizados com COVID-19: uma revisão integrativa. Reas. 2020;12(11):4852-52.
Lao WP, Imam SA, Nguyen SA. Anosmia, hyposmia, and dysgeusia as indicators for positive SARS-CoV-2 infection. World J Otorhinolaryngol Head Neck Surg. 2020;(6 Suppl 1):S22.
Yuki K, Fujiogi M, Koutsogiannaki S. COVID-19 pathophysiology: a review. Clin Immunol. 2020;215:108427.
Siddiqi HK, Mehra MR. COVID-19 illness in native and immunosuppressed states: a clinical–therapeutic staging proposal. J Heart Lung Transplant. 2020;39(5):405.
Tavares CAM, Avelino-Silva TJ, Benard G, Cardozo FAM, Fernandes JR, Girardi ACC, Jacob Filho W. ACE2 Expression and Risk Factors for COVID-19 Severity in Patients with Advanced Age. Arq Bras Cardiol. 2020;115(4):701-7.
Yang J, Zheng Y, Gou X, Pu K, Chen Z, Guo Q, et al. Prevalence of comorbidities and its effects in patients infected with SARS-CoV-2: a systematic review and meta-analysis. Int J Infect Dis. 2020;94:91-5.
Pranata R, Lim MA, Yonas E, Vania R, Lukito AA, Siswanto BB, et al. Bodymass index and outcome in patients with COVID-19: a dose–response meta-analysis. Diabetes Metab. 2021;47(2):101178.
Gao F, Zheng KI, Wang XB, Sun QF, Pan KH, Wang, TY, et al. Obesity is a risk factor for greater COVID-19 severity. Diabetes Care. 2020;43(7):e72-e74.
Piovacari SMF, Santos GFCG, Santana GA, Scacchetti T, Castro MG. Fluxo de assistência nutricional para pacientes admitidos com COVID-19 e SCOVID-19 em unidade hospitalar. Braspen J. 2020;35(1): 6-8.
World Health Organization. Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. World Health Organ Tech Rep Ser. 1995;854:1-452.
Lipschitz, DA. Screening for nutritional status in the elderly. Prim Care. 1994;21(1):55-67.
Malik, VS, Ravindra K, Attri SV, Bhadada SK, Singh M. Higher body mass index is an important risk factor in COVID-19 patients: a systematic review and meta-analysis. Environ Sci Pollut Res Int. 2020;27(33):42115-23.
Bortolini GA, Moura A, Lima A, Moreira H, Medeiros O, DiefenthalerI, et al. Guias alimentares: estratégia para redução do consumo de alimentos ultraprocessados e prevenção da obesidade. Rev Panam Salud Publica. 2019;43:e59.
World Health Organization. Obesity: preventing and managing the global epidemic. World Health Organ Tech Rep Ser. 2000;894:1-253.
Schiffrin EL, Flack JM, Ito S, Muntner P, Webb RC. Hypertension and COVID-19. Am J Hypertens. 2020;33(5):373-4.
Cummings MJ, Baldwin MR, Abrams D, Jacobson SD, Meyer BJ, Balough EM, et al. Epidemiology, clinical course, and outcomes of critically ill adults with COVID-19 in New York City: a prospective cohort study. Lancet. 2020;395(10239):1763-70.
Kalligeros M, Shehadeh F, Mylona EK, Benitez G, Beckwith CG, Chan PA, et al. Association of obesity with disease severity among patients with coronavirus disease 2019. Obesity. 2020;28(7):1200-4.
Du Y, Lv Y, Zha W, Zhou N, Hong X. Association of Body mass index (BMI) with Critical COVID-19 and in-hospital Mortality: a dose-response meta-analysis. Metabolism. 2021;117:154373.
Zuin M, Rigatelli G, Zuliani G, Rigatelli A, Mazza A, Roncon L. Arterial hypertension and risk of death in patients with COVID-19 infection: systematic review and meta-analysis. J Infect. 2020;81(1):e84.
Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395(10229):1054-62.
Liu K, Chen Y, Lin R, Han K. Clinical features of COVID-19 in elderly patients: a comparison with young and middle-aged patients. J Infect. 2020;80(6):e14-e18.
Yuan M, Yin W, Tao Z, Tan W, Hu Y. Association of radiologic findings with mortality of patients infected with 2019 novel coronavirus in Wuhan, China. Plos One. 2020;15(3):e0230548.
Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical Characteristics of 138 Hospitalized Patients with 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020;323(11):1061-69.
Blimark C, Holmberg E, Mellqvist UH. Multiple myeloma and infections: a population-based study on 9253 multiple myeloma patients. Haematologica. 2015;100:107-13.
CDC Covid-19 Response Team. Severe outcomes among patients with coronavirus disease 2019 (COVID-19) - United States, February 12-March 16, 2020. Morb Mortal Wkly Rep. 2020;69(12):343-46.
Kuderer NM, Choueiri TK, Shah DP, Shyr Y, Rubinstein SM, Rivera DR, et al. Clinical impact of COVID-19 on patients with cancer (CCC19): a cohort study. Lancet. 2020;395(10241):1907-18.
Liang W, Guan W, Chen R, Wang W, Li J, Xu K, et al. Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China. Lancet Oncol. 2020;21(3):335-7.
Pironi L, Sasdelli AS, Ravaioli F, Baracco B, Battaiola C, Bocedi G, et al. Malnutrition and nutritional therapy in patients with SARS-CoV-2 disease. Clin Nutr. 2021;40(3):1330-7.
Caccialanza R, Formisano E, Klersy C, Ferretti V, Ferrari A, Demontis S, et al. Nutritional parameters associated with prognosis in non-critically ill hospitalized COVID-19 patients: the NUTRI-COVID19 study. Clin Nutr. 2021;5614(21):00316-2.
Formisano E, Di Maio P, Ivaldi C, Sferrazzo E, Arieta L, Bongiovanni S, et al. nutritional therapy for patients with coronavirus disease 2019 (COVID-19): Practical protocol from a single center highly affected by an outbreak of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Nutrition, 2021;82:111048.
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Derechos de autor 2023 Jéssica Francisca Soares RIBEIRO, Ilma Kruze Grande de ARRUDA, Marília Tokiko Oliveira TOMIYA, Eduarda Silva de Castello BRANCO, Lilian Andrade SOLON, Tauane Alves DUTRA
Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.
