Avaliação do índice de prognóstico nutricional associado com a gravidade da doença, presença de comorbidades, resultados de exames laboratoriais e desfecho clínico em pacientes infectados com COVID-19
Palavras-chave:
COVID-19, Óbito, Severidade da doença, Índice prognóstico nutricionalResumo
Objetivo
A COVID-19 resultou em uma pandemia global e marcadores para prognóstico da doença vêm sendo estudados, como o Índice de Prognóstico Nutricional. O objetivo do estudo foi avaliar associações do índice com gravidade da doença, presença de comorbidades, resultados de exames laboratoriais e desfecho clínico.
Métodos
As variáveis avaliadas foram o Índice de Prognóstico Nutricional, severidade da doença, comorbidades, exames laboratoriais e desfecho clínico. O Índice de Prognóstico Nutricional foi calculado usando a equação: 10 x albumina sérica [g/dL] + 0,005 x contagem total de linfócitos [n/mm³]. Os participantes foram categorizados em desnutrição grave (PNI <35), desnutrição moderada (PNI 35-38) e sem desnutrição (PNI >38).
Resultados
A amostra (53% de homens) apresentou idade média de 56,8±17,4 anos. Dos participantes classificados com Índice de Prognóstico Nutricional 2, 23,4% obtiveram alta hospitalar, indicando uma associação com alta mortalidade (p<0,01). A classificação do Índice de Prognóstico Nutricional esteve associada com gravidade da doença (p=0,01), com maior proporção de pacientes críticos no grupo com Índice de Prognóstico Nutricional 2 (60%). O Índice de Prognóstico Nutricional 2 também apresentou níveis significativamente mais baixos de hemoglobina, hematócritos, contagem de linfócitos e albumina (todos com p<0,01). Na análise multivariada, níveis do Índice de Prognóstico Nutricional 1 e Índice de Prognóstico Nutricional 2 apresentaram maior risco de mortalidade (OR: 2,54; IC95%: 1,73-3,72), bem como associação com miocardiopatias (OR: 1,92; IC95%: 1,00-3,69).
Conclusão
Os resultados sugerem que o PNI pode ser um marcador relevante na estratificação de risco em pacientes com COVID-19, sendo os níveis de Índice de Prognóstico Nutricional 1 e Índice de Prognóstico Nutricional 2 proporcionalmente associados à maior gravidade e mortalidade.
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Copyright (c) 2025 Vinicius Camilo Silva de Alencar, Rozangela Maria de Almeida Fernandes Wyszomirska, Aryana Isabelle de Almeida Neves Siqueira, Josué de Oliveira Leitão, Layane Victoria Ananias da Silva, Leonardo Martins Aboim Inglês
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
