Sarcopenia e risco de desnutrição como fatores de risco para complicações da COVID-19
DOI:
https://doi.org/10.11606/issn.2176-7262.rmrp.2023.206364Palavras-chave:
Envelhecimento, COVID-19, Hospitalização, Unidade de Terapia Intensiva, DesnutriçãoResumo
Objetivo: Este estudo teve como objetivo associar o risco nutricional e de sarcopenia com desfechos clínicos em pacientes idosos com COVID-19. Métodos: Trata-se de um estudo de coorte retrospectivo longitudinal. Idosos hospitalizados com diagnóstico de COVID-19 foram incluídos no estudo. O risco nutricional foi avaliado usando o Malnutrition Universal Screening Tool (MUST) e o risco de sarcopenia foi avaliado usando o SARC-F. As associações foram avaliadas por modelos logísticos multivariados. Resultados: No total, 127 pacientes (média de idade: 71,25 ±8,06 anos) foram acompanhados até o desfecho clínico. Risco de sarcopenia foi diagnosticado em 63,8% da amostra, enquanto risco nutricional foi observado em 72% deles. Além disso, 48,8% da amostra necessitou
de internação em unidade de terapia intensiva (UTI), 38,6% necessitaram ventilação mecânica e 32,3% foram a óbito. Idosos com risco de sarcopenia tiveram maior chance de internação em UTI (OR: 5,62; IC 95%: 2,2-14,3), necessidade de ventilação mecânica (OR: 4,0; IC 95%: 1,5-10,2) e óbito (OR: 5,06; IC 95%: 1,7-14,2). O risco de desnutrição avaliado pelo MUST foi um importante fator de risco para óbito (OR = 30,15; IC 95%: 3,6-245,8; p<0,01). Conclusão: O risco de sarcopenia foi fator de risco para óbito, internação em UTI e ventilação mecânica,
enquanto o risco nutricional foi fator de risco para óbito.
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Referências
World Health Organization. Coronavirus disease (COVID-19). 2022 [cited 2022 Jan 16]. Available from: https://www.who.int/health-topics/coronavirus#tab=tab_1
Brazil. Ministério da Saúde. Boletim epidemiológico especial: Doença pelo Novo Coronavírus COVID-19. Secretaria de Vigilância em Saúde. 2021 [cited 2021 Dec 15]. Available from: https://www.gov.br/saude/pt-br/centrais-de-conteudo/publicacoes/boletins/boletins-epidemiologicos/covid-19/2021/boletim_epidemiologico_covid_93.pdf/view
Guo W, Li M, Dong Y, Zhou H, Zhang Z, Tian C, et al. Diabetes is a risk factor for the progression and prognosis of COVID-19. Diabetes/metabolism research and reviews. 2020;36(7):e3319.
Zhu H, Rhee JW, Cheng P, Waliany S, Chang A, Witteles RM, et al. Cardiovascular Complications in Patients with COVID-19: Consequences of Viral Toxicities and Host Immune Response. Current Cardiology Reports. 2020;22(5):32.
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. International journal of infectious diseases. 2020;94:91–95.
Sharma JR, Yadav U. COVID-19 severity in obese patients: Potential mechanisms and molecular targets for clinical intervention. Obesity Research & Clinical Practice. 2021;15(2):163–171.
Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;39(10223):507–513.
Suleyman G, Fadel RA, Malette KM, Hammond C, Abdulla H, Entz A, et al. Clinical Characteristics and Morbidity Associated with Coronavirus Disease 2019 in a Series of Patients in Metropolitan Detroit. JAMA network open. 2020;3(6):e2012270.
Azzolino D, Saporiti E, Proietti M, Cesari M. Nutritional Considerations in Frail Older Patients with COVID-19. The Journal of Nutrition, Health & Aging. 2020;24(7):696–698.
Papadopoulou SK. Sarcopenia: A Contemporary Health Problem among Older Adult Populations. Nutrients. 2020;12(5):1293.
Marcos-Pérez D, Sánchez-Flores M, Proietti S, Bonassi S, Costa S, Teixeira JP, et al. Association of inflammatory mediators with frailty status in older adults: results from a systematic review and meta-analysis. GeroScience. 2020;42(6):1451–1473
Franceschi C, Campisi J. Chronic inflammation (inflammaging) and its potential contribution to age-associated diseases. The Journals of Gerontology. 2014;69 (Suppl 1):S4–S9.
Souza IP, Vale MC, Sena AC, Barboza CD. Utilization of SARC-F for sarcopenia screening in adults hospitalized patients. Nutrición Clínica Y Dietética Hospitalaria. 2020;40(3):99-105.
Welch C, Greig C, Masud T, Wilson D, Jackson TA. COVID-19 and Acute Sarcopenia. Aging and Disease. 2020;11(6):1345–1351.
Ruiz AJ, Buitrago G, Rodríguez N, Gómez G, Sulo S, Gómez C, et al. Clinical and economic outcomes associated with malnutrition in hospitalized patients. Clinical Nutrition. 2019;38(3):1310–1316.
Stefano M, Andrea B, Daniela C, Emanuela M, Lorena P, Daniela D, et al. Malnutrition risk as a negative prognostic factor in COVID-19 patients. Clinical Nutrition ESPEN. 2021;45:369–373.
Haskell WL, Lee IM, Pate RR, Powell KE, Blair SN, Franklin BA, et al. Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Medicine and Science in Sports and Exercise. 2007;39(8):1423–1434.
British Association for Parenteral and Enteral Nutrition (BAPEN). Malnutrition Advisory Group. O FOLHETO EXPLICATIVO DA ‘MUST’: Um guia para a Ferramenta Universal para Rastreio da Malnutrição (MUST) para adultos. 2011. Available from: https://www.bapen.org.uk/screening-and-must/must/must-toolkit/the-must-itself/must-portugues
Lipschitz DA. Screening for nutritional status in the elderly. Primary care. 1994;21(1):55–67.
Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al. Frailty in older adults: evidence for a phenotype. The Journals of Gerontology. 2001;56(3):M146–M156.
Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, Cederholm T, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age and Ageing. 2019;48(4):16–31.
Morais A, Aquino JS, da Silva-Maia JK, Vale SH, Maciel BL, Passos TS. Nutritional status, diet and viral respiratory infections: perspectives for severe acute respiratory syndrome coronavirus 2. British Journal of Nutrition. 2021;125(8):851–862. https://doi.org/10.1017/S0007114520003311
Li T, Zhang Y, Gong C, Wang J, Liu B, Shi L, et al. Prevalence of malnutrition and analysis of related factors in elderly patients with COVID-19 in Wuhan, China. European Journal of Clinical Nutrition. 2020;74(6):871–875.
Bedock D, Bel Lassen P, Mathian A, Moreau P, Couffignal J, Cianguara C, et al. Prevalence and severity of malnutrition in hospitalized COVID-19 patients. Clinical Nutrition ESPEN. 2020;40:214-219.
Soares AL, Mussoi TD. Mini nutritional assessment to determine nutritional risk and malnutrition in elderly hospitalized. Revista Brasileira de Nutrição Clínica. 2014;29(2):105-10.
Pinheiro TA, Barcala-Jorge AS, Andrade JM, Pinheiro TA, Ferreira E, Crespo TS, et al. Obesity and malnutrition similarly alter the renin-angiotensin system and inflammation in mice and human adipose. Journal of Nutritional Biochemistry. 2017;48:74–82.
Hoffmann M, Kleine-Weber H, Schroeder S, Kruger N, Herrler T, Erichsen S, et al. SARS-CoV-2 Cell Entry Depends on ACE2 and TMPRSS2 and Is Blocked by a Clinically Proven Protease Inhibitor. Cell. 2020;181(2):271–280.e8.
Gwela A, Mupere E, Berkley JA, Lancioni C. Undernutrition, Host Immunity and Vulnerability to Infection Among Young Children. The Pediatric Infectious Disease Journal. 2019;38(8):e175–e177.
Huang C, Wang Y, Li X, Ren L, Zhao J, Zhang L, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497–506.
Zhou Y, Fu B, Zheng X, Wang D, Zhao C, Qi Y, et al. Pathogenic T-cells and inflammatory monocytes incite inflammatory storms in severe COVID-19 patients. National Science Review. 2020;7(6):998–1002.
Wierdsma NJ, Kruizenga HM, Konings, LA, Krebbers D, Jorissen JR, Joosten M-H, et al. Poor nutritional status, risk of sarcopenia and nutrition related complaints are prevalent in COVID-19 patients during and after hospital admission. Clinical Nutrition ESPEN. 2021;43:369–376.
Zhang XM, Chen D, Xie XH, Zhang J-E, Zeng Y, Cheng AS. Sarcopenia as a predictor of mortality among the critically ill in an intensive care unit: a systematic review and meta-analysis. BMC geriatrics. 2021;21(1):339.
Flower L, Puthucheary Z. Muscle wasting in the critically ill patient: how to minimise subsequent disability. British Journal of Hospital Medicine. 2020;81(4):1–9.
Davies A, Wellard-Cole L, Rangan A, Allman-Farinelli M. Validity of self-reported weight and height for BMI classification: A cross-sectional study among young adults. Nutrition. 2020;71:110622.
Silva D, Lima S, Sena-Evangelista K, Marchioni DM, Cobucci RN, De Andrade FB. Nutritional Risk Screening Tools for Older Adults with COVID-19: A Systematic Review. Nutrients. 2020;12(10):2956.
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Copyright (c) 2023 Laís Gomes Lessa Vasconcelos, Janatar Stella Vasconcelos de Melo Me Mpomo, Mateus de Lima Macena, Thamires Otaviano Marques de Souza, Celina de Azevedo Dias, Sandra Mary Lima Vasconcelos, Müller Ribeiro-Andrade, João Araújo Barros-Neto
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
