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Wang Q, Shi P, Cao L, Li H, Chen X, Wang P, Zhang J. Unveiling the detrimental vicious cycle linking skeletal muscle and COVID-19: A systematic review and meta-analysis. J Evid Based Med 2024. [PMID: 38975690 DOI: 10.1111/jebm.12629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 06/18/2024] [Indexed: 07/09/2024]
Abstract
OBJECTIVE Skeletal muscle catabolism supports multiple organs and systems during severe trauma and infection, but its role in COVID-19 remains unclear. This study investigates the interactions between skeletal muscle and COVID-19. METHODS The PubMed, EMbase, and The Cochrane Library databases were systematically searched from January 2020 to August 2023 for cohort studies focusing on the impact of skeletal muscle on COVID-19 prevalence and outcomes, and longitudinal studies examining skeletal muscle changes caused by COVID-19. Skeletal muscle quantity (SMQN) and quality (SMQL) were assessed separately. The random-effect model was predominantly utilized for statistical analysis. RESULTS Seventy studies with moderate to high quality were included. Low SMQN/SMQL was associated with an increased risk of COVID-19 infection (OR = 1.62, p < 0.001). Both the low SMQN and SMQL predicted COVID-19-related mortality (OR = 1.53, p = 0.016; OR = 2.18, p = 0.001, respectively). Mortality risk decreased with increasing SMQN (OR = 0.979, p = 0.009) and SMQL (OR = 0.972, p = 0.034). Low SMQN and SMQL were also linked to the need for intensive care unit/mechanical ventilation, increased COVID-19 severity, and longer hospital stays. Significant skeletal muscle wasting, characterized by reduced volume and strength, was observed during COVID-19 infection and the pandemic. CONCLUSIONS This study reveals a detrimental vicious circle between skeletal muscle and COVID-19. Effective management of skeletal muscle could be beneficial for treating COVID-19 infections and addressing the broader pandemic. These findings have important implications for the management of future virus pandemics. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42023395476.
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Affiliation(s)
- Qin Wang
- Department of Pediatrics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Peipei Shi
- Department of Pediatrics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Lu Cao
- Department of Pediatrics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Haoran Li
- Department of Thoracic Surgery, Thoracic Oncology Institute, Peking University People's Hospital, Beijing, China
| | - Xiankai Chen
- Department of Thoracic Surgical Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Peiyu Wang
- Department of Pediatrics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- Department of Thoracic Surgery, Thoracic Oncology Institute, Peking University People's Hospital, Beijing, China
| | - Jianjiang Zhang
- Department of Pediatrics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
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Sankararaman S, Venegas C, Seth S, Palchaudhuri S. "Feed a Cold, Starve a Fever?" A Review of Nutritional Strategies in the Setting of Bacterial Versus Viral Infections. Curr Nutr Rep 2024; 13:314-322. [PMID: 38587572 DOI: 10.1007/s13668-024-00536-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/27/2024] [Indexed: 04/09/2024]
Abstract
PURPOSE OF REVIEW Some data, mostly originally derived from animal studies, suggest that low glucose intake is protective in bacterial sepsis but detrimental in overwhelming viral infections. This has been interpreted into a broad belief that different forms of sepsis may potentially require different nutritional management strategies. There are a few mechanistic differences between the host interactions with virus and bacteria which can explain why there may be opposing responses to macronutrient and micronutrient during the infected state. Here, we aim to review relevant evidence on the mechanisms and pathophysiology of nutritional management strategies in various infectious syndromes and summarize their clinical implications. RECENT FINDINGS Newer literature - in the context of the SARS-CoV-19 pandemic - offers some insight to viral infections. There is still limited clinically applicable data during infection that clearly delineate the role of nutrition during an active viral vs bacterial infections. Based on contrasting findings in different models of viruses and bacteria, the macronutrient and micronutrient needs may depend more on specific infectious organisms that may not be generalizable as bacterial versus viral. Overall, the metabolic effects of sepsis are context dependent, and various host-specific (e.g., age, baseline nutritional status, immune status, comorbidities) and illness variables (phase, duration, and severity of illness) play a significant role in determining the outcome besides pathogen-specific (virus or bacterial or fungi and combined infections) factors. Microbe therapy (probiotics and prebiotics) seems to have therapeutic potential in both viral and bacterial infected states, and this seems like a promising area for further practical research.
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Affiliation(s)
- Senthilkumar Sankararaman
- Division of Pediatric Gastroenterology, UH Rainbow Babies & Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Carla Venegas
- Department Critical Care Medicine and Nutrition Support Team, Mayo Clinic, Jacksonville, FL, USA
| | - Sonia Seth
- Upstate Medical University, Syracuse, NY, USA
| | - Sonali Palchaudhuri
- Division of Gastroenterology, Massachusetts General Hospital, Boston, MA, USA.
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Guðnadóttir SD, Gunnarsdóttir I, Hernandez UB, Ingadóttir ÁR. High risk of malnutrition among hospitalised coronavirus disease 2019 (COVID-19) patients is associated with mortality and other clinical outcomes. Clin Nutr ESPEN 2024; 61:1-7. [PMID: 38777420 DOI: 10.1016/j.clnesp.2024.02.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 01/28/2024] [Accepted: 02/21/2024] [Indexed: 05/25/2024]
Abstract
INTRODUCTION Increasing evidence indicates an association between nutritional status and Coronavirus disease 2019 (COVID-19) disease severity. The aim of the study was to describe the risk of malnutrition, body mass index (BMI) and vitamin D status of hospitalised COVID-19 patients and assess whether they are associated with duration of hospital stay, intensive care unit (ICU) admission, mechanical ventilation, and mortality. METHODS The study is a descriptive retrospective study of 273 patients with COVID-19 admitted to Hospital from February 2020 to March 2021. Patients were screened for risk of malnutrition using a validated screening tool. BMI was calculated from height and weight. Insufficient Vitamin D status was defined as 25(OH)vitD <50 nmol/L. Logistic regression analysis was used to assess the association between indicators of nutritional status of patients with COVID-19, and outcomes such as duration of stay >7 days, ICU admission, mechanical ventilation, and mortality. Interaction between risk of malnutrition and BMI of ≥30 kg/m2 was assessed using the likelihood ratio test with hospital stay, ICU admission, mechanical ventilation, and mortality as outcomes. RESULTS Screening for risk of malnutrition identified 201 (74%) patients at a medium to high risk of malnutrition. Patients defined as being at a medium or high risk of malnutrition were more likely to be hospitalised for >7 days compared to those defined as low risk (OR: 10.72; 95% CI: 3.9-29.46; p < 0.001 and OR: 61.57; 95% CI: 19.48-194.62; p < 0.001, respectively). All patients who were admitted to ICU (n = 41) and required mechanical ventilation (n = 27) were defined as having medium or high risk of malnutrition. High risk of malnutrition was also associated with increased odds of mortality (OR: 8.87; 955 CI 1.08-72,96; p = 0.042). BMI of ≥30 kg/m2 (43%) and 25(OH)vitD <50 nmol/L (20%) were not associated with duration of stay >7 days or mortality, although BMI ≥30 kg/m2 was associated with increased risk of ICU admission (OR: 7.12; 95% CI: 1.59-31.94; p = 0.010) and mechanical ventilation (OR: 8.86; 95% CI: 1.12-69.87; p = 0.038). Interactions between risk of malnutrition and BMI ≥30 kg/m2 were not significant to explain the outcomes of hospital stay >7 days, ICU admission, mechanical ventilation, or mortality. CONCLUSION High risk of malnutrition among hospitalised COVID-19 patients was associated with longer duration of hospital stay, ICU admission, mechanical ventilation and mortality, and BMI ≥30 kg/m2 was associated with ICU admission and mechanical ventilation. Insufficient Vitamin D status was not associated with duration of hospital stay, ICU admission, mechanical ventilation, or mortality.
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Affiliation(s)
| | - Ingibjörg Gunnarsdóttir
- Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland; Department of Clinical Nutrition, Landspitali University Hospital, Reykjavik, Iceland
| | | | - Áróra Rós Ingadóttir
- Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland; Department of Clinical Nutrition, Landspitali University Hospital, Reykjavik, Iceland
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Al-Taie A, Arueyingho O, Khoshnaw J, Hafeez A. Clinical outcomes of multidimensional association of type 2 diabetes mellitus, COVID-19 and sarcopenia: an algorithm and scoping systematic evaluation. Arch Physiol Biochem 2024; 130:342-360. [PMID: 35704400 DOI: 10.1080/13813455.2022.2086265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 05/25/2022] [Accepted: 05/31/2022] [Indexed: 01/08/2023]
Abstract
BACKGROUND The aim of this study was to provide a scoping and comprehensive review for the clinical outcomes from the cross-link of Type 2 diabetes mellitus (T2DM), COVID-19, and sarcopenia. METHODS By using PRISMA guidelines and searching through different databases that could provide findings of evidence on the association of T2DM, COVID-19, and sarcopenia. RESULTS Thirty-three studies reported a relationship between sarcopenia with T2DM, twenty-one studies reported the prognosis COVID-19 in patients with T2DM, ten studies reported the prognosis of COVID-19 in patients with sarcopenia, five studies discussed the outcomes of sarcopenia in patients with COVID-19, and one study reported sarcopenia outcomes in the presence of T2DM and COVID-19. CONCLUSION There is an obvious multidimensional relationship between T2DM, COVID-19 and sarcopenia which can cause prejudicial effects, poor prognosis, prolonged hospitalisation, lowered quality of life and a higher mortality rate during the current COVID-19 pandemic.
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Affiliation(s)
- Anmar Al-Taie
- Clinical Pharmacy Department, Faculty of Pharmacy, Istinye University, Istanbul, Turkey
| | - Oritsetimeyin Arueyingho
- EPSRC Centre for Doctoral Training in Digital Health and Care, University of Bristol, Bristol, UK
| | - Jalal Khoshnaw
- Pharmacy Department, Faculty of Pharmacy, Girne American University, Mersin, Turkey
| | - Abdul Hafeez
- Department of Pharmaceutics, Glocal School of Pharmacy, Glocal University, Saharanpur, Uttar Pradesh, India
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López-Gómez JJ, Bachiller BR, de Luis Roman D. Management of disease-related malnutrition: a real-world experience with a novel concentrated high-protein energy-dense oral nutritional supplement. Postgrad Med 2024; 136:52-59. [PMID: 38251982 DOI: 10.1080/00325481.2024.2307869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 01/17/2024] [Indexed: 01/23/2024]
Abstract
OBJECTIVE Despite the availability of a wide range of oral nutritional supplements (ONS) offerings, individuals with malnutrition are still struggling to meet their nutritional targets. A new concentrated and high-protein energy-dense ONS (≥2.1 kcal/mL;32 g protein/200 mL) with high-quality protein (60% whey protein) has emerged as a pivotal formula to reach the patient's energy-protein requirements, enhance compliance, and maximize stimulation of muscle protein synthesis, key factors driving better nutritional, functional, and clinical outcomes. The purpose of this article is to provide our clinical experience using this new nutritionally concentrated ONS as a therapeutic strategy for patients with DRM. METHODS Three clinical cases have been examined using new assessment procedures and a new form of nutritional therapy, and their impact on the nutritional and functional outcomes in patients with moderate-to-severe DRM. RESULTS A tailored individualized nutritional interventions improved anthropometric, biochemical, and functional outcomes (Case 1,2, and 3) assessed using hand grip strength, bioimpedance and muscle ultrasound, and as well as good gastrointestinal tolerance (Case 1) and compliance to the ONS in patients with DRM (Case 1,2,3). CONCLUSION The use of this novel high-protein energy-dense formula with high-quality protein source (≥2.1 kcal/mL; 32 g protein/200 mL; 60% whey protein) overcome common practical challenges in the medical nutrition therapy of patients with DRM, either because these patients require a highly concentrated formulation to meet nutritional requirements due to loss of appetite, lack of interest in food, and high caloric-protein needs due to disease, and a large quantity and quality of protein to optimize muscle recovery due to sarcopenia, common in patients with moderate-severe malnutrition.
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Affiliation(s)
- Juan J López-Gómez
- Centro de Investigación de Endocrinología y Nutrición, Facultad de Medicina Valladolid, Servicio Endocrinología y Nutrición Hospital Clínico Universitario, Valladolid, Spain
| | - Beatriz Ramos Bachiller
- Centro de Investigación de Endocrinología y Nutrición, Facultad de Medicina Valladolid, Servicio Endocrinología y Nutrición Hospital Clínico Universitario, Valladolid, Spain
| | - Daniel de Luis Roman
- Centro de Investigación de Endocrinología y Nutrición, Facultad de Medicina Valladolid, Servicio Endocrinología y Nutrición Hospital Clínico Universitario, Valladolid, Spain
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Yakti FAZ, Abusalah L, Ganji V. Sarcopenia and Mortality in Critically Ill COVID-19 Patients. Life (Basel) 2023; 14:24. [PMID: 38255640 PMCID: PMC10820280 DOI: 10.3390/life14010024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 11/10/2023] [Accepted: 12/15/2023] [Indexed: 01/24/2024] Open
Abstract
COVID-19 can manifest as either asymptomatic or progressing to a severe phase in some patients, which may require hospitalization. These patients may experience dyspnea and hypoxia, leading to the development of acute respiratory distress syndrome. Studies have reported an increased risk of severe sarcopenia in COVID-19 patients during and after recovery. This narrative review aimed to summarize and synthesize available studies on the association between sarcopenia and mortality in critically ill COVID-19 patients. A total of 22 studies conducted on hospitalized COVID-19 patients were included in this review. Of those, 17 studies reported a direct association, while 5 studies showed no association between sarcopenia and mortality in severe COVID-19 patients. It is important to maintain muscle quality and quantity in defense against COVID-19. The measurement of lean muscle mass should be included in the risk assessment of severely ill COVID-19 patients as part of the therapy plan.
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Affiliation(s)
- Fatima Al Zahra Yakti
- Human Nutrition Department, College of Health Sciences, QU Health, Qatar University, Doha P.O. Box 2713, Qatar; (F.A.Z.Y.); (L.A.)
| | - Lana Abusalah
- Human Nutrition Department, College of Health Sciences, QU Health, Qatar University, Doha P.O. Box 2713, Qatar; (F.A.Z.Y.); (L.A.)
| | - Vijay Ganji
- Department of Nutrition and Dietetics, School of Health and Human Sciences, Indiana University Indianapolis, 1050 Wishard Blvd., Indianapolis, IN 46202, USA
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López-Gómez JJ, García-Beneitez D, Jiménez-Sahagún R, Izaola-Jauregui O, Primo-Martín D, Ramos-Bachiller B, Gómez-Hoyos E, Delgado-García E, Pérez-López P, De Luis-Román DA. Nutritional Ultrasonography, a Method to Evaluate Muscle Mass and Quality in Morphofunctional Assessment of Disease Related Malnutrition. Nutrients 2023; 15:3923. [PMID: 37764706 PMCID: PMC10534706 DOI: 10.3390/nu15183923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 09/04/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023] Open
Abstract
Nutritional ultrasonography is an emerging technique for measuring muscle mass and quality. The study aimed to evaluate the relationship between the parameters of body mass and quality of ultrasonography with other parameters of morphofunctional assessment in patients with disease-related malnutrition (DRM). METHODS A cross-sectional study was developed on 144 patients diagnosed with DRM according to the Global Leadership Initiative on Malnutrition (GLIM) criteria. Morphofunctional evaluation was assessed with anthropometric variables, handgrip strength and bioelectrical impedanciometry (BIA). Nutritional ultrasonography of quadriceps rectus femoris (QRF) was made (muscle mass (Muscle Area of Rectus Femoris index (MARFI)), Y axis and muscle quality (X-Y index and echogenicity). RESULTS The mean age of patients was 61.4 (17.34) years. The prevalence of sarcopenia in the sample was 33.3%. Patients with sarcopenia (S) had lower values of MARFI [(S: 1.09 (0.39) cm2/m2; NoS: 1.27 (0.45); p = 0.02), Y axis (S: 0.88 (0.27); NoS: 1.19 (0.60); p < 0.01) and X-Y index (S: 1.52 (0.61); NoS: 1.30 (0.53); p < 0.01)]. There was a correlation between BIA parameters (phase angle) and muscle mass ultrasonographic variables (MARFI) (r = 0.35; p < 0.01); there was an inverse correlation between muscle quality ultrasonographic variables (echogenicity) and handgrip strength (r = -0.36; p < 0.01). In the multivariate analysis adjusted by age, the highest quartile of the X-Y index had more risk of death OR: 4.54 CI95% (1.11-18.47). CONCLUSIONS In patients with DRM and sarcopenia, standardized muscle mass and muscle quality parameters determined by ultrasonography of QRF are worse than in patients without sarcopenia. Muscle quality parameters had an inverse correlation with electric parameters from BIA and muscle strength. The highest quartile of the X-Y index determined by ultrasonography was associated with increased mortality risk.
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Affiliation(s)
- Juan José López-Gómez
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valladolid, 47003 Valladolid, Spain; (R.J.-S.); (O.I.-J.); (D.P.-M.); (B.R.-B.); (E.G.-H.); (E.D.-G.); (P.P.-L.); (D.A.D.L.-R.)
- Centro de Investigación Endocrinología y Nutrición, Universidad de Valladolid, 47003 Valladolid, Spain
| | | | - Rebeca Jiménez-Sahagún
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valladolid, 47003 Valladolid, Spain; (R.J.-S.); (O.I.-J.); (D.P.-M.); (B.R.-B.); (E.G.-H.); (E.D.-G.); (P.P.-L.); (D.A.D.L.-R.)
- Centro de Investigación Endocrinología y Nutrición, Universidad de Valladolid, 47003 Valladolid, Spain
| | - Olatz Izaola-Jauregui
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valladolid, 47003 Valladolid, Spain; (R.J.-S.); (O.I.-J.); (D.P.-M.); (B.R.-B.); (E.G.-H.); (E.D.-G.); (P.P.-L.); (D.A.D.L.-R.)
- Centro de Investigación Endocrinología y Nutrición, Universidad de Valladolid, 47003 Valladolid, Spain
| | - David Primo-Martín
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valladolid, 47003 Valladolid, Spain; (R.J.-S.); (O.I.-J.); (D.P.-M.); (B.R.-B.); (E.G.-H.); (E.D.-G.); (P.P.-L.); (D.A.D.L.-R.)
- Centro de Investigación Endocrinología y Nutrición, Universidad de Valladolid, 47003 Valladolid, Spain
| | - Beatriz Ramos-Bachiller
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valladolid, 47003 Valladolid, Spain; (R.J.-S.); (O.I.-J.); (D.P.-M.); (B.R.-B.); (E.G.-H.); (E.D.-G.); (P.P.-L.); (D.A.D.L.-R.)
- Centro de Investigación Endocrinología y Nutrición, Universidad de Valladolid, 47003 Valladolid, Spain
| | - Emilia Gómez-Hoyos
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valladolid, 47003 Valladolid, Spain; (R.J.-S.); (O.I.-J.); (D.P.-M.); (B.R.-B.); (E.G.-H.); (E.D.-G.); (P.P.-L.); (D.A.D.L.-R.)
- Centro de Investigación Endocrinología y Nutrición, Universidad de Valladolid, 47003 Valladolid, Spain
| | - Esther Delgado-García
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valladolid, 47003 Valladolid, Spain; (R.J.-S.); (O.I.-J.); (D.P.-M.); (B.R.-B.); (E.G.-H.); (E.D.-G.); (P.P.-L.); (D.A.D.L.-R.)
- Centro de Investigación Endocrinología y Nutrición, Universidad de Valladolid, 47003 Valladolid, Spain
| | - Paloma Pérez-López
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valladolid, 47003 Valladolid, Spain; (R.J.-S.); (O.I.-J.); (D.P.-M.); (B.R.-B.); (E.G.-H.); (E.D.-G.); (P.P.-L.); (D.A.D.L.-R.)
- Centro de Investigación Endocrinología y Nutrición, Universidad de Valladolid, 47003 Valladolid, Spain
| | - Daniel A. De Luis-Román
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valladolid, 47003 Valladolid, Spain; (R.J.-S.); (O.I.-J.); (D.P.-M.); (B.R.-B.); (E.G.-H.); (E.D.-G.); (P.P.-L.); (D.A.D.L.-R.)
- Centro de Investigación Endocrinología y Nutrición, Universidad de Valladolid, 47003 Valladolid, Spain
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Frigotto MF, Rodrigues R, Rabello R, Pietta-Dias C. COVID-19 in older adult residents in nursing homes: factors associated with mortality and impact on functional capacity. SPORT SCIENCES FOR HEALTH 2023; 19:527-535. [PMID: 36855399 PMCID: PMC9951134 DOI: 10.1007/s11332-022-01040-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 12/30/2022] [Indexed: 03/02/2023]
Abstract
Objective To verify if the functional capacity prior to COVID-19 infection was different between Survivor and Non-survivor older adults. Also, to verify the effect of the isolation period after COVID-19 infection on the functional capacity of the Survivors residing in nursing homes. Materials and methods Older adults residing in nursing homes were evaluated 30 days before the COVID-19 outbreak at the site for (i) general health characteristics (obtained from medical records); (ii) gait speed, handgrip strength and 30-s sit-to-stand; (iii) sarcopenia and (iv) estimated muscle mass. Comparisons were made between Survivors and Non-survivors of COVID-19. After the isolation, the Survivors performed the assessments again. Results Twenty-one (81 ± 9.3 years) participants tested positive for COVID-19 and participated in the study, 12 survivors. No difference was observed between Survivors and Non-survivors in any of the outcomes evaluated. However, a moderate effect size was observed for handgrip strength, with lower values for the Non-survivors group (- 16%; d = 0.53). The isolation period reduced the number of sit-to-stand repetitions with moderate effect size in the Survivors (p = 0.046, gav = 0.66). Conclusion Although the null hypothesis analysis did not find significant differences between the groups, the effect size suggests that older adults residing in nursing homes who died from COVID-19 had lower handgrip strength. In the survivors, the isolation period after COVID-19 infection only negatively impacted the sit-to-stand performance.
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Affiliation(s)
- Michele Fernandes Frigotto
- Exercise Research Laboratory, Federal University of Rio Grande do Sul, Porto Alegre, RS 90690-200 Brazil
| | - Rodrigo Rodrigues
- Institute of Education, Federal University of Rio Grande, Rio Grande, RS Brazil
| | - Rodrigo Rabello
- Department of Biomedical Sciences for Health, University of Milan, Milan, MI Italy
| | - Caroline Pietta-Dias
- Exercise Research Laboratory, Federal University of Rio Grande do Sul, Porto Alegre, RS 90690-200 Brazil
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Frenzel AP, Bielemann RM, Barbosa-Silva TG, Gonzalez MC. Applicability of the SARC-F questionnaire by remote interview. Nutrition 2023; 105:111871. [PMID: 36413820 DOI: 10.1016/j.nut.2022.111871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 08/10/2022] [Accepted: 10/08/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVE The aim of this study was to assess the applicability of the strength, assistance with walking, rising from a chair, climbing stairs, and falls (SARC-F) questionnaire by telephone to identify sarcopenia risk (SR; SARC-F ≥6) and low muscle function risk (LMFR; SARC-F ≥ 4) and their associated risk factors in a cohort of community-dwelling older adults in southern Brazil. METHODS A longitudinal study was carried out with community-dwelling older individuals from COMO VAI? STUDY Sociodemographic, behavioral, and health-related information were collected at baseline, and, in the second assessment, the SARC-F questionnaire was applied by phone or in-person interviews. Older adults identified with sarcopenia at the baseline assessment were excluded. Adjusted analysis by Poisson regression according to hierarchical levels was performed. RESULTS Of the 1451 participants interviewed at baseline, only 951 participated in the second assessment. During the second assessment, 732 adults (77%) were interviewed by phone and 219 (23%) in person. There was no statistically significant difference for the SR (9.1 versus 9.7%, P = 0.802) and LMFR (22.4 versus 20.0%, P = 0.435) prevalence when the SARC-F questionnaire was administered in person or by phone, respectively. Age ≥80 y, presence of depressive symptoms, multimorbidity, dependence to perform one or more daily activities, and polypharmacy were factors associated with a higher risk for poor outcomes in older adults interviewed by phone. CONCLUSIONS The similar prevalence between in-person and remote assessments suggests the feasibility of using the SARC-F questionnaire by phone interview as a reliable alternative for sarcopenia and low muscle function risk assessment without the requirement of face-to-face evaluations.
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Affiliation(s)
- Aline P Frenzel
- Postgraduate Program in Health and Behavior, Catholic University of Pelotas (UCPel), Pelotas, Brazil
| | - Renata M Bielemann
- Postgraduate Program in Nutrition and Foods, Federal University of Pelotas (UFPel), Pelotas, Brazil
| | | | - Maria Cristina Gonzalez
- Postgraduate Program in Health and Behavior, Catholic University of Pelotas (UCPel), Pelotas, Brazil; Postgraduate Program in Nutrition and Foods, Federal University of Pelotas (UFPel), Pelotas, Brazil.
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Wang Y, Tan S, Yan Q, Gao Y. Sarcopenia and COVID-19 Outcomes. Clin Interv Aging 2023; 18:359-373. [PMID: 36923269 PMCID: PMC10010141 DOI: 10.2147/cia.s398386] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 03/02/2023] [Indexed: 03/18/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) spread rapidly and became a severe global public health threat. Older adults have a high risk of COVID-19 and its associated mortality. Sarcopenia has emerged as a predictor of poor outcomes in COVID-19 patients, including lengthy hospital stays, mortality, intensive care unit admission, need for invasive mechanical ventilation, and poor rehabilitation outcomes. Chronic inflammation, immune dysfunction, respiratory muscle dysfunction, and swallowing dysfunction may underlie the association between sarcopenia and the poor outcomes of COVID-19 patients. Interleukin 6 receptor blockers (tocilizumab or sarilumab) are recommended for treating patients with severe COVID-19, and their therapeutic effects on sarcopenia are of great interest. This review aimed to analyze the current reports on the association between sarcopenia and COVID-19 and provide an update on the contribution of sarcopenia to the severity and adverse outcomes of COVID-19 and its underlying mechanisms. We also aimed to explore the different screening tools for sarcopenia concurrent with COVID-19, and advocate for early diagnosis and treatment of sarcopenia. Given that the fight against the COVID-19 pandemic may be long-term, further research into understanding the effects of sarcopenia in patients infected with the Omicron variant is necessary.
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Affiliation(s)
- Yuhan Wang
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, People's Republic of China
| | - Shuwen Tan
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, People's Republic of China
| | - Qihui Yan
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, People's Republic of China
| | - Ying Gao
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, People's Republic of China
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Piotrowicz K, Ryś M, Perera I, Gryglewska B, Fedyk-Łukasik M, Michel JP, Wizner B, Sydor W, Olszanecka A, Grodzicki T, Gąsowski J. Factors associated with mortality in hospitalised, non-severe, older COVID-19 patients - the role of sarcopenia and frailty assessment. BMC Geriatr 2022; 22:941. [PMID: 36476473 PMCID: PMC9727948 DOI: 10.1186/s12877-022-03571-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 10/31/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND COVID-19 has affected older persons the most. The propensity to have severe COVID-19 or die of the infection was especially prevalent among older subjects with multimorbidity, frailty and sarcopenia. The aim of our study was to check which of the simple clinical biomarkers, including the assessment of muscle and frailty, would associate with the survival and the length of hospital stay in older patients with COVID-19. An additional aim was to report the influence of chronic diseases, chronic medication use, and COVID-19 signs and symptoms on the aforementioned outcome measures. METHODS The CRACoV study was a prospective single-center (University Hospital in Krakow, Krakow, Poland) observational study of clinical outcomes in symptomatic COVID-19 patients that required hospital treatment. We analysed data of persons aged ≥ 65 years. We assessed muscular parameters in accordance with EWGSOP2, frailty with the Rockwood Clinical Frailty Scale. We used the data of the initial and 3-month assessment. Demographic characteristics, past medical history, and baseline laboratory values were gathered as a part of routine care. We calculated sex and age, and additionally number-of-diseases adjusted odds ratios of mortality associated with studied factors and betas of the relation with these factors and the length of hospital stay. RESULTS The mean (standard deviation, SD) age of 163 participants (44.8% women, 14.8% died) was 71.8 (5.6) years, age range 65-89 years. One score greater SARC-F was associated with 34% (p = 0.003) greater risk of death, and 16.8 h longer hospital stay (p = 0.01). One score greater Rockwood was associated with 86% (p = 0.002) greater risk of death, but was unrelated to the length of hospital stay. Hand grip strength and dynapenia were unrelated to mortality, but dynapenia was related to longer hospital stay. Probable sarcopenia was associated with 441% (p = 0.01) greater risk of death. CONCLUSIONS In conclusion, the patient assessment with SARC-F and the Rockwood Clinical Frailty Scale may significantly improve the prediction of outcomes in older patients with COVID-19 and by extension might be of use in other acute severe infections. This, however, requires further research to confirm.
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Affiliation(s)
- Karolina Piotrowicz
- grid.5522.00000 0001 2162 9631Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Kraków, Poland ,grid.412700.00000 0001 1216 0093Department of Internal Medicine and Geriatrics, University Hospital in Kraków, Kraków, Poland
| | - Monika Ryś
- grid.5522.00000 0001 2162 9631Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Kraków, Poland ,grid.412700.00000 0001 1216 0093Department of Internal Medicine and Geriatrics, University Hospital in Kraków, Kraków, Poland
| | - Ian Perera
- grid.5522.00000 0001 2162 9631Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Kraków, Poland ,grid.412700.00000 0001 1216 0093Department of Internal Medicine and Geriatrics, University Hospital in Kraków, Kraków, Poland
| | - Barbara Gryglewska
- grid.5522.00000 0001 2162 9631Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Kraków, Poland ,grid.412700.00000 0001 1216 0093Department of Internal Medicine and Geriatrics, University Hospital in Kraków, Kraków, Poland
| | - Małgorzata Fedyk-Łukasik
- grid.5522.00000 0001 2162 9631Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Kraków, Poland ,grid.412700.00000 0001 1216 0093Department of Internal Medicine and Geriatrics, University Hospital in Kraków, Kraków, Poland
| | | | - Barbara Wizner
- grid.5522.00000 0001 2162 9631Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Kraków, Poland ,grid.412700.00000 0001 1216 0093Department of Internal Medicine and Geriatrics, University Hospital in Kraków, Kraków, Poland
| | - Wojciech Sydor
- grid.412700.00000 0001 1216 0093Center for Innovative Therapies, Clinical Research Coordination Center, University Hospital in Kraków, Kraków, Poland ,grid.5522.00000 0001 2162 9631Department of Rheumatology and Immunology, Jagiellonian University Medical College, Kraków, Poland
| | - Agnieszka Olszanecka
- grid.5522.00000 0001 2162 9631Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Kraków, Poland
| | - Tomasz Grodzicki
- grid.5522.00000 0001 2162 9631Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Kraków, Poland ,grid.412700.00000 0001 1216 0093Department of Internal Medicine and Geriatrics, University Hospital in Kraków, Kraków, Poland
| | - Jerzy Gąsowski
- grid.5522.00000 0001 2162 9631Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Kraków, Poland ,grid.412700.00000 0001 1216 0093Department of Internal Medicine and Geriatrics, University Hospital in Kraków, Kraków, Poland ,grid.5522.00000 0001 2162 9631Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, University Hospital, 2 Jakubowskiego St., building I, 5th floor, 30-688 Kraków, Poland
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López-Gómez JJ, Lastra-González P, Gómez-Hoyos E, Ortolá-Buigues A, Jiménez-Sahagún R, Cuadrado-Clemente L, Benito-Sendín-Plaar K, Cuenca-Becerril S, Portugal-Rodríguez E, De Luis Román DA. Evolution of nutrition support in patients with COVID-19 disease admitted in the Intensive Care Unit. ENDOCRINOL DIAB NUTR 2022; 69:802-809. [PMID: 36470821 PMCID: PMC9691446 DOI: 10.1016/j.endien.2022.11.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 10/16/2021] [Indexed: 05/27/2023]
Abstract
INTRODUCTION Nutritional support in patients with COVID19 can influence the mean stay and complications in the patient in Intensive Care Unit (ICU). AIMS To evaluate the selection of enteral nutritional treatment in the COVID-19 patient admitted to the ICU. To know the development of dysphagia and its treatment. To evaluate the adjustment to the requirements and its relationship with the patient's complications. MATERIAL AND METHODS One-center longitudinal retrospective study in 71 patients admitted to the ICU with COVID19 infection and complete enteral nutrition between March and April 2020. Clinical variables were collected: length of stay in ICU, mean stay and rate of complications; and estimated anthropometric variables. RESULTS The mean age was 61.84 (13.68) years. Among the patients analyzed, 33 (46.5%) died. The median stay in the ICU was 20 (15.75-32) days and the mean stay was 37 (26.75-63) days. The type of formula most prescribed was normoprotein 24 (35.3%) and diabetes-specific 23 (33.8%) depending on the prescribed formula. There was no difference in mean stay (p = 0.39) or death rate (p = 0.35). The percentage of achievement of the estimated protein requirements was 50 (34.38-68.76). At discharge, 8 (21%) of the patients had dysphagia. A relationship was observed between the mean ICU stay and the probability of developing dysphagia (OR: 1.035 (1.004-1.07); p = 0.02). CONCLUSIONS In the patient with COVID19 disease admitted to the ICU, only half of the necessary protein requirements were reached. The presence of dysphagia at discharge was related to the length of time the patient was in the ICU.
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Affiliation(s)
- Juan J López-Gómez
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valladolid, Valladolid, Spain; Centro de Investigación en Endocrinología y Nutrición, Universidad de Valladolid (IENVA), Valladolid, Spain.
| | | | - Emilia Gómez-Hoyos
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valladolid, Valladolid, Spain; Centro de Investigación en Endocrinología y Nutrición, Universidad de Valladolid (IENVA), Valladolid, Spain
| | - Ana Ortolá-Buigues
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valladolid, Valladolid, Spain; Centro de Investigación en Endocrinología y Nutrición, Universidad de Valladolid (IENVA), Valladolid, Spain
| | - Rebeca Jiménez-Sahagún
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valladolid, Valladolid, Spain; Centro de Investigación en Endocrinología y Nutrición, Universidad de Valladolid (IENVA), Valladolid, Spain
| | - Laura Cuadrado-Clemente
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valladolid, Valladolid, Spain; Centro de Investigación en Endocrinología y Nutrición, Universidad de Valladolid (IENVA), Valladolid, Spain
| | - Katia Benito-Sendín-Plaar
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valladolid, Valladolid, Spain; Centro de Investigación en Endocrinología y Nutrición, Universidad de Valladolid (IENVA), Valladolid, Spain
| | - Sara Cuenca-Becerril
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valladolid, Valladolid, Spain; Centro de Investigación en Endocrinología y Nutrición, Universidad de Valladolid (IENVA), Valladolid, Spain
| | | | - Daniel A De Luis Román
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valladolid, Valladolid, Spain; Centro de Investigación en Endocrinología y Nutrición, Universidad de Valladolid (IENVA), Valladolid, Spain
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A Snapshot of the Experience of Dietitians during the COVID-19 Crisis in Five Arab Countries: Findings from a Regional Cross-Sectional Study. Nutrients 2022; 14:nu14224904. [PMID: 36432590 PMCID: PMC9695406 DOI: 10.3390/nu14224904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 11/13/2022] [Accepted: 11/16/2022] [Indexed: 11/22/2022] Open
Abstract
COVID-19's intimidating spread has challenged the resilience of the global health systems, causing shifts in the practices of healthcare workers, including dietitians. The current study aimed to assess the change in dietitians' practices and duties in hospitals/clinics after the commencement of COVID-19 pandemic. This cross-sectional study was conducted in five Arab countries between November 2020 and January 2021. A convenient sample of 903 dietitians filled an online self-administered questionnaire to meet the study aims. Nearly 40.0% of the dietitians experienced a change in their workload and caseload during the pandemic. Besides, 18.7% of the dietitians had been assigned additional tasks in their facilities. Nearly half the dietitians (46.9%) had started giving remote nutrition consultations, associated with a 21% drop in the number of dietitians offering in-person consultations (p = 0.001). Approximately 58.9% of the dietitians provided nutrition care to COVID-19 patients, with 48.4% having access to personal protective equipment. Moreover, 17.0% of dietitians supported COVID-19 patients with enteral and parenteral nutrition. In addition, 45.0% of dietitians reported that managing COVID-19 was challenging given that it was a newly discovered condition.
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Aguiar GBD, Dourado KF, Andrade MISD, Domingos Júnior IR, Barros-Neto JA, Vasconcelos SML, Petribú MDMV, Santos CMD, Moura MWSD, Aguiar CBD, Campos MIX, Santiago ERC, Silva JHLD, Simões SKDS, Rodrigues ACDM, França Filho JCDD, Souza NMMD, Santos TM. Frequency and factors associated with sarcopenia prediction in adult and elderly patients hospitalized for COVID-19. Exp Gerontol 2022; 168:111945. [PMID: 36064158 PMCID: PMC9443615 DOI: 10.1016/j.exger.2022.111945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 07/20/2022] [Accepted: 08/27/2022] [Indexed: 01/08/2023]
Abstract
Patients with COVID-19 may develop symptoms that interfere with food intake. Systemic inflammatory response associated with physical inactivity and/or immobilization during hospital stay can induce weight and muscle loss leading to sarcopenia and worsening the clinical condition of these patients. The present study identifies the frequency and factors associated with sarcopenia prediction in adult and elderly patients hospitalized for COVID-19. It is a cohort-nested cross-sectional study on adult and elderly patients admitted to wards and intensive care units (ICUs) of 8 hospitals in a northeastern Brazilian state. The study was conducted from June 2020 to June 2021. Sociodemographic, economic, lifestyle, and current and past clinical history variables were collected. Sarcopenia prediction was determined by the Strength, Assistance in walking, Rise from a chair, Climb stairs, and Falls (SARC-F) questionnaire compiled in the Remote-Malnutrition APP (R-MAPP). Patients were diagnosed with sarcopenia when the final score ≥ 4 points. The study included 214 patients with a mean age of 61.76 ± 16.91 years, of which 52.3 % were female and 57.5 % elderly. Sarcopenia prevailed in 40.7 % of the sample. Univariate analysis showed greater probability of sarcopenia in elderly individuals, nonpractitioners of physical activities, hypertensive patients, diabetic patients, and those hospitalized in the ICU. In the multivariate model, the type of hospital admission remained associated with sarcopenia prediction, where patients admitted to the ICU were 1.43 (95 % CI: 1.04; 1.97) more likely to have sarcopenia than those undergoing clinical treatment. Sarcopenia prediction was not associated with patient outcome (discharge, transfer, or death) (p = 0.332). The study highlighted an important percentage of sarcopenia prediction in patients with COVID-19, especially those admitted to the ICU. Additional investigations should be carried out to better understand and develop early diagnostic strategies to assist in the management of sarcopenic patients with COVID-19.
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Affiliation(s)
- Gisele Barbosa de Aguiar
- Residency Program in Clinical Nutrition, Hospital Barão de Lucena, Academic Center of Vitória de Santo Antão, Federal University of Pernambuco (CAV/UFPE), Recife, Pernambuco, Brazil.
| | - Keila Fernandes Dourado
- Residency Program in Clinical Nutrition, Hospital Barão de Lucena, Academic Center of Vitória de Santo Antão, Federal University of Pernambuco (CAV/UFPE), Recife, Pernambuco, Brazil
| | | | | | | | | | | | - Cláudia Mota Dos Santos
- Residency Program in Clinical Nutrition, Hospital Barão de Lucena, Academic Center of Vitória de Santo Antão, Federal University of Pernambuco (CAV/UFPE), Recife, Pernambuco, Brazil
| | - Mayana Wanessa Santos de Moura
- Residency Program in Clinical Nutrition, Hospital Barão de Lucena, Academic Center of Vitória de Santo Antão, Federal University of Pernambuco (CAV/UFPE), Recife, Pernambuco, Brazil
| | - Claudiane Barbosa de Aguiar
- Postgraduate Program in Morphotechnology, Department of Histology and Embryology, Federal University of Pernambuco (UFPE), Recife, Pernambuco, Brazil
| | | | | | - José Hélio Luna da Silva
- Postgraduate Program in Nutrition, Physical Activity and Phenotypic Plasticity (PPGNAFPF), Federal University of Pernambuco, Academic Center of Vitória de Santo Antão, Vitória de Santo Antão, Pernambuco, Brazil
| | | | | | | | | | - Thayná Menezes Santos
- Postgraduate Program in Nutrition, Physical Activity and Phenotypic Plasticity (PPGNAFPF), Federal University of Pernambuco, Academic Center of Vitória de Santo Antão, Vitória de Santo Antão, Pernambuco, Brazil
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da Silva CL, Sousa TMM, de Sousa Junior JB, Nakano EY. Nutritional factors associated with mortality in hospitalized patients with COVID-19. CLINICAL NUTRITION OPEN SCIENCE 2022; 45:17-26. [PMID: 36035064 PMCID: PMC9391077 DOI: 10.1016/j.nutos.2022.08.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 08/12/2022] [Indexed: 12/04/2022] Open
Abstract
Background & aims Malnutrition is a risk factor that can lead to diminished physical and mental function and impaired clinical outcome from diseases. This study was performed to investigate the influence of nutritional characteristics, age and the presence of pre-comorbidities in hospital mortality or medical discharge in a sample of hospitalized patients with COVID-19. Methods This historical cohort study was conducted in adults and elderly patients with COVID-19 who were admitted to a nursing ward at the University Hospital of Brasilia (Brazil). Data regarding demographics, comorbidities, laboratory parameters, nutritional characteristics (NRS 2002, SARC-F, BMI) and discharge or death were retrospectively extracted from medical records. Differences in each group (in-hospital mortality or discharge) were assessed using unpaired Student's t test for continuous variables, or Pearson Chi-square tests for categorical data. Results A total of 222 patients with COVID-19 were enrolled in this study. Nutritional risk and sarcopenia risk were higher in patients who died compared to patients who were discharged (3.55 ± 1.30 vs 2.96 ± 1.30; p = 0.005, 6.81 ± 1.84 vs 4.96 ± 2.95; p < 0.001, respectively). BMI, albumin, and total protein were lower in mortality group than in the discharge group (25.10 ± 5.46 vs 27.82 ± 6.76; p = 0.009, 2.81 ± 0.62 vs 3.27 ± 0.53; p < 0.001, 6.08 ± 0.87 vs 6.48 ± 0.86; p = 0.007, respectively). The mean age between groups was also different with a higher age in the mortality group (70.24 ± 16.23) than in the discharge group (60.54 ± 16.57). Conclusions Uses of validated tools to identify risk for malnutrition and sarcopenia would be beneficial in hospitalized patients with COVID-19 in order to optimize the treatment between them.
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Affiliation(s)
- Clíslian Luzia da Silva
- University of Brasília, University Hospital of Brasília, Sector of Big Areas North 605 - Asa Norte, Brasília, DF, 70840-901, Brazil
| | - Thaís Muniz Montalvão Sousa
- University of Brasília, University Hospital of Brasília, Sector of Big Areas North 605 - Asa Norte, Brasília, DF, 70840-901, Brazil
| | - Josimar Barbosa de Sousa Junior
- University of Brasília, University Hospital of Brasília, Sector of Big Areas North 605 - Asa Norte, Brasília, DF, 70840-901, Brazil
| | - Eduardo Yoshio Nakano
- University of Brasília, Department of Statistics, University of Brasília - CIC Building Est Campus Darcy Ribeiro - Asa Norte, Brasília, DF, 70910-900, Brazil
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Barrea L, Vetrani C, Caprio M, Cataldi M, Ghoch ME, Elce A, Camajani E, Verde L, Savastano S, Colao A, Muscogiuri G. From the Ketogenic Diet to the Mediterranean Diet: The Potential Dietary Therapy in Patients with Obesity after CoVID-19 Infection (Post CoVID Syndrome). Curr Obes Rep 2022; 11:144-165. [PMID: 35524067 PMCID: PMC9075143 DOI: 10.1007/s13679-022-00475-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/17/2022] [Indexed: 01/08/2023]
Abstract
PURPOSE OF REVIEW This review primarily examines the evidence for areas of consensus and on-going uncertainty or controversy about diet and physical exercise approaches for in the post-CoVID. We propose an ideal dietary and physical activity approach that the patient with obesity should follow after CoVID-19 infection in order to reduce the clinical conditions associated with post-CoVID syndrome. RECENT FINDINGS The CoVID-19 disease pandemic, caused by the severe acute respiratory syndrome coronavirus-2, has spread all over the globe, infecting hundreds of millions of individuals and causing millions of death. It is also known to be is associated with several medical and psychological complications, especially in patients with obesity and weight-related disorders who in general pose a significant global public health problem, and in specific affected individuals are on a greater risk of developing poorer CoVID-19 clinical outcomes and experience a higher rate of mortality. Little is still known about the best nutritional approach to be adopted in this disease especially in the patients post-CoVID syndrome. To the best of our knowledge, no specific nutritional recommendations exist to manage in the patients post-CoVID syndrome. We report a presentation of nutritional therapeutic approach based on a ketogenic diet protocol followed by a transition to the Mediterranean diet in patients post-infection by CoVID, combined to a physical activity program to address conditions associated with post-CoVID syndrome.
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Affiliation(s)
- Luigi Barrea
- Dipartimento Di Scienze Umanistiche, Centro Direzionale, Università Telematica Pegaso, Via Porzio, isola F2, 80143, Napoli, Italy.
- Department of Clinical Medicine and Surgery, Endocrinology Unit, Centro Italiano Per La Cura E Il Benessere del Paziente Con Obesità (C.I.B.O), University Medical School of Naples, Via Sergio Pansini 5, 80131, Naples, Italy.
| | - Claudia Vetrani
- Department of Clinical Medicine and Surgery, Endocrinology Unit, Centro Italiano Per La Cura E Il Benessere del Paziente Con Obesità (C.I.B.O), University Medical School of Naples, Via Sergio Pansini 5, 80131, Naples, Italy
- Dipartimento Di Medicina Clinica E Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Massimiliano Caprio
- Laboratory of Cardiovascular Endocrinology, IRCCS San Raffaele Roma, 00166, Rome, Italy
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, 00166, Rome, Italy
| | - Mauro Cataldi
- Department of Neuroscience, Reproductive Medicine and Dentistry, Section of Pharmacology, Medical School of Naples, Federico II University, 80131, Naples, Italy
| | - Marwan El Ghoch
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, P.O. Box 11-5020, Riad El Solh, Beirut, 11072809, Lebanon
| | - Ausilia Elce
- Dipartimento Di Scienze Umanistiche, Centro Direzionale, Università Telematica Pegaso, Via Porzio, isola F2, 80143, Napoli, Italy
| | - Elisabetta Camajani
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, 00166, Rome, Italy
- PhD Programme in Endocrinological Sciences, Sapienza University of Rome, 00161, Rome, Italy
| | - Ludovica Verde
- Department of Clinical Medicine and Surgery, Endocrinology Unit, Centro Italiano Per La Cura E Il Benessere del Paziente Con Obesità (C.I.B.O), University Medical School of Naples, Via Sergio Pansini 5, 80131, Naples, Italy
- Dipartimento Di Medicina Clinica E Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Silvia Savastano
- Department of Clinical Medicine and Surgery, Endocrinology Unit, Centro Italiano Per La Cura E Il Benessere del Paziente Con Obesità (C.I.B.O), University Medical School of Naples, Via Sergio Pansini 5, 80131, Naples, Italy
- Dipartimento Di Medicina Clinica E Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Annamaria Colao
- Department of Clinical Medicine and Surgery, Endocrinology Unit, Centro Italiano Per La Cura E Il Benessere del Paziente Con Obesità (C.I.B.O), University Medical School of Naples, Via Sergio Pansini 5, 80131, Naples, Italy
- Dipartimento Di Medicina Clinica E Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131, Naples, Italy
- Cattedra Unesco "Educazione Alla Salute E Allo Sviluppo Sostenibile", University Federico II, Naples, Italy
| | - Giovanna Muscogiuri
- Department of Clinical Medicine and Surgery, Endocrinology Unit, Centro Italiano Per La Cura E Il Benessere del Paziente Con Obesità (C.I.B.O), University Medical School of Naples, Via Sergio Pansini 5, 80131, Naples, Italy
- Dipartimento Di Medicina Clinica E Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131, Naples, Italy
- Cattedra Unesco "Educazione Alla Salute E Allo Sviluppo Sostenibile", University Federico II, Naples, Italy
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Xu Y, Xu JW, You P, Wang BL, Liu C, Chien CW, Tung TH. Prevalence of Sarcopenia in Patients With COVID-19: A Systematic Review and Meta-Analysis. Front Nutr 2022; 9:925606. [PMID: 35859753 PMCID: PMC9289534 DOI: 10.3389/fnut.2022.925606] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 06/13/2022] [Indexed: 12/12/2022] Open
Abstract
Background It has been speculated that patients with sarcopenia are aggravated by the current novel coronavirus disease 2019 (COVID-19) epidemic. However, there is substantial uncertainty regarding the prevalence of sarcopenia in patients with COVID-19. Objectives The purpose of the study was to systematically evaluate the prevalence of sarcopenia in patients with COVID-19, including stratification by gender, study location, study population, study design, and diagnostic criteria. Design This is the systematic literature review and meta-analysis. Methods An electronic search was performed in MEDLINE/PubMed, Embase, Cochrane Library, and Web of Science and Scopus to identify observational studies reporting a prevalence estimate for sarcopenia in patients with COVID-19. Studies were reviewed in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines and a meta-analysis was performed. Risk of bias (RoB) was assessed using the Newcastle–Ottawa Scale (NOS) for cohort studies and Joanna Briggs Institute (JBI) manual for cross-sectional studies, and Stata 14.0 was used to perform meta-analyses. Results A total of 4,639 studies were initially identified. After removing the duplicates and applying the selection criteria, we reviewed 151 full-text studies. A total of 21 studies, including 5,407 patients, were eligible for inclusion in this review finally. The prevalence of sarcopenia in patients with COVID-19 in individual studies varied from 0.8 to 90.2%. The pooled prevalence of sarcopenia in COVID-19 was 48.0% (95% confidence interval, CI: 30.8 to 65.1%, I2 = 99.68%, p = 0.000). We did not find any significant differences in the prevalence estimates between gender specificity (OR = 1.34; 95% CI = 0.80–2.26; p = 0.001). By sex, the prevalence was 42.5% (95% CI: 31.7 to 53.4%) in men and 35.7% (95% CI: 24.2 to 47.2%) in women. The prevalence estimates significantly varied based on population settings and different diagnostic criteria of sarcopenia. ICU patients (69.7, 95% CI: 51.7 to 85.2%) were more likely to suffer from sarcopenia compared to other population settings. Conclusion To our knowledge, this is the first meta-analysis reporting on the prevalence of sarcopenia in patients with COVID-19. Sarcopenia is frequently observed in patients with COVID-19, with varying prevalence across population settings. This study would be useful for clinicians to prompt the increasing awareness of identifying sarcopenia and developing interventions at patients with COVID-19 with high risk of sarcopenia. Further prospective longitudinal studies to define the association of sarcopenia and its prognostic outcomes in COVID-19 survivors are urgently needed to propose the most appropriate treatment strategies during their admission and discharge. Systematic Review Registration [www.crd.york.ac.uk/prospero/], identifier [CRD42022300431].
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Affiliation(s)
- Ying Xu
- Institute for Hospital Management, Tsing Hua University, Shenzhen, China
- Evidence-Based Medicine Centre, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China
| | - Jia-wen Xu
- Institute for Hospital Management, Tsing Hua University, Shenzhen, China
| | - Peng You
- Institute for Hospital Management, Tsing Hua University, Shenzhen, China
| | - Bing-Long Wang
- School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Chao Liu
- Institute for Hospital Management, Tsing Hua University, Shenzhen, China
| | - Ching-Wen Chien
- Institute for Hospital Management, Tsing Hua University, Shenzhen, China
- *Correspondence: Ching-Wen Chien,
| | - Tao-Hsin Tung
- Evidence-Based Medicine Centre, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China
- Tao-Hsin Tung,
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18
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Gómez-Uranga A, Guzmán-Martínez J, Esteve-Atiénzar PJ, Wikman-Jorgensen P, Núñez-Cruz JM, Espinosa-del-Barrio L, Hernández-Isasi I, Pomares-Gómez FJ, Perelló-Camacho E, Fernández-García N, Sánchez-Miralles Á, Giner-Galvañ V. Nutritional and Functional Impact of Acute SARS-CoV-2 Infection in Hospitalized Patients. J Clin Med 2022; 11:jcm11092424. [PMID: 35566549 PMCID: PMC9103467 DOI: 10.3390/jcm11092424] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 04/24/2022] [Accepted: 04/25/2022] [Indexed: 02/06/2023] Open
Abstract
Aim: To assess the prevalence of malnutrition, frailty, and sarcopenia and the relationships between them in patients hospitalized for COVID-19. Methods: This was a cross-sectional study of the prevalence, determinants, and associations between malnutrition (GLIM 2019 criteria), sarcopenia (SARC-F scale, dynamometry, and calf circumference), and frailty (FRAIL scale) upon discharge following hospitalization for COVID 19. Results: A total of 101 patients (67.3% men, mean age 66.3 years) were recruited. Malnutrition was diagnosed in 49.5%, sarcopenia in 32.7%, and frailty in 28.7% of patients. Of the patients with malnutrition, 48% were also sarcopenic, and 42% were frail. There was a significant association between malnutrition and the severity of pneumonia according to the CURB-65 scale (odds ratio [OR] 2.61, p = 0.036), between sarcopenia and a Barthel score lower than 60 points (OR 29.52, p < 0.001), and between frailty and both a Barthel score lower than 60 points (OR 32.27, p < 0.001) and a length of hospital stay of over 30 days (OR 9.11, p = 0.008). Conclusions: Malnutrition, sarcopenia, and frailty are prevalent and interrelated entities in patients hospitalized for acute SARS CoV-2 infection, especially in patients with greater baseline functional impairment prior to admission and a higher infection severity.
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Affiliation(s)
- Angie Gómez-Uranga
- Internal Medicine Service, University Hospital San Juan de Alicante, 03550 Alicante, Spain; (J.G.-M.); (P.W.-J.); (J.M.N.-C.); (L.E.-d.-B.); (I.H.-I.); (V.G.-G.)
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), 46020 Valencia, Spain; (F.J.P.-G.); (E.P.-C.); (N.F.-G.); (Á.S.-M.)
- Correspondence: (A.G.-U.); (P.J.E.-A.)
| | - Javier Guzmán-Martínez
- Internal Medicine Service, University Hospital San Juan de Alicante, 03550 Alicante, Spain; (J.G.-M.); (P.W.-J.); (J.M.N.-C.); (L.E.-d.-B.); (I.H.-I.); (V.G.-G.)
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), 46020 Valencia, Spain; (F.J.P.-G.); (E.P.-C.); (N.F.-G.); (Á.S.-M.)
| | - Pedro Jesús Esteve-Atiénzar
- Internal Medicine Service, University Hospital San Juan de Alicante, 03550 Alicante, Spain; (J.G.-M.); (P.W.-J.); (J.M.N.-C.); (L.E.-d.-B.); (I.H.-I.); (V.G.-G.)
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), 46020 Valencia, Spain; (F.J.P.-G.); (E.P.-C.); (N.F.-G.); (Á.S.-M.)
- Correspondence: (A.G.-U.); (P.J.E.-A.)
| | - Philip Wikman-Jorgensen
- Internal Medicine Service, University Hospital San Juan de Alicante, 03550 Alicante, Spain; (J.G.-M.); (P.W.-J.); (J.M.N.-C.); (L.E.-d.-B.); (I.H.-I.); (V.G.-G.)
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), 46020 Valencia, Spain; (F.J.P.-G.); (E.P.-C.); (N.F.-G.); (Á.S.-M.)
| | - Juan Manuel Núñez-Cruz
- Internal Medicine Service, University Hospital San Juan de Alicante, 03550 Alicante, Spain; (J.G.-M.); (P.W.-J.); (J.M.N.-C.); (L.E.-d.-B.); (I.H.-I.); (V.G.-G.)
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), 46020 Valencia, Spain; (F.J.P.-G.); (E.P.-C.); (N.F.-G.); (Á.S.-M.)
| | - Leticia Espinosa-del-Barrio
- Internal Medicine Service, University Hospital San Juan de Alicante, 03550 Alicante, Spain; (J.G.-M.); (P.W.-J.); (J.M.N.-C.); (L.E.-d.-B.); (I.H.-I.); (V.G.-G.)
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), 46020 Valencia, Spain; (F.J.P.-G.); (E.P.-C.); (N.F.-G.); (Á.S.-M.)
| | - Isidro Hernández-Isasi
- Internal Medicine Service, University Hospital San Juan de Alicante, 03550 Alicante, Spain; (J.G.-M.); (P.W.-J.); (J.M.N.-C.); (L.E.-d.-B.); (I.H.-I.); (V.G.-G.)
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), 46020 Valencia, Spain; (F.J.P.-G.); (E.P.-C.); (N.F.-G.); (Á.S.-M.)
| | - Francisco J. Pomares-Gómez
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), 46020 Valencia, Spain; (F.J.P.-G.); (E.P.-C.); (N.F.-G.); (Á.S.-M.)
- Endocrinology and Nutrition Section, University Hospital San Juan de Alicante, 03550 Alicante, Spain
| | - Eva Perelló-Camacho
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), 46020 Valencia, Spain; (F.J.P.-G.); (E.P.-C.); (N.F.-G.); (Á.S.-M.)
- Endocrinology and Nutrition Section, University Hospital San Juan de Alicante, 03550 Alicante, Spain
| | - Nuria Fernández-García
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), 46020 Valencia, Spain; (F.J.P.-G.); (E.P.-C.); (N.F.-G.); (Á.S.-M.)
- Rehabilitation Service, University Hospital San Juan de Alicante, 03550 Alicante, Spain
| | - Ángel Sánchez-Miralles
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), 46020 Valencia, Spain; (F.J.P.-G.); (E.P.-C.); (N.F.-G.); (Á.S.-M.)
- Intensive Care Unit, University Hospital San Juan de Alicante, 03550 Alicante, Spain
- Clinical Medicine Department, University Miguel Hernández de Elche, 03550 Alicante, Spain
| | - Vicente Giner-Galvañ
- Internal Medicine Service, University Hospital San Juan de Alicante, 03550 Alicante, Spain; (J.G.-M.); (P.W.-J.); (J.M.N.-C.); (L.E.-d.-B.); (I.H.-I.); (V.G.-G.)
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), 46020 Valencia, Spain; (F.J.P.-G.); (E.P.-C.); (N.F.-G.); (Á.S.-M.)
- Clinical Medicine Department, University Miguel Hernández de Elche, 03550 Alicante, Spain
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19
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Levy D, Giannini M, Oulehri W, Riou M, Marcot C, Pizzimenti M, Debrut L, Charloux A, Geny B, Meyer A. Long Term Follow-Up of Sarcopenia and Malnutrition after Hospitalization for COVID-19 in Conventional or Intensive Care Units. Nutrients 2022; 14:nu14040912. [PMID: 35215562 PMCID: PMC8880495 DOI: 10.3390/nu14040912] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 02/11/2022] [Accepted: 02/16/2022] [Indexed: 02/01/2023] Open
Abstract
Background: The post-COVID-19 condition, defined as COVID-19-related signs and symptoms lasting at least 2 months and persisting more than 3 months after infection, appears now as a public health issue in terms of frequency and quality of life alterations. Nevertheless, few data are available concerning long term evolution of malnutrition and sarcopenia, which deserve further attention. Method: Sarcopenia was investigated prospectively, together with weight evolution, at admission and at 3 and 6 months after hospital discharge in 139 COVID-19 patients, using the European Working Group on Sarcopenia in Older People (EWGSOP2) criteria, associating both decreased muscle strength and muscle mass, assessed, respectively, with hand dynamometer and dual-energy X-ray absorptiometry. Results: Of the 139 patients, 22 presented with sarcopenia at 3 months; intensive care units (ICU) length of stay was the sole factor associated with sarcopenia after multivariate analysis. Although the entire group did not demonstrate significant weight change, weight decreased significantly in the sarcopenia group (Five and eight patients, showing, respectively, >5 or >10% weight decrease). Interestingly, at 6 months, 16 of the 22 patients recovered from sarcopenia and their weight returned toward baseline values. Conclusions: Sarcopenia and malnutrition are frequently observed in patients hospitalized for COVID-19, even 3 months after infection occurrence, but can largely be reversed at 6 months after discharge. Enhanced patient care is needed in sarcopenic patients, particularly during long stays in an ICU.
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Affiliation(s)
- Dan Levy
- Translational Medicine Federation of Strasbourg (FMTS), Team 3072 “Mitochondria, Oxidative Stress and Muscle Protection”, Faculty of Medicine, University of Strasbourg, 67000 Strasbourg, France; (D.L.); (M.G.); (W.O.); (M.R.); (M.P.); (L.D.); (A.C.); (A.M.)
- Physiology and Functional Exploration Service, University Hospital of Strasbourg, 67091 Strasbourg, France
| | - Margherita Giannini
- Translational Medicine Federation of Strasbourg (FMTS), Team 3072 “Mitochondria, Oxidative Stress and Muscle Protection”, Faculty of Medicine, University of Strasbourg, 67000 Strasbourg, France; (D.L.); (M.G.); (W.O.); (M.R.); (M.P.); (L.D.); (A.C.); (A.M.)
- Physiology and Functional Exploration Service, University Hospital of Strasbourg, 67091 Strasbourg, France
| | - Walid Oulehri
- Translational Medicine Federation of Strasbourg (FMTS), Team 3072 “Mitochondria, Oxidative Stress and Muscle Protection”, Faculty of Medicine, University of Strasbourg, 67000 Strasbourg, France; (D.L.); (M.G.); (W.O.); (M.R.); (M.P.); (L.D.); (A.C.); (A.M.)
- Department of Anesthesiology and Surgical Critical Care, University Hospital of Strasbourg, 67091 Strasbourg, France
| | - Marianne Riou
- Translational Medicine Federation of Strasbourg (FMTS), Team 3072 “Mitochondria, Oxidative Stress and Muscle Protection”, Faculty of Medicine, University of Strasbourg, 67000 Strasbourg, France; (D.L.); (M.G.); (W.O.); (M.R.); (M.P.); (L.D.); (A.C.); (A.M.)
- Physiology and Functional Exploration Service, University Hospital of Strasbourg, 67091 Strasbourg, France
| | - Christophe Marcot
- Department of Pneumology, University Hospital of Strasbourg, 67091 Strasbourg, France;
| | - Megane Pizzimenti
- Translational Medicine Federation of Strasbourg (FMTS), Team 3072 “Mitochondria, Oxidative Stress and Muscle Protection”, Faculty of Medicine, University of Strasbourg, 67000 Strasbourg, France; (D.L.); (M.G.); (W.O.); (M.R.); (M.P.); (L.D.); (A.C.); (A.M.)
| | - Lea Debrut
- Translational Medicine Federation of Strasbourg (FMTS), Team 3072 “Mitochondria, Oxidative Stress and Muscle Protection”, Faculty of Medicine, University of Strasbourg, 67000 Strasbourg, France; (D.L.); (M.G.); (W.O.); (M.R.); (M.P.); (L.D.); (A.C.); (A.M.)
| | - Anne Charloux
- Translational Medicine Federation of Strasbourg (FMTS), Team 3072 “Mitochondria, Oxidative Stress and Muscle Protection”, Faculty of Medicine, University of Strasbourg, 67000 Strasbourg, France; (D.L.); (M.G.); (W.O.); (M.R.); (M.P.); (L.D.); (A.C.); (A.M.)
- Physiology and Functional Exploration Service, University Hospital of Strasbourg, 67091 Strasbourg, France
| | - Bernard Geny
- Translational Medicine Federation of Strasbourg (FMTS), Team 3072 “Mitochondria, Oxidative Stress and Muscle Protection”, Faculty of Medicine, University of Strasbourg, 67000 Strasbourg, France; (D.L.); (M.G.); (W.O.); (M.R.); (M.P.); (L.D.); (A.C.); (A.M.)
- Physiology and Functional Exploration Service, University Hospital of Strasbourg, 67091 Strasbourg, France
- Correspondence:
| | - Alain Meyer
- Translational Medicine Federation of Strasbourg (FMTS), Team 3072 “Mitochondria, Oxidative Stress and Muscle Protection”, Faculty of Medicine, University of Strasbourg, 67000 Strasbourg, France; (D.L.); (M.G.); (W.O.); (M.R.); (M.P.); (L.D.); (A.C.); (A.M.)
- Physiology and Functional Exploration Service, University Hospital of Strasbourg, 67091 Strasbourg, France
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20
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López-Gómez JJ, Lastra-González P, Gómez-Hoyos E, Ortolá-Buigues A, Jiménez-Sahagún R, Cuadrado-Clemente L, Benito-Sendín-Plaar K, Cuenca-Becerril S, Portugal-Rodríguez E, Román DADL. [Evolution of nutrition support in patients with covid19 disease admitted in the intensive care unit]. ENDOCRINOL DIAB NUTR 2022; 69:802-809. [PMID: 35018334 PMCID: PMC8739011 DOI: 10.1016/j.endinu.2021.10.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 10/16/2021] [Indexed: 01/15/2023]
Abstract
Introducción El soporte nutricional en el enfermo COVID-19 ingresado en Unidad de Cuidados Intensivos (UCI) puede influir en la evolución durante la hospitalización y al alta. Objetivos Evaluar la selección del tratamiento nutricional enteral en el paciente con infección COVID-19 ingresado en UCI. Conocer el desarrollo de disfagia y su tratamiento. Evaluar el ajuste a los requerimientos y su relación con las complicaciones del paciente. Material y métodos Estudio retrospectivo longitudinal unicéntrico en 71 pacientes ingresados en UCI con infección COVID que recibieron nutrición enteral total entre marzo y abril de 2020. Se recogieron datos de estancia en UCI, estancia media y tasa de complicaciones; variables antropométricas estimadas y diagnóstico de disfagia. Resultados La edad media fue de 61,84 (13,68) años. Entre los pacientes analizados fallecieron 33 (46,5%). La mediana de estancia en UCI fue de 20 (15,75-32) días y la estancia media fue de 37 (26,75-63) días. El tipo de fórmula más prescrita fue la normoproteica (24 [35,3%]) y la específica de diabetes (23 [33,8%]). No hubo diferencia en la estancia media (p = 0,39) o en la tasa de éxitus (p = 0,35) en función de la fórmula prescrita. El porcentaje de consecución de los requerimientos proteicos estimados fue del 50% (34,38-68,76). Al alta, 8 (21%) de los pacientes tenían disfagia. Se observó un aumento en el riesgo de disfagia en función de la estancia media en UCI (OR: 1,035 [1,004-1,07]; p = 0,02). Conclusiones En el paciente con infección COVID-19 en UCI únicamente se alcanzaron la mitad de los requerimientos proteicos necesarios en una situación de estrés. La presencia de disfagia al alta se relacionó con el tiempo que el paciente estuvo en la UCI.
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Affiliation(s)
- Juan J López-Gómez
- Servicio de Endocrinología y Nutrición. Hospital Clínico Universitario de Valladolid, Spain.,Centro de Investigación en Endocrinología y Nutrición. Universidad de Valladolid (IENVA), Spain
| | | | - Emilia Gómez-Hoyos
- Servicio de Endocrinología y Nutrición. Hospital Clínico Universitario de Valladolid, Spain.,Centro de Investigación en Endocrinología y Nutrición. Universidad de Valladolid (IENVA), Spain
| | - Ana Ortolá-Buigues
- Servicio de Endocrinología y Nutrición. Hospital Clínico Universitario de Valladolid, Spain.,Centro de Investigación en Endocrinología y Nutrición. Universidad de Valladolid (IENVA), Spain
| | - R Jiménez-Sahagún
- Servicio de Endocrinología y Nutrición. Hospital Clínico Universitario de Valladolid, Spain.,Centro de Investigación en Endocrinología y Nutrición. Universidad de Valladolid (IENVA), Spain
| | - Laura Cuadrado-Clemente
- Servicio de Endocrinología y Nutrición. Hospital Clínico Universitario de Valladolid, Spain.,Centro de Investigación en Endocrinología y Nutrición. Universidad de Valladolid (IENVA), Spain
| | - Katia Benito-Sendín-Plaar
- Servicio de Endocrinología y Nutrición. Hospital Clínico Universitario de Valladolid, Spain.,Centro de Investigación en Endocrinología y Nutrición. Universidad de Valladolid (IENVA), Spain
| | - Sara Cuenca-Becerril
- Servicio de Endocrinología y Nutrición. Hospital Clínico Universitario de Valladolid, Spain.,Centro de Investigación en Endocrinología y Nutrición. Universidad de Valladolid (IENVA), Spain
| | | | - Daniel A De Luis Román
- Servicio de Endocrinología y Nutrición. Hospital Clínico Universitario de Valladolid, Spain.,Centro de Investigación en Endocrinología y Nutrición. Universidad de Valladolid (IENVA), Spain
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