The role of nutritional status in the clinical outcomes of elderly with COVID-19 under intensive care

Authors

  • Wanessa de Oliveira Rocha Escola Superior de Ciências da Saúde -ESCS
  • Caroline Soares Menezes Secretaria de Estado de Saúde do Distrito Federal - SESDF
  • Bruna de Abreu Flores Toscano Secretaria de Estado de Saúde do Distrito Federal - SESDF

DOI:

https://doi.org/10.51723/ccs.v33i01.934

Keywords:

Covid-19, Malnutrition, Obesity, Nutrition Assessment, Mortality

Abstract

Elderly people and patients with comorbidities were identified as being at high risk for the severe form of COVID-19. Objective: To investigate the role of nutritional status in clinical outcomes of elderly patients with COVID-19 under intensive care. Method: Longitudinal, retrospective, observational and analytical study. Elderly individuals with COVID-19, admitted to the ICU and emergency box of a public hospital that are reference for the treatment of COVID-19, were included. Poisson regression was used to verify the association of inadequate nutritional risk with the presented outcomes. Results: The sample consisted of 153 elderly, with 58% men. Previous nutritional disorders interfered with clinical outcomes, overweight patients had a higher risk of needing mechanical ventilation (RR: 2.15; 95%CI: 1.01-4.57; p= 0.044), but those with malnutrition evolved more to death. 66.3% of patients without excess weight and 33.63% with excess weight died. However, there was no association between overweight and death in elderly hospitalized with COVID-19 (p=0.119). Conclusion: It was found that inadequate nutritional status, both overweight/obesity and malnutrition, can contribute to unfavorable outcomes, such as the need for mechanical ventilation and death, respectively. These findings reinforce the need for further studies to clarify the role of nutritional status in the clinical outcomes of COVID-19.

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Author Biographies

  • Wanessa de Oliveira Rocha, Escola Superior de Ciências da Saúde -ESCS

    Nutricionista. Especialista em Nutrição clínica com ênfase em Urgência e Trauma pela Secretaria de Estado de Saúde do Distrito Federal – SES-DF. Graduada em Nutrição pela Universidade Federal de Alagoas - UFAL.

  • Caroline Soares Menezes, Secretaria de Estado de Saúde do Distrito Federal - SESDF

    Nutricionista. Mestre em Ciências para a Saúde e Tutora do Programa de Residência Multiprofissional em Urgência e Trauma pela Secretaria de Estado de Saúde do Distrito Federal - SES-DF. Graduada em Nutrição pela Universidade Católica de Brasília - UCB. Brasília, Brasil.

  • Bruna de Abreu Flores Toscano, Secretaria de Estado de Saúde do Distrito Federal - SESDF

    Nutricionista. Especialista de Nutrição Enteral e Parenteral pela Sociedade Brasileira de Nutrição Parenteral e Enteral -SBNPE, Especialista em Nutrição Clínica pela Secretaria de Estado de Saúde do Distrito Federal - SES-DF, preceptora do Programa de Residência Multiprofissional em Urgência e Trauma pela SES-DF. Graduada em Nutrição pela Universidade de Brasília - UnB. Brasília, Brasil.

References

Ministério da Saúde M. Coronavírus Brasil [Internet]. 2021 [cited 2021 Jan 17]. Available from: https://covid.saude.gov.br/

CDC. Coronavirus Disease 2019 (COVID-19) | CDC [Internet]. 2021 [cited 2021 Jan 17]. Available from: https://www.cdc.gov/coronavirus/2019-ncov/index.html

Agondi RC, Rizzo L V, Kalil J, Barros MT. Imunossenescência. Rev. bras. alerg. imunopatol. 2012;35(5):169-76. Available from: file:///C:/Users/1636677.FEPECS/Downloads/v35n5a02.pdf

Moreira NCF, Krausch-Hofmann S, Matthys C, Vereecken C, Vanhauwaert E, Declercq A, et al. Risk factors for malnutrition in older adults: A systematic review of the literature based on longitudinal data [Internet]. Adv Nutr. 2016; 7(3): 507–22. doi: 10.3945/an.115.011254

Popkin BM, Du S, Green WD, Beck MA, Algaith T, Herbst CH, et al. Individuals with obesity and COVID-19: A global perspective on the epidemiology and biological relationships. ObesityReviews. 2020;21:e13128. doi: 10.1111/obr.13128 [Epub ahead of print]

Recinella G, Marasco G, Serafini G, Maestri L, Bianchi G, Forti P, et al. Prognostic role of nutritional status in elderly patients hospitalized for COVID-19: a monocentric study. Aging Clinical and Experimental Research (2020) 32:2695–2701. https://doi.org/10.1007/s40520-020-01727-5

Organización Panamericana de la Salud. División de Promoción y Protección de la Salud (HPP). Encuesta Multicentrica salud beinestar y envejecimiento (SABE) em América Latina el Caribe: Informe Preliminar[Internet]. In: XXXVI Reunión del Comité asesor de investigaciones em Salud; 9-11 jun 2001; Kingston, Jamaica: OPAS, 2002. Available from:

www.opas.org/program/sabe.html

Kakeshita IS. Adaptação e validação de Escalas de Silhuetas para crianças e adultos brasileiros [dissertação]. Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto; 2008; 96p.

Lidoriki I, Frountzas M, Schizas D. Could nutritional and functional status serve as prognostic factors for COVID-19 in the elderly? Medical Hypotheses, 2020:144. https://doi.org/10.1016/j.mehy.2020.109946. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7264929/pdf/main.pdf

Pal R, Bhansali A. COVID-19, diabetes mellitus and ACE2: The conundrum [Internet]. Vol. 162, Diabetes Research and Clinical Practice. Elsevier Ireland Ltd; 2020 [cited 2021 Jan 18]. p. 108132. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7118535/

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. Eur J Clin Nutr [Internet]. 2020, 74(6):871–5. Available from: DOI: 10.1038/s41430-020-0642-3

Burfeind KG, Michaelis KA, Marks DL. The central role of hypothalamic inflammation in the acute illness response and cachexia. Semin Cell Dev Biol. 2016, 54:42-52. doi: 10.1016/j.semcdb.2015.10.038.

Barazzoni R, Bischoff SC, Breda J, Wickramasinghe K, Krznaric Z, Nitzan D, et al. ESPEN expert statements and practical guidance for nutritional management of individuals with SARS-CoV-2 infection. Clinical Nutrition 2020, 39: 1631e1638. Available from: https://doi.org/10.1016/j.clnu.2020.03.022

Yang J, Hu J, Zhu C. Obesity aggravates COVID‐19: A systematic review and meta‐analysis. J Med Virol 2021, 93(1):257–61. Available from: https://onlinelibrary.wiley.com/doi/10.1002/jmv.26237

Allard L, Ouedraogo E, Molleville J, Bihan H, Giroux-Leprieur B, Sutton A, Baudry C, Josse C, Didier M, Deutsch D, Bouchaud O, Cosson E. Malnutrition: Percentage and Association with Prognosis in Patients Hospitalized for Coronavirus Disease 2019. Nutrients 2020, 28;12(12):3679. doi: 10.3390/nu12123679

Simonnet A, Chetboun M, Poissy J, Raverdy V, Noulette J, Duhamel A, Labreuche J, Mathieu D, Pattou F, Jourdain M; LICORN and the Lille COVID-19 and Obesity study group. High Prevalence of Obesity in Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) Requiring Invasive Mechanical Ventilation. Obesity (Silver Spring). 2020, 28(7):1195-1199. doi: 10.1002/oby.22831

Albashir AAD. The potential impacts of obesity on COVID-19. Clin Med (Lond). 2020, 20(4): e109-e113. doi: 10.7861/clinmed.2020-0239.

Schetz M, De Jong A, Deane AM, Druml W, Hemelaar P, Pelosi P, et al. Obesity in the critically ill: a narrative review. Intensive Care Med 2019, 45:757–769

https://doi.org/10.1007/s00134-019-05594-1. Available from: https://doi.org/10.1007/s00134-019-05594-1

Biscarini S, Colaneri M, Ludovisi S, Seminari E, Pieri TC, Valsecchi P, Gallazzi I, Giusti E, Cammà C, Zuccaro V, Mondelli MU. The obesity paradox: Analysis from the SMAtteo COVID-19 Registry (SMACORE) cohort. Nutr Metab Cardiovasc Dis. 2020, 30;30(11):1920-1925. Available from: doi: 10.1016/j.numecd.2020.07.047

Ball L, Serpa Neto A, Pelosi P. Obesity and survival in critically ill patients with acute respiratory distress syndrome: A paradox within the paradox [Internet]. Ball et al. Critical Care 2017, 21:114. Available from: doi 10.1186/s13054-017-1682-5

Published

2022-03-11

Issue

Section

Clínica Assistencial

How to Cite

1.
The role of nutritional status in the clinical outcomes of elderly with COVID-19 under intensive care. Com. Ciências Saúde [Internet]. 2022 Mar. 11 [cited 2024 Nov. 19];33(01). Available from: https://revistaccs.espdf.fepecs.edu.br/index.php/comunicacaoemcienciasdasaude/article/view/934

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