La inflamación, la desnutrición y la infección por SARS-CoV-2: una combinación nefasta

Gómez, Juana Carretero; Nogueroles, M.C. Mafé; Vallo, F. Garrachón; Álvarez, Elena Escudero; Botejara, E. Maciá; González, Jessica

doi:10.1016/j.rce.2020.07.007

Cited by 13 publications

(10 citation statements)

References 27 publications

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“…Secondly, the presence of non-respiratory symptoms, such as anosmia, dysgeusia, hyporexia or diarrhea, can promote the loss of appetite and reduce dietary intake, worsening the nutrient deficiency. Finally, mechanical ventilation or the use of broad-spectrum antibiotics can make oral intake even more difficult, aggravating this inflammatory state [18,32,33].…”

Section: Discussionmentioning

confidence: 99%

Influence of nutritional status on clinical outcomes among hospitalized patients with COVID-19

Nicolau¹,

Ayala²,

Sanchís

et al. 2021

Clinical Nutrition ESPEN

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Background and aims Several factors that worsen the prognosis of the new coronavirus SARS-CoV-2 have been identified, such as obesity or diabetes. However, despite that nutrition may change in a lockdown situation, little is known about the influence of malnutrition among subjects hospitalized due to COVID-19. Our study aimed to assess whether the presence of malnutrition among patients admitted due to COVID-19 had any impact on clinical outcomes compared with patients with the same condition but well nourished. Methods 75 patients admitted to hospital due to COVID-19 were analyzed cross-sectionally. Subjective Global Assessment (SGA) was completed by phone interview. Clinical parameters included were extracted from the electronic medical record. Results According to the SGA, 27 admitted due to a COVID-19 infection had malnutrition. Patients not well nourished were older than patients with a SGA grade A (65±14.1 vs 49±15.1 years; p<0.0001). Length of hospital stay among poorly nourished patients was significantly higher (18.4±15.6 vs 8.5±7.7 days; p=0.001). Mortality rates and admission to ICU were greater among subjects with any degree of malnutrition compared with well-nourished patients (7.4% vs 0%; p=0.05 and 44.4% vs 6.3%; p<0.0001). CRP (120.9±106.2 vs 60.8±62.9mg/l; p=0.03), D-dimer (1516.9±1466.9 vs 461.1±353.7ng/ml; p<0.0001) and ferritin (847.8±741.1 vs 617.8±598.7mcg/l; p=0.03) were higher in the group with malnutrition. Haemoglobin (11.6±2.1 vs 13.6±1.5g/dl; p<0.0001) and albumin 3.2±0.7 vs 4.1±0.5g/dl; p<0.0001) were lower in patients with any degree of malnutrition. Conclusions The presence of a poor nutritional status is related to a longer stay in hospital, a greater admission in the ICU and a higher mortality.

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Section: Discussionmentioning

confidence: 99%

Influence of nutritional status on clinical outcomes among hospitalized patients with COVID-19

Nicolau¹,

Ayala²,

Sanchís

et al. 2021

Clinical Nutrition ESPEN

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“…COVIDrelated MN arises due to increased nutritional requirements (hypercatabolism) and the presence of a severe inflammatory status. Furthermore, oropharyngeal dysphagia (OD) and other COVID symptoms such as cough, dyspnea, diarrhea, ageusia, and anosmia contribute to a hyporexic status, and can make food intake unsafe [6,7]. As such, MN worsens the already poor prognosis of COVID-19, especially in multimorbid older patients [6,8].…”

Section: Introductionmentioning

confidence: 99%

COVID-19 is associated with oropharyngeal dysphagia and malnutrition in hospitalized patients during the spring 2020 wave of the pandemic

et al. 2022

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Background and aims Prevalence and complications of oropharyngeal dysphagia (OD) and malnutrition (MN) in COVID-19 patients is unknown. Our aim was to assess the prevalence, risk factors and clinical outcomes of OD and MN in a general hospital during the first wave of the COVID-19 pandemic. Methods This was a prospective, observational study involving clinical assessment of OD (Volume-Viscosity Swallowing Test), and nutritional screening (NRS2002) and assessment (GLIM criteria) in COVID-19 patients hospitalized in general wards at the Consorci Sanitari del Maresme, Catalonia, Spain. The clinical characteristics and outcomes of patients were assessed at pre-admission, admission and discharge, and after 3 and 6-months follow-up. Results We included 205 consecutive patients (69.28 ±17.52 years, Charlson 3.74 ±2.62, mean hospital stay 16.8 ±13.0 days). At admission, Barthel Index was 81.3 ±30.3; BMI 28.5 ±5.4 kg/m 2 ; OD prevalence 51.7% (44.1% impaired safety of swallow); and 45.5% developed MN with a mean weight loss of 10.1 ±5.0 kg during hospitalization. OD was an independent risk factor for MN during hospitalization (OR 3.96 [1.45–10.75]), and hospitalization was prolonged in patients with MN compared with those without (21.9 ±14.8 vs 11.9 ±8.9 days, respectively; p<0.0001). OD was independently associated with comorbidities, neurological symptoms, and low functionality. At 6-month follow-up, prevalence of OD was still 23.3% and that of MN only 7.1%. Patients with OD at discharge showed reduced 6-month survival than those without OD at discharge (71.6% vs 92.9%, p<0.001); in contrast, those with MN at discharge did not show 6-month survival differences compared to those without (85.4% vs 83.8%, p=0.8). Conclusions Prevalence and burden of OD and MN in patients hospitalized in COVID-19 wards is very high. Our results suggest that optimizing the management of MN might shorten the hospitalization period but optimizing the management of OD will likely impact the nutritional status of COVID-19 patients and improve their clinical outcomes and survival after hospital discharge. ClinicalTrials.gov Identifier: NCT04346212.

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“…The same explains that despite the higher nutritional need, the inflammatory picture and other associated symptoms, patients develop one hyporexia frame, which extends as sequelae of a process after intubation evolving for dysphagia, especially elderly and multimorbid (10) .…”

Section: Covid-19's Nutritional Alterationsmentioning

confidence: 94%

“…Despite the various clinic tables presented by patients, gastrointestinal symptoms are present in most cases. Under this view, there are reports that malnutrition as a progressive result that is stays with the patients during after-disease especially in severe cases (10).…”

Section: Covid-19's Nutritional Alterationsmentioning

confidence: 98%

Manifestações Gastrointestinais Diretas E Indiretas

Rebelo¹,

Pinho²,

Oliveira³

et al. 2021

Ciências Médicas: Estudos Clínicos E Revisões Bibliográficas

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A constante evolução da pesquisa na área da saúde está refletida nos avanços das ciências médicas, em que o diagnóstico, o conhecimento sobre antigas e novas doenças e até mesmo a nossa própria atuação e vivências como profissionais estão em permanente status de atualização.O presente livro contém 23 capítulos elaborados por autores pesquisadores da área das ciências médicas e áreas afins. Estando as nossas vidas tão marcadas pela pandemia (ainda em curso) da covid-19 e sendo este livro uma obra que trata sobre saúde, vida e doença, o tema covid-19 corresponde, oportunamente, ao maior número de capítulos.Acredito que esta obra multidisciplinar representa uma importante contribuição para as ciências médicas, especialmente como fonte de revisão e atualização para nós, acadêmicos e profissionais da área.Em nossos livros selecionamos um dos capítulos para premiação como forma de incentivo para os autores, e entre os excelentes trabalhos selecionados para compor este livro, o premiado foi o capítulo 17, intitulado "MÉTODOS LABORATORIAIS UTILIZADOS PARA O DIAGNÓS-TICO DAS LEUCEMIAS: UMA REVISÃO BIBLIOGRÁFICA".

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La inflamación, la desnutrición y la infección por SARS-CoV-2: una combinación nefasta

Cited by 13 publications

References 27 publications

Influence of nutritional status on clinical outcomes among hospitalized patients with COVID-19

Influence of nutritional status on clinical outcomes among hospitalized patients with COVID-19

COVID-19 is associated with oropharyngeal dysphagia and malnutrition in hospitalized patients during the spring 2020 wave of the pandemic

Manifestações Gastrointestinais Diretas E Indiretas

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