Association between nutritional therapy and complications in patients diagnosed with COVID-19 followed in the state of Pernambuco

Main Article Content

Karine Maria Moreira Almeida
https://orcid.org/0000-0003-4480-7650
Keila Fernandes Dourado
https://orcid.org/0000-0003-1346-8940
João Araújo Barros Neto
https://orcid.org/0000-0002-7603-1095
Isa Galvão Rodrigues
Gabriela Maria Floro Pereira Arcoverde
https://orcid.org/0000-0001-8749-029X
Marina de Moraes Vasconcelos Petribú
https://orcid.org/0000-0001-8073-0086

Abstract

Objective: To analyze the association between nutritional therapy and complications in patients diagnosed with COVID-19 followed in Pernambuco. Methods: A prospective cohort study was conducted to investigate secondary data from multicenter research from June 2020 to June 2021. Patients of both sexes over 18 years old were hospitalized for COVID-19 in wards or intensive care units of eight hospitals. Sociodemographic and economic data, nutritional status, nutritional therapy, gastrointestinal complications, and clinical outcome were collected during admission and at the end of hospitalization. Results: The sample consisted of 272 patients, with a median age of 67 years (IQR 54 - 76), equally distributed between men and women (50.4% vs. 49.6%). A higher frequency of overweight/obesity (40.31%) was observed. The most frequent alterations were inappetence (12.88%) and dysgeusia (8.28%). It was observed that 84.6% received an early diet, the caloric adequacy varied between 72.1% and 60.7%, the oral route between 82.4% and 70.7%, the majority (58%) received up to 1.3 g of protein per day, and 46.7% died. Caloric adequacy was associated with dysgeusia (p = 0.040) and clinical outcome (p = 0.044) and tended to be associated with vomiting (p = 0.077). No association was found with proteins. Conclusion: Nutritional therapy is associated with gastrointestinal symptoms such as vomiting and dysgeusia and the clinical outcome of patients with COVID-19.



Article Details

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1.
Almeida KMM, Dourado KF, Barros Neto JA, Rodrigues IG, Arcoverde GMFP, Petribú M de MV. Association between nutritional therapy and complications in patients diagnosed with COVID-19 followed in the state of Pernambuco. HSJ [Internet]. 2022 Dec. 19 [cited 2024 Dec. 22];12(4):48-56. Available from: https://portalrcs.hcitajuba.org.br/index.php/rcsfmit_zero/article/view/1301
Section
ORIGINAL ARTICLE
Author Biographies

Karine Maria Moreira Almeida, Federal University of Pernambuco

Resident Nutritionist, Federal University of Pernambuco, Residency Program in Clinical Nutrition at Hospital Barão de Lucena, Recife, PE, Brazil.

Keila Fernandes Dourado, Federal University of Pernambuco

Associate Professor at the Nucleus of Nutrition/ Academic Center of Vitória/ Federal University of Pernambuco (UFPE), PhD in Nutrition from UFPE.

João Araújo Barros Neto, Federal University of Alagoas

Adjunct Professor at the Faculty of Nutrition/ Federal University of Alagoas (UFAL), PhD in Interactive Processes between Organs and Systems at UFBA.

Isa Galvão Rodrigues, University of Pernambuco

Clinical Nutritionist, University of Pernambuco, Pernambuco Cardiological Emergency Room, Recife, PE, Brazil. PhD student in Health Sciences at UPE.

Gabriela Maria Floro Pereira Arcoverde, University of Pernambuco

Clinical Nutritionist, University of Pernambuco, Pernambuco Cardiological Emergency Room, Recife, PE, Brazil. PhD student in Nutrition at UFPE.

Marina de Moraes Vasconcelos Petribú, Federal University of Pernambuco

Associate Professor at the Nucleus of Nutrition/ Academic Center of Vitória/ Federal University of Pernambuco (UFPE), PhD in Nutrition from UFPE.

References

Machhi J, Herskovitz J, Senan AM, Dutta D, Nath B, Oleynikov MD, et al. The Natural History, Pathobiology, and Clinical Manifestations of SARS-CoV-2 Infections. J Neuroimmune Pharmacol. 2020;15(3):359-86. https://doi.org/10.1007/s11481-020-09944-5

Zou X, Chen K, Zou J, Han P, Hao J, Han Z. Single-cell RNA-seq data analysis on the receptor ACE2 expression reveals the potential risk of different human organs vulnerable to 2019-nCoV infection. Front Med. 2020;14(2):185-92. https://doi.org/10.1007/s11684-020-0754-0

Iser BPM, Silva I, Raymundo VT, Poleto MB, Schuelter-Trevisol F, Bobinski F. Suspected COVID-19 case definition: a narrative review of the most frequent signs and symptoms among confirmed cases. Epidemiol Serv Saúde. 2020;29(3):e2020233. https://doi.org/10.5123/S1679-49742020000300018

Shi Y, Wang Y, Shao C, Huang J, Gan J, Huang X, et al. COVID-19 infection: the perspectives on immune responses. Cell Death Differ. 2020;27(5):1451-4. https://doi.org/10.1038/s41418-020-0530-3

Gomes DF, Gandolfo AS, De Oliveira AC, Potenza ALS, Micelli CLO, Almeida CB, et al. "Say No to Child Malnutrition" Campaign 11: important steps to fight hospital malnutrition. Braspen J. 2019;34(1):3-23.

Iddir M, Brito A, Dingeo G, Del Campo SSF, Samouda H, La Frano MR, Bohn T. Strengthening the Immune System and Reducing Inflammation and Oxidative Stress through Diet and Nutrition: Considerations during the COVID-19 Crisis. Nutrients. 2020;12(6):1562. https://doi.org/10.3390/nu12061562

Associação Brasileira de Empresas e Pesquisa. Critério de Classificação Econômica Brasil. Alterações na aplicação do Critério Brasil. 2021.Available from: https://www.abep.org/criterio-brasil

World Health Organization - WHO. Physical status: the use and interpretation of anthropometry: Report of a WHO Expert Committee. Technical Report Series nº 854. Geneva: World Health Organization; 1995.

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. In: XXXVI Reunión del Comité asesor de investigaciones em Salud; 9-11 jun 2001; Kingston, Jamaica: OPAS, 2002.

Beserra EA, Rodrigues PA, Lisboa AQ. Validação de métodos subjetivos para estimativa do índice de massa corporal em pacientes acamados. Com Ciências Saúde. 2011;22(1):19-26.

Campos LF, Barreto PA, Ceniccola GD, Gonçalves RC, De Matos LBN, Zambelli CMSF, et al. Review of the BRASPEN technical report on nutritional therapy in patients hospitalized with COVID-19. Braspen J. 2021;36(1):122-6.

Nunes AP, Zanchim MC, Kümpel DA, Rodrigues TP, Zanin J. Caloric-protein adequacy of enteral nutritional therapy in critically ill patients of a highly complex hospital in Rio Grande do Sul. Braspen J. 2018;33(2):116-21.

Lian JS, Hu JH, Gao J, Zheng L, Zhang YM, et al. Epidemiological, clinical and virological characteristics of 74 cases of coronavirus-infected disease 2019 (COVID-19) with gastrointestinal symptoms. Gut. 2020;69(6):1002-19. https://doi.org/10.1136/gutjnl-2020-320926

Zarifian A, Bidary MZ, Arekhi S, Rafiee M, Gholamalizadeh H, Amiriani A, et al. Gastrointestinal and hepatic abnormalities in patients with confirmed COVID-19: A systematic review and meta-analysis. J Med Virol. 2021;93(1):336-50. https://doi.org/10.1002/jmv.26314

Flores-Silva FD, García-Grimshaw M, Valdés-Ferrer SI, Vigueras-Hernández AP, Domínguez-Moreno R, Tristán-Samaniego DP, et al. Neurologic manifestations in hospitalized patients with COVID-19 in Mexico City. PLoS One. 2021;16(4):e0247433. https://doi.org/10.1371/journal.pone.0247433

Bedock D, Lassen PB, Mathian A, Moreau P, Couffignal J, Ciangura C, et al. Prevalence and severity of malnutrition in hospitalized COVID-19 patients. Clin Nutr ESPEN. 2020; 40:214-9. https://doi.org/10.1016/j.clnesp.2020.09.018

Wierdsma NJ, Kruizenga HM, Konings LA, Krebbers D, Jorissen JR, Joosten MI, et al. Poor nutritional status, risk of sarcopenia and nutrition related complaints are prevalent in COVID-19 patients during and after hospital admission. Clin Nutr ESPEN. 2021; 43:369-76. https://doi.org/10.1016/j.clnesp.2021.03.021

Sikaroudi MK, Zonooz SR, Ebrahimi Z, Jebraili H, Farsi F, Talebi A, et al. Assessment of anorexia and weight loss during the infection and recovery period of patients with coronavirus disease 2019 (COVID-19). Clin Nutr Open Sci. 2021;40:102-10. https://doi.org/10.1016/j.nutos.2021.11.001

Ye Q, Wang B, Zhang T, Xu J, Shang S. The mechanism and treatment of gastrointestinal symptoms in patients with COVID-19. Am J Physiol Gastrointest Liver Physiol. 2020;319(2):G245-52. https://doi.org/10.1152/ajpgi.00148.2020

Vaillant MF, Agier L, Martineau C, Philipponneau M, Romand D, Masdoua V, et al. Food intake and weight loss of surviving inpatients in the course of COVID-19 infection: A longitudinal study of the multicenter NutriCoviD30 cohort. Nutrition. 2022; 93:111433. https://doi.org/10.1016/j.nut.2021.111433

Tsuchiya H. Oral Symptoms Associated with COVID-19 and Their Pathogenic Mechanisms: A Literature Review. Dent J (Basel). 2021;9(3):32. https://doi.org/10.3390/dj9030032

Xu H, Zhong L, Deng J, Peng J, Dan H, Zeng X, et al. High expression of ACE2 receptor of 2019-nCoV on the epithelial cells of oral mucosa. Int J Oral Sci. 2020;12(1):8. https://doi.org/10.1038/s41368-020-0074-x

Sato T, Ueha R, Goto T, Yamauchi A, Kondo K, Yamasoba T. Expression of ACE2 and TMPRSS2 Proteins in the Upper and Lower Aerodigestive Tracts of Rats: Implications on COVID 19 Infections. Laryngoscope. 2021;131(3):E932-39. https://doi.org/10.1002/lary.29132

Wang Z, Zhou J, Marshall B, Rekaya R, Ye K, Liu HX. SARS-CoV-2 Receptor ACE2 is enriched in a subpopulation of mouse tongue epithelial cells in nongustatory papillae but not in taste buds or embryonic oral epithelium. ACS Pharmacol Transl Sci. 2020;3(4):749-58. https://doi.org/10.1021/acsptsci.0c00062

Sakaguchi W, Kubota N, Shimizu T, Saruta J, Fuchida S, Kawata A, et al. Existence of SARS-CoV-2 entry molecules in the oral cavity. Int J Mol Sci. 2020;21(17):6000. https://doi.org/10.3390/ijms21176000

Vaira LA, Salzano G, Fois AG, Piombino P, De Riu G. Potential pathogenesis of ageusia and anosmia in COVID-19 patients. Int Forum Allergy Rhinol. 2020;10(9):1103-4. https://doi.org/10.1002/alr.22593

Finsterer J, Stollberger C. Causes of hypogeusia/hyposmia in SARS-CoV2 infected patients. J Med Virol. 2020;92(10):1793-4. https://doi.org/10.1002/jmv.25903

Milanetti E, Miotto M, Di Rienzo L, Nagaraj M, Monti M, Golbek TW,et al. In-Silico Evidence for a Two Receptor Based Strategy of SARS-CoV-2. Front Mol Biosci. 2021;8:690655. https://doi.org/10.3389/fmolb.2021.690655

Mariz BALA, Brandão TB, Ribeiro ACP, Lopes MA, Santos-Silva AR. New Insights for the Pathogenesis of COVID-19-Related Dysgeusia. J Dent Res. 2020;99(10):1206. https://doi.org/10.1177/0022034520936638

Dos Santos JA, Normando AGC, Da Silva RLC, Acevedo AC, Canto GL, Sugaya N, et al. Oral Manifestations in Patients with COVID-19: A Living Systematic Review. J Dent Res. 2021;100(2):141-54. https://doi.org/10.1177/0022034520957289

Antwi J, Appiah B, Oluwakuse B, Abu BAZ. The Nutrition-COVID-19 Interplay: a Review. Curr Nutr Rep. 2021;10(4):364-74. https://doi.org/10.1007/s13668-021-00380-2

Alves TCHS, Guimarães RS, Souza SF, Brandão NA, Daltro CHDC, Conceição-Machado MEP, et al. Influence of nutritional assistance on mortality by COVID-19 in critically ill patients. Clin Nutr ESPEN. 2021; 44:469-71. https://doi.org/10.1016/j.clnesp.2021.05.016

Pironi L, Sasdelli AS, Ravaioli F, Baracco B, Battaiola C, Bocedi G, et al. Malnutrition and nutritional therapy in patients with SARS-CoV-2 disease. Clin Nutr. 2021;40(3):1330-7. https://doi.org/10.1016/j.clnu.2020.08.021

Nakamura K, Liu K, Katsukawa H, Nydahl P, Ely EW, Kudchadkar SR, et al. Nutrition therapy in the intensive care unit during the COVID-19 pandemic: Findings from the ISIIC point prevalence study. Clin Nutr. 2021;S0261-5614(21)00450-7. https://doi.org/10.1016/j.clnu.2021.09.033

Cereda E, Guzzardella A, Klersy C, Belliato M, Pellegrini A, Sciutti F, et al. Early caloric deficit is associated with a higher risk of death in invasive ventilated COVID-19 patients. Clin Nutr. 2021;S0261-5614(21)00094-7. https://doi.org/10.1016/j.clnu.2021.02.020

Miguélez M, Velasco C, Camblor M, Cedeño J, Serrano C, Bretón I, et al. Nutritional management and clinical outcome of critically ill patients with COVID-19: A retrospective study in a tertiary hospital. Clin Nutr. 2021;S0261-5614(21)00499-4. https://doi.org/10.1016/j.clnu.2021.10.020

Alencar ES, Muniz LSDS, Holanda JLG, Oliveira BDD, Carvalho MCF, Leitão AMM, et al. Enteral nutritional support for patients hospitalized with COVID-19: Results from the first wave in a public hospital. Nutrition. 2022;94:111512. https://doi.org/10.1016/j.nut.2021.111512

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. Clin Nutr. 2020;39(6):1631-8. https://doi.org/10.1016/j.clnu.2020.03.022

Stachowska E, Folwarski M, Jamioł-Milc D, Maciejewska D, Skonieczna-Żydecka K. Nutritional Support in Coronavirus 2019 Disease. Medicina (Kaunas). 2020;56(6):289. https://doi.org/10.3390/medicina56060289

Laviano A, Koverech A, Zanetti M. Nutrition support in the time of SARS-CoV-2 (COVID-19). Nutrition. 2020;74:110834. https://doi.org/10.1016/j.nut.2020.110834

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