Weight loss as a predictor of poor prognosis in patients hospitalized for COVID-19

Main Article Content

Brena Letícia Gomes de Paiva
https://orcid.org/0000-0001-5340-2976
João Araújo Barros-Neto
https://orcid.org/0000-0002-7603-1095
Maria Bárbara Galdino Silva
https://orcid.org/0000-0002-8217-0278
Clécia Alves da Silva
Flaviani Diogo Reis Augusto
Sandra Mary Lima Vasconcelos
Claudia Porto Sabino Pinho Ramiro

Abstract

Objective: To evaluate the relationship between weight loss and markers of poor prognosis in patients hospitalized with COVID-19 in the state of Pernambuco. Methods: A multicenter, cross-sectional study coupled with prospective analysis variables involving 71 individuals with COVID-19 admitted for hospitalization in 8 public hospitals in Recife, in the State of Pernambuco. Individuals of both sexes, aged ≥ 20 years, hospitalized from June 2020 to June 2021 were included. Sociodemographic, clinical, and nutritional data and prognostic markers were collected. Results: The average age was 54.6±15.6 years, with 54.9% of individuals being male. It was found that 26.8% of the patients were diabetic and 52.1% were hypertensive. The anthropometric profile indicated that 56.3% were overweight and 5.6% were underweight. Positive screening for sarcopenia was observed in 16.9%. The median weight loss was 3.1% (0.0-6.6%), with a loss > 5% evident in 29.6% of the sample. It was found that weight loss was more frequent in men (16 (41.0%) vs. 5 (15.6%); p = 0.020) and that demographic, clinical, and nutritional variables were not associated with body weight loss. There was no statistical association between weight loss and prognostic variables (p NS). Conclusion: Although the study did not demonstrate an association between weight loss and prognostic variables, this should be considered when assessing patients with COVID-19 and should be investigated and treated as an essential health promotion measure.



Article Details

How to Cite
1.
Paiva BLG de, Barros-Neto JA, Silva MBG, Silva CA da, Augusto FDR, Vasconcelos SML, et al. Weight loss as a predictor of poor prognosis in patients hospitalized for COVID-19. HSJ [Internet]. 2023 Sep. 19 [cited 2024 Nov. 2];13(3):81-8. Available from: https://portalrcs.hcitajuba.org.br/index.php/rcsfmit_zero/article/view/1447
Section
ORIGINAL ARTICLE
Author Biographies

Brena Letícia Gomes de Paiva, Hospital das Clínicas de Pernambuco

Specialist in Nutrition from the Uniprofessional Residency Program in Clinical Nutrition at Hospital das Clínicas de Pernambuco - HC/UFPE.

João Araújo Barros-Neto, Universidade Federal de Alagoas

Professor at the Faculty of Nutrition at the Federal University of Alagoas (FANUT/UFAL), PhD in Interactive Processes of Organs and Systems at the Institute of Health Sciences/UFBA.

Maria Bárbara Galdino Silva, Hospital das Clínicas de Pernambuco

Specialist in Nutrition from the Uniprofessional Residency Program in Clinical Nutrition at Hospital das Clínicas de Pernambuco - HC/UFPE.

Clécia Alves da Silva, Hospital das Clínicas de Pernambuco

Specialist in Nutrition from the Uniprofessional Residency Program in Clinical Nutrition at Hospital das Clínicas de Pernambuco - HC/UFPE.

Flaviani Diogo Reis Augusto, Hospital das Clínicas de Pernambuco

Specialist in Nutrition from the Uniprofessional Residency Program in Clinical Nutrition at Hospital das Clínicas de Pernambuco - HC/UFPE.

Sandra Mary Lima Vasconcelos, Universidade Federal de Alagoas

Professor at the Faculty of Nutrition at the Federal University of Alagoas (FANUT/UFAL), PhD in Sciences (UFAL).

Claudia Porto Sabino Pinho Ramiro, Hospital das Clínicas de Pernambuco

PhD in Nutrition from the Federal University of Pernambuco (UFPE), Preceptor of the Nutrition Residency Program at Hospital das Clínicas de Pernambuco (HC-UFPE).

References

Sohrabi C, Alsafi Z, Neill NO, Khan M, Kerwan A. World Health Organization declares global emergency: A review of the 2019 novel coronavirus (COVID-19). Int J Surger. 2020;76:71-6. https://doi.org/10.1016/j.ijsu.2020.02.034

Cao T-T, Zhang G-Q, Pellegrini E, Zhao Q, Li J, Luo L, et al. COVID-19 and its effects on the digestive system. World J Gastroenterol. 2021;27(24):3502-15https://doi.org/10.3748/wjg.v27.i24.3502

Agência Nacional de Vigilância Sanitária (ANVISA). Nota Técnica No 04/2020 GVIMS /GGTES/ANVISA. Orientações para Serviços de Saúde: Medidas de Prevenção e Controle que Devem Ser Adotadas Durante a Assistência aos Casos Suspeitos ou Confirmados de Infecção pelo novo coronavírus (2019- nCoV). [Internet]. ANVISA: Brasília; 2020. 92 p. Available from: https://bit.ly/3Zkwmce

World Health Organization WHO. COVID-19 (Dashboard). [Internet]. Available from: https://covid19.who.int

Liu Y, Gayle AA, Wilder-Smith A, Rocklöv J. The reproductive number of COVID-19 is higher compared to SARS coronavirus. J Travel Med. 2020;27(2):taaa021. https://doi.org/10.1093/jtm/taaa021

Abate S, Chekole Yigrem A, Estifanos Birhane M, Kalkidan HA, Robel Hussen K. Prevalence and outcomes of malnutrition among hospitalized COVID-19 patients: A systematic review and meta-analysis. Clin Nutr ESPEN. 2021;43:174-83. https://doi.org/10.1016/j.clnesp.2021.03.002

Anker MS, Landmesser U, von Haehling S, Butler J, Coats AJS, Anker SD. Weight loss, malnutrition, and cachexia in COVID-19: facts and numbers. J Cachexia Sarcopenia Muscle. 2021;12(1):9-13. https://doi.org/10.1002/jcsm.12674

Dawei W, Bo H, Chang H, Fangfang Z, Xing L, Jing Z, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020;323(11):1061-9. https://doi.org/10.1001/jama.2020.1585

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

Singer P, Blaser AR, Berger MM, Alhazzani W, Calder PC, Casaer MP, et al. ESPEN guideline on clinical nutrition in the intensive care unit. Clin Nutr. 2019;38(1):48-79. https://doi.org/10.1016/j.clnu.2018.08.037

Li Q, Guan X, Wu P, Wang X, Zhou L, Tong Y, et al. Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus-Infected Pneumonia. N Engl J Med. 2020;382(13):1199-207. https://doi.org/10.1056/NEJMoa2001316

Zhao X, Li Y, Ge Y, Shi Y, Lv P, Zhang J, et al. Evaluation of Nutrition Risk and Its Association With Mortality Risk in Severely and Critically Ill COVID-19 Patients. J Parenter Enter Nutr. 2021;45(1):32-42. https://doi.org/10.1002/jpen.1953

Kikutani T, Ichikawa Y, Kitazume E, Mizukoshi A, Tohara T, Takahashi N, et al. COVID-19 infection-related weight loss decreases eating/swallowing function in schizophrenic patients. Nutrients. 2021;13(4):2-9. https://doi.org/10.3390/nu13041113

World Health Organization. Physical Status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. Geneva: WHO; 1995 [Cited 13 Sep 2023]. 463 p. Available from: https://bit.ly/3PC5elD

Lipschitz DA. Screening for nutritional status in the elderly. Prim Care. 1994;21(1):55-67. https://doi.org/10.1016/S0095-4543(21)00452-8

Barbosa-Silva TG, Menezes AMB, Bielemann RM, Malmstrom TK, Gonzalez MC. Enhancing SARC-F: Improving Sarcopenia Screening in the Clinical Practice. J Am Med Dir Assoc. 2016;17(12):1136-41. https://doi.org/10.1016/j.jamda.2016.08.004

Bedock D, Couffignal J, Bel Lassen P, Soares L, Mathian A, Fadlallah JP, et al. Evolution of nutritional status after early nutritional management in covid-19 hospitalized patients. Nutrients. 2021;13(7):2276. https://doi.org/10.3390/nu13072276

Martin- Martinez A, Omar O, Paula V, Viridiana A, Nascimento W, Costa A, et al. COVID-19 is associated with oropharyngeal dysphagia and malnutrition in hospitalized patients during the spring 2020 wave of the pandemic. Clin Nutr ESPEN. 2021;43:369-76. https://doi.org/10.1016/j.clnu.2021.06.010

Wierdsma NJ, Kruizenga HM, Konings LA, Krebbers D, Jorissen JR, Joosten MHI, 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

Di Filippo L, De Lorenzo R, D'Amico M, Sofia V, Roveri L, Mele R, et al. COVID-19 is associated with clinically significant weight loss and risk of malnutrition, independent of hospitalisation: A post-hoc analysis of a prospective cohort study. Clin Nutr. 2021;40(4):2420-6. https://doi.org/10.1016/j.clnu.2020.10.043

Allard L, Ouedraogo E, Molleville J, Bihan H, Giroux-Leprieur B, Sutton A, et al. Malnutrition: Percentage and association with prognosis in patients hospitalized for coronavirus disease 2019. Nutrients. 2020;12(12):3679. https://doi.org/10.3390/nu12123679

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

Damayanthi HDWT, Prabani KIP. Nutritional determinants and COVID-19 outcomes of older patients with COVID-19: A systematic review. Arch Gerontol Geriatr. 2021;95(July-August):104411. https://doi.org/10.1016/j.archger.2021.104411

Holdoway A. Nutritional management of patients during and after COVID-19 illness. Br J Community Nurs. 2020;25:S6-10. https://doi.org/10.12968/bjcn.2020.25.Sup8.S6

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. 2020;74(6):871-5. https://doi.org/10.1038/s41430-020-0642-3

Galanopoulos M, Gkeros F, Doukatas A, Karianakis G, Pontas C, Tsoukalas N, et al. COVID-19 pandemic: Pathophysiology and manifestations from the gastrointestinal tract. World J Gastroenterol. 2020;26(31):4579-88. https://doi.org/10.3748/wjg.v26.i31.4579

Morley JE, Kalantar-Zadeh K, Anker SD. COVID-19: a major cause of cachexia and sarcopenia? J Cachexia Sarcopenia Muscle. 2020;11(4):863-5. https://doi.org/10.1002/jcsm.12589

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

Abe T, Bell ZW, Wong V, Spitz RW, Yamada Y, Song JS, et al. Skeletal muscle size distribution in large-sized male and female athletes. Am J Hum Biol. 2021;33(2):23473. https://doi.org/10.1002/ajhb.23473

Fiorindi C, Campani F, Rasero L, Campani C, Livi L, Giovannoni L. Prevalence of nutritional risk and malnutrition during and after hospitalization for COVID-19 infection: Preliminary results of a single- centre experience. Clin Nutr ESPEN. 2021;45:351-5. https://doi.org/10.1016/j.clnesp.2021.07.020

Zhang P, He Z, Yu G, Peng D, Feng Y, Ling J, et al. The modified NUTRIC score can be used for nutritional risk assessment as well as prognosis prediction in critically ill COVID-19 patients. Clin Nutr. 2021;40(2):534-41. https://doi.org/10.1016/j.clnu.2020.05.051

Wang P, Li Y, Wang Q. Sarcopenia: An underlying treatment target during the COVID-19 pandemic. Nutrition. 2021;84:111104. https://doi.org/10.1016/j.nut.2020.111104

Youssef N, Elbadry M, Al Shafie A, Abdalazeem A, Hasan S, Tahoon M, et al. Nutritional status associated with clinical outcomes among patients hospitalized with COVID-19: A multicenter prospective study in Egypt. Nurs Heal Sci. 2022;24(1):204-13. https://doi.org/10.1111/nhs.12913

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

Most read articles by the same author(s)