Relação entre estado nutricional, hábitos de vida e prognóstico em pacientes diagnosticados com COVID-19 hospitalizados no estado de Pernambuco
Conteúdo do artigo principal
Resumo
Objetivo: Analisar a relação entre estado nutricional e hábitos de vida com o prognóstico de pacientes hospitalizados com COVID-19 acompanhados no estado de Pernambuco. Métodos: Estudo multicêntrico, transversal, acoplado a variáveis de análise prospectiva, envolvendo pacientes com COVID-19 e internados em 8 hospitais. Foram incluídos indivíduos com idade ≥ 18 anos, de ambos os sexos, hospitalizados no período de junho de 2020 a junho de 2021. Foram coletados dados socioeconômicos, clínicos, antropométricos, hábitos de vida e variáveis prognósticas. Resultados: A amostra foi composta por 263 indivíduos com média de idade de 62,9 ± 16,6 anos e distribuição homogênea entre os sexos. Observou-se que 8,2% eram tabagistas, 20,9% referiram o consumo de álcool e que 80,1% eram sedentários. O perfil antropométrico apontou 49,5% de excesso de peso e 7,0% de baixo peso. A desnutrição e o excesso de peso foram associados a um maior tempo de internamento (desn. 66,7% e exc. peso 64,5% vs. eutrofia 30,0%; p = 0,021), o tabagismo com óbito (tab 65,0% vs. não-tab 33,7%; p = 0,006) e necessidade de internação em Unidade de Terapia Intensiva (sim 64,3%, não 31,5%; p = 0,014). A frequência de dispneia foi superior nos pacientes que referiram o consumo de bebidas alcoólicas (sim 69,6% vs. não 48,1%; p = 0,007). A atividade física não se associou a nenhum fator prognóstico. Conclusão: Os extremos nutricionais e hábitos de vida inadequados, como o tabagismo e o consumo de álcool, constituem fatores de risco para um mau prognóstico em indivíduos com COVID-19.
Detalhes do artigo
Os autores mantêm os direitos autorais e concedem ao HSJ o direito de primeira publicação. A partir de 2024, as publicações serão licenciadas sob a Attribution 4.0 International , permitindo seu compartilhamento, reconhecendo a autoria e publicação inicial nesta revista.
Os autores estão autorizados a assumir contratos adicionais separadamente para distribuição não exclusiva da versão do trabalho publicada nesta revista (por exemplo, publicação em repositório institucional ou como capítulo de livro), com reconhecimento de autoria e publicação inicial nesta revista.
Os autores são incentivados a publicar e distribuir seu trabalho on-line (por exemplo, em repositórios institucionais ou em sua página pessoal) a qualquer momento após o processo editorial.
Além disso, o AUTOR fica informado e consente que o HSJ possa incorporar seu artigo em bases de dados e indexadores científicos existentes ou futuros, nas condições definidas por estes a cada momento, o que envolverá, pelo menos, a possibilidade de que os titulares de esses bancos de dados podem executar as seguintes ações no artigo.
Referências
World Health Organization (WHO). WHO Coronavirus (COVID-19) Dashboard. Situation by Region, Country, Territory & Area. [cited 17 Nov 2021]. Available from: https://covid19.who.int/table
Lai CC, Shih TP, Ko WC, Tang HJ, Hsueh PR. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges. Int J Antimicrob Agents. 2020;55(3):105924.
https://doi.org/10.1016/j.ijantimicag.2020.105924
Azevedo RB, Botelho BG, Hollanda JVG, Ferreira LVL, Andrade LZJ, Oei SSML, et al. Covid-19 and the cardiovascular system: a comprehensive review. J Hum Hypertens. 2020;35:4-11. https://doi.org/10.1038/s41371-020-0387-4
Sobrado MM, Mateo-Abad M, Vrotsou K, Vergara I. Health Status and Lifestyle Habits of Vulnerable, Community-Dwelling Older People During the COVID-19 Lockdown. J Frailty Aging. 2021;10(3):286-9. https://doi.org/10.14283/jfa.2021.12
Zabetakis I, Lordan R, Norton C, Tsoupras, A. The Inflammation Link and the Role of Nutrition in Potential Mitigation. Nutrients. 2020;12(5):1466. https://doi.org/10.3390/nu12051466
Anker MS, Landmesser U, Haehling SV, 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
Stanton R, To QG, Khalesi S, Williams SL, Alley SJ, Thwaite TL, et al. Depression, Anxiety and Stress during COVID-19: Associations with changes in physical activity, sleep, tobacco and alcohol use in australian adults. Int J Environ Res Public Health. 2020;17(11):4065. https://doi.org/10.3390/ijerph17114065
Engin AB, Engin ED, Engin A. Two important controversial risk factors in SARS-CoV-2 infection: Obesity and smoking. Environ Res. 2020;78:103411. https://doi.org/10.1016/j.etap.2020.103411
Beserra EA, Rodrigues PA, Lisboa AQ. Validação de métodos subjetivos para estimativa do índice de massa corporal em pacientes acamados. Com Ciências Saúde [Internet]. 2011[cited 21 Nov 2022];22(1):19-26. Available from: http://bit.ly/3GBunsE
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.
Lipschitz DA. Screening for nutritional status in the elderly. Primary Care. 1994; 21(1):55-67. https://doi.org/10.1016/S0095-4543(21)00452-8
Haskell WL, Lee IM, Pate RR, Powell KE, Blair SN, Franklin BA, et al. A Physical activity and public health: updated recommendation for adults from the American Collegeof Sports Medicine and the American Heart Association. Med Sci Sports Exerc. 2007;39(8):1423-34. https://doi.org/10.1249/mss.0b013e3180616b27
Simonnet A, Chetboun M, Poissy J, Raverdy V, Noulette J, Duhamel A, et al. High prevalence of obesity in severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2) requiring invasive mechanical ventilation. Obesity. 2020;28(7):1195-9. https://doi.org/10.1002/oby.22831
Hamer M, Gale, CR, Kivimaki M, Batty GD. Overweight, obesity, and risk of hospitalization for COVID-19: A community-based cohort study of adults in the United Kingdom. Proc Natl Acad Sci U S A. 2020;117(35):21011-3. https://doi.org/10.1073/pnas.2011086117
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;74:871-5. https://doi.org/10.1038/s41430-020-0642-3
Pironi L, Sasdelli AS, Ravaiolli F, Leoni L, Mari GA. 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
Fresán U, Guevara M, Elía F, Albéniz E, Burgui C, Castilla J, et al. Independent Role of Severe Obesity as a Risk Factor for COVID-19 Hospitalization: A Spanish Population-Based Cohort Study. Obesity. 2021;29(1):29-37. https://doi.org/10.1002/oby.23029
Nicolau J, Ayala L, Sanchís P, Olivares J, Dotres K, Soler AG, et al. Influence of nutritional status on clinical outcomes among hospitalized patients with COVID-19. Clin Nutr ESPEN. 2021;43:223-9. https://doi.org/10.1016/j.clnesp.2021.04.013
Mariconi D, Mais S, Rebelos E, Virdis A, Manca ML, Marco S, et al. Obesity prolongs the hospital stay in patients affected by COVID-19, and may impact on SARS-COV-2 shedding. Obes Res Clin Pract. 2020;14(3):205-9. https://doi.org/10.1016/j.orcp.2020.05.009
Al-Salameh A, Lanoix JP, Bennis Y, Andrejak C, Brochot E, Deschasse G, et al. The association between body mass index class and coronavirus disease 2019 outcomes. Int J Obes. 2021;45(3):700-5. https://doi.org/10.1038/s41366-020-00721-1
Cordova E, Mykietiuk A, Sued O, Vedia L, Pacifico N, Matias H, et al. Clinical characteristics and outcomes of hospitalized patients with SARS-CoV-2 infection in a Latin American country: Results from the ECCOVID multicenter prospective study. Plos One. 2020;16(10):e0258260. https://doi.org/10.1371/journal.pone.0258260
Petrova D, Fernández ES, Barranco MR, Pérez PN, Moleón JJJ, Sánchez MJ. La obesidad como factor de riesgo en personas con COVID-19: posibles mecanismos e implicaciones. Aten Primaria. 2020; 52(7):496-500. https://doi.org/10.1016/j.aprim.2020.05.003
Fiorindi C, Campani F, Rosero L, Campani C, Livi L, Giovannoni L, et al. 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
Fedele D, Francesco A, Riso S, Collo A. Obesity, malnutrition, and trace element deficiency in the coronavirus disease (COVID-19) pandemic: An overview. Nutrition. 2021;81:111016. https://doi.org/10.1016/j.nut.2020.111016
Zhang J, Dong X, Cao Y, Yuan Y, Yang Y, Yan Y, et al. Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China. Allergy. 2020;75:1730-41. https://doi.org/10.1111/all.14238
Guan W, Ni Z, Hu Y, Liang W, Ou C, He J, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020;382:1708-20. https://doi.org/10.1056/NEJMoa2002032
27 - Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395(10229):1054-62. https://doi.org/10.1016/S0140-6736(20)30566-3
Liu W, Tao Z, Wanh L, Yuan M, Liu K, Zhou L, et al. Analysis of factors associated with disease outcomes in hospitalized patients with 2019 novel coronavirus disease. Chin Med J (Engl). 2020;133(9):1032-8. https://doi.org/10.1097/CM9.0000000000000775
Patanavanich R, Glantz AS. Smoking Is Associated With COVID-19 Progression: A Meta-analysis. Nicotine Tob Res. 2020;22(9):1653-6. https://doi.org/10.1093/ntr/ntaa082
Berlin I, Thomas D, Faou AL, Cornuz J. COVID-19 and Smoking. Nicotine Tob Res. 2020;22(9):1650-2. https://doi.org/10.1093/ntr/ntaa059
Saurabh S, Verma MK, Gautam V, Kumar N, Jain V, Goel AD, et al. Tobacco, alcohol use and other risk factors for developing symptomatic COVID-19 vs asymptomatic SARS-CoV-2 infection: a case-control study from western Rajasthan, India. Trans R Soc Trop Med Hyg. 2021;115(7):820-31. https://doi.org/10.1093/trstmh/traa172
Fan X, Liu Z, Poulsen KL, Wu X, Miyata T, Dasarathy S, et al. Alcohol Consumption Is Associated with Poor Prognosis in Obese Patients with COVID-19: A Mendelian Randomization Study Using UK Biobank. Nutrients. 2021;13(5):1592. https://doi.org/10.3390/nu13051592
Feng Y, Ling Y, Bai T, Xie Y, Huang J, Li J, et al. COVID-19 with Different Severities: A Multicenter Study of Clinical Features. Am J Respir Crit Care Med. 2020; 201(11):1380-8. https://doi.org/10.1164/rccm.202002-0445OC
Ojo AS, Balagun AS, Williams O, Ojo OS. Pulmonary Fibrosis in COVID-19 Survivors: Predictive Factors and Risk Reduction Strategies. Pulm Med. 2020; 2020:6175964. https://doi.org/10.1155/2020/6175964
Yuan Q, Huang H, Chen X, Chen R, Zhang Y, Pan X, et al. Does pre-existent physical inactivity have a role in the severity of COVID-19? Ther Adv Respir Dis. 2021;15:17534666211025221. https://doi.org/10.1177/17534666211025221
Sallis R, Young DR, Tartof SY, Sallis JF, Sall J, Li Q, et al. Physical inactivity is associated with a higher risk for severe COVID-19 outcomes: a study in 48 440 adult patients. Br J Sports Med. 2021;55:1099-105. https://doi.org/10.1136/bjsports-2021-104080
37 - Zhang X, Li X, Sun Z, He Y, Xu W, Campbell H, et al. Physical activity and COVID-19: an observational and Mendelian randomisation study. J Glob Health. 2020;10(2):020514. https://doi.org/10.7189/jogh.10.020514
Fuzeki E, Groneberg DA, Banzer W. Physical activity during COVID-19 induced lockdown: recommendations. J Occup Med Toxicol. 2020;15:25. https://doi.org/10.1186/s12995-020-00278-9
Milogia MN, Vito G, Franchi M, Paoli A, Moro T, Marcolin G, et al. Impact of sedentarism due to the COVID-19 home confinement on neuromuscular, cardiovascular and metabolic health: Physiological and pathophysiological implications and recommendations for physical and nutritional countermeasures. Eur J Sport Sci. 2021;21(4):614-35. https://doi.org/10.1080/17461391.2020.1761076
Berger MM. Nutrition Status Affects COVID-19 Patient Outcomes. JPEN J Parenter Enteral Nutr 2020;44(7):1166-7. https://doi.org/10.1002/jpen.1954