重症监护室收治的患有 COVID-19 的老年人的小腿围度与临床和生化指标的关系:一项回顾性横断面研究

Diseases Pub Date : 2024-05-08 DOI:10.3390/diseases12050097
Vanessa A. Araújo, Jefferson S. Souza, Bruna M. Giglio, P. C. Lobo, Gustavo D. Pimentel
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摘要

背景:COVID-19 是一种传染性疾病,其特点是严重的分解代谢和炎症状态,导致肌肉质量下降。肌肉质量评估有助于识别营养风险并协助早期管理,尤其是对营养风险较高的老年人。本研究旨在评估入住重症监护室(ICU)的患有 COVID-19 的老年人的小腿围(CC)与临床和生化指标及死亡率的关系。研究方法在一家公立医院进行了一项回顾性横断面研究。CC根据体重指数(BMI)进行调整,BMI为25-29.9、30-39.9和≥40 kg/m2时,CC分别减少3、7或12厘米,当女性<33厘米和男性<34厘米时,CC被归类为减少。对 BMI 和 CC 之间的皮尔逊相关性进行了分析,以评估变量之间的联系。回归分析对性别、年龄和 BMI 变量进行了调整。Cox 回归用于评估与 CC 相关的存活率。结果:共纳入了 208 名被诊断为 COVID-19 的入住重症监护室的老年人,其中 84% (n = 176)被归类为 CC 下降。与 CC 正常组相比,这些患者年龄更大、体重指数(BMI)更低、营养风险更高、营养不良、尿素浓度和尿素-肌酐比值(UCR)更高。无论是否对混杂因素进行调整,在考克斯回归中,有营养风险和营养不良的水肿患者与 CC 降低之间存在关联。结论:CC在入住重症监护室的患有 COVID-19 的老年人中,CC 与病情严重程度、生化指标或死亡率无关,但与通过主观全面评估(SGA)评定的中度营养不良患者有关。
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Association of Calf Circumference with Clinical and Biochemical Markers in Older Adults with COVID-19 Admitted at Intensive Care Unit: A Retrospective Cross-Sectional Study
Background: COVID-19 is an infectious disease characterized by a severe catabolic and inflammatory state, leading to loss of muscle mass. The assessment of muscle mass can be useful to identify nutritional risk and assist in early management, especially in older adults who have high nutritional risks. The aim of this study was to evaluate the association of calf circumference (CC) with clinical and biochemical markers and mortality in older adults with COVID-19 admitted to the intensive care unit (ICU). Methods: A retrospective cross-sectional study was conducted in a public hospital. CC was adjusted for body mass index (BMI), reducing 3, 7, or 12 cm for a BMI of 25–29.9, 30–39.9, and ≥40 kg/m2, respectively, and classified as reduced when <33 cm for women and <34 cm for men. Pearson’s correlation between BMI and CC was performed to assess the association between variables. Regression analysis was adjusted for sex, age, and BMI variables. Cox regression was used to assess survival related to CC. Results: A total of 208 older adults diagnosed with COVID-19 admitted to ICU were included, of which 84% (n = 176) were classified as having reduced CC. These patients were older, with lower BMI, higher nutritional risk, malnourished, and higher concentration of urea and urea–creatinine ratio (UCR) compared with the group with normal CC. There was an association between edematous patients at nutritional risk and malnourished with reduced CC in the Cox regression, either adjusted or not for confounding. Conclusions: CC was not associated with severity, biochemical markers, or mortality in older adults with COVID-19 admitted to the ICU, but it was associated with moderately malnourished patients assessed by subjective global assessment (SGA).
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