Gonçalves Thiago José Martins, Gonçalves Sandra Elisa Adami Batista, Guarnieri Andreia, Risegato Rodrigo Cristovão, Guimarães Maysa Penteado, de Freitas Daniella Cabral, Razuk-Filho Alvaro, Benedito Junior Pedro Batista, Parrillo Eduardo Fagundes
Sancta Maggiore Hospital, Prevent Senior Private Health Operator, São Paulo, Brazil.
Sancta Maggiore Hospital, Prevent Senior Private Health Operator, São Paulo, Brazil.
Clin Nutr ESPEN. 2020 Dec;40:110-114. doi: 10.1016/j.clnesp.2020.10.008. Epub 2020 Oct 13.
BACKGROUND & AIM: Verify the prevalence of hypovitaminosis D and obesity in elderly patients infected by new coronavirus. The patients developed severe symptoms and were admitted in intensive care unit (ICU) to receive invasive ventilation due to diagnosis of acute respiratory distress syndrome (ARDS).
A cross-sectional descriptive study composed of elderly (age ≥ 60 years) admitted to the ICU. Were collected demographic (sex, age), anthropometric data, presence of comorbidities (hypertension, diabetes, heart disease, lung, neurological and oncological diseases), severity score in ICU (SAPS III), PaO/FiO ratio, analysis of C-reactive protein (CRP) and serum dosage of 25-hydroxy vitamin D (25 OHD) in the first day of hospitalization to identify elderly with hypovitaminosis D (low values < 30 ng/mL). The diagnosis of obesity in elderly was determined by calculating the body mass index (BMI) ≥ 30 kg/m.
A total of 176 elderly met the inclusion criteria. 54% were elderly men and mean age of 72.9 ± 9.1 years. The median BMI was 30.5 (28.1-33) kg/m with 68.7% having a nutritional diagnosis of obesity and 15.3% had BMI ≥ 35 kg/m. The most prevalent comorbidities were hypertension (72.2%) and diabetes (40.9%). Prevalence of hypovitaminosis D with values of 25 OHD <30 ng/mL, < 20 ng/mL and <10 ng/mL was 93.8%, 65.9% and 21% respectively. The prevalence of hypovitaminosis D (<30 ng/mL) in obese elderly was 94.2%. There was a negative and significant bivariate correlation between BMI and levels of 25 OHD (r = - 0.15; p = 0.04).
Hypovitaminosis D and obesity in elderly have a high prevalence in critically ill patients in ICU infected by the new coronavirus. Laboratory investigation of vitamin D becomes important, especially in obese elderly patients.
验证新型冠状病毒感染老年患者中维生素D缺乏症和肥胖症的患病率。这些患者出现严重症状，因诊断为急性呼吸窘迫综合征（ARDS）而入住重症监护病房（ICU）接受有创通气治疗。
一项横断面描述性研究，研究对象为入住ICU的老年患者（年龄≥60岁）。收集人口统计学资料（性别、年龄）、人体测量数据、合并症（高血压、糖尿病、心脏病、肺部疾病、神经系统疾病和肿瘤疾病）的存在情况、ICU严重程度评分（SAPS III）、动脉血氧分压/吸入氧浓度比值、C反应蛋白（CRP）分析以及住院首日血清25-羟维生素D（25 OHD）剂量，以确定维生素D缺乏症老年患者（数值<30 ng/mL为低值）。通过计算体重指数（BMI）≥30 kg/m²来确定老年患者肥胖症的诊断。
共有176名老年患者符合纳入标准。其中54%为老年男性，平均年龄为72.9±9.1岁。BMI中位数为30.5（28.1 - 33）kg/m²，68.7%的患者营养诊断为肥胖，15.3%的患者BMI≥35 kg/m²。最常见的合并症为高血压（72.2%）和糖尿病（40.9%）。25 OHD值<30 ng/mL、<20 ng/mL和<10 ng/mL的维生素D缺乏症患病率分别为93.8%、65.9%和21%。肥胖老年患者中维生素D缺乏症（<30 ng/mL）的患病率为94.2%。BMI与25 OHD水平之间存在负向且显著的双变量相关性（r = - 0.15；p = 0.04）。
在新型冠状病毒感染的ICU重症患者中，老年患者维生素D缺乏症和肥胖症的患病率较高。维生素D的实验室检测变得很重要，尤其是在肥胖老年患者中。
