Endocrinology and Nutrition Department, Hospital Universitario Son Llàtzer, Health Research Institute of the Balearic Islands (IdISBa), Ctra Manacor Km 4, 07198, Palma de Mallorca, Baleares, Spain.
Endocrinology and Nutrition Department, Hospital Universitario Son Llàtzer, Health Research Institute of the Balearic Islands (IdISBa), Ctra Manacor Km 4, 07198, Palma de Mallorca, Baleares, Spain.
Clin Nutr ESPEN. 2021 Dec;46:434-438. doi: 10.1016/j.clnesp.2021.09.722. Epub 2021 Sep 25.
The clinical spectrum of the SARS-CoV-2 infection is very broad, ranging from asymptomatic infection to severe pneumonia. However, the majority of fatalities related to COVID-19 have involved old, frail and patients with comorbidities, such as obesity, groups that also have high rates of a poor nutritional status. To assess the impact on clinical outcomes of the coexistence of any degree of obesity and low albumin levels on admission among patients with COVID-19.
This is a sub-analysis of a former study where 75 patients admitted due to COVID-19 were evaluated cross-sectionally. In this analysis, patients were divided in two groups, according to the presence of obesity and albumin levels on admission lower than 3.5 g/dl.
11 out 75 patients evaluated (14.7%) had obesity and albumin levels lower than 3.5 g/dl. Patients with obesity and hypoalbuminemia were older than patients without these two conditions (65.3 ± 7.7 vs 54.2 ± 17 years; p = 0.01). CRP (141.4 ± 47.9 vs 70.1 ± 60.6 mg/l; p = 0.002), D-dimer (2677.3 ± 2358.3 vs 521.7 ± 480.3 ng/ml; p = 0.001), fibrinogen (765.9 ± 123.9 vs 613.5 ± 158gr/L; p = 0.007) ferritin levels (903.1 ± 493 vs 531.4 ± 418.9 mcg/l; p = 0.01) and procalcitonin (3.5 ± 0.6 vs 1.1 ± 0.7 ng/ml; p = 0.009) were significantly higher in the group with obesity and hypoalbuminemia. Among patients with low albumin and obesity, length of hospital was higher (21.9 ± 18.7 vs 10.5 ± 9.5 days; p = 0.004) and the proportion of subjects admitted to ICU was greater (81.8% vs 11.5%; p < 0.0001). However, mortality rates were comparable between the two groups (3.8% vs 0%; p = 0.5).
The combination of obesity and hypoalbuminemia may worsen the prognosis of patients with a SARS-CoV-2 infection. Therefore, prompt identification and amelioration of nutritional status could be beneficial.
SARS-CoV-2 感染的临床表现非常广泛，从无症状感染到严重肺炎不等。然而，与 COVID-19 相关的大多数死亡病例都涉及到年老、体弱和患有合并症的患者，如肥胖症，这些患者的营养状况也很差。本研究旨在评估 COVID-19 患者入院时任何程度的肥胖症和低白蛋白血症并存对临床结局的影响。
这是一项对 75 例因 COVID-19 住院患者进行的横断面评估的子分析。在这项分析中，根据入院时的肥胖症和白蛋白水平低于 3.5 g/dl 将患者分为两组。
评估的 75 例患者中有 11 例（14.7%）存在肥胖症和白蛋白水平低于 3.5 g/dl。肥胖症和低白蛋白血症患者比没有这两种情况的患者年龄更大（65.3 ± 7.7 岁 vs 54.2 ± 17 岁；p = 0.01）。肥胖症和低白蛋白血症患者的 CRP（141.4 ± 47.9 vs 70.1 ± 60.6 mg/l；p = 0.002）、D-二聚体（2677.3 ± 2358.3 vs 521.7 ± 480.3 ng/ml；p = 0.001）、纤维蛋白原（765.9 ± 123.9 vs 613.5 ± 158 gr/L；p = 0.007）、铁蛋白水平（903.1 ± 493 vs 531.4 ± 418.9 mcg/l；p = 0.01）和降钙素原（3.5 ± 0.6 vs 1.1 ± 0.7 ng/ml；p = 0.009）水平显著更高。在低白蛋白血症和肥胖症患者中，住院时间更长（21.9 ± 18.7 天 vs 10.5 ± 9.5 天；p = 0.004），入住 ICU 的比例更大（81.8% vs 11.5%；p < 0.0001）。然而，两组的死亡率相当（3.8% vs 0%；p = 0.5）。
肥胖症和低白蛋白血症的合并可能使 SARS-CoV-2 感染患者的预后恶化。因此，及时识别和改善营养状况可能有益。
