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因 COVID-19 住院的成年和老年患者中肌少症预测的频率和相关因素。

Frequency and factors associated with sarcopenia prediction in adult and elderly patients hospitalized for COVID-19.

机构信息

Residency Program in Clinical Nutrition, Hospital Barão de Lucena, Academic Center of Vitória de Santo Antão, Federal University of Pernambuco (CAV/UFPE), Recife, Pernambuco, Brazil.

Residency Program in Clinical Nutrition, Hospital Barão de Lucena, Academic Center of Vitória de Santo Antão, Federal University of Pernambuco (CAV/UFPE), Recife, Pernambuco, Brazil.

出版信息

Exp Gerontol. 2022 Oct 15;168:111945. doi: 10.1016/j.exger.2022.111945. Epub 2022 Sep 5.

Abstract

Patients with COVID-19 may develop symptoms that interfere with food intake. Systemic inflammatory response associated with physical inactivity and/or immobilization during hospital stay can induce weight and muscle loss leading to sarcopenia and worsening the clinical condition of these patients. The present study identifies the frequency and factors associated with sarcopenia prediction in adult and elderly patients hospitalized for COVID-19. It is a cohort-nested cross-sectional study on adult and elderly patients admitted to wards and intensive care units (ICUs) of 8 hospitals in a northeastern Brazilian state. The study was conducted from June 2020 to June 2021. Sociodemographic, economic, lifestyle, and current and past clinical history variables were collected. Sarcopenia prediction was determined by the Strength, Assistance in walking, Rise from a chair, Climb stairs, and Falls (SARC-F) questionnaire compiled in the Remote-Malnutrition APP (R-MAPP). Patients were diagnosed with sarcopenia when the final score ≥ 4 points. The study included 214 patients with a mean age of 61.76 ± 16.91 years, of which 52.3 % were female and 57.5 % elderly. Sarcopenia prevailed in 40.7 % of the sample. Univariate analysis showed greater probability of sarcopenia in elderly individuals, nonpractitioners of physical activities, hypertensive patients, diabetic patients, and those hospitalized in the ICU. In the multivariate model, the type of hospital admission remained associated with sarcopenia prediction, where patients admitted to the ICU were 1.43 (95 % CI: 1.04; 1.97) more likely to have sarcopenia than those undergoing clinical treatment. Sarcopenia prediction was not associated with patient outcome (discharge, transfer, or death) (p = 0.332). The study highlighted an important percentage of sarcopenia prediction in patients with COVID-19, especially those admitted to the ICU. Additional investigations should be carried out to better understand and develop early diagnostic strategies to assist in the management of sarcopenic patients with COVID-19.

摘要

患有 COVID-19 的患者可能会出现妨碍进食的症状。与住院期间身体不活动和/或固定相关的全身性炎症反应会导致体重和肌肉流失,从而导致肌肉减少症,并使这些患者的临床状况恶化。本研究旨在确定 COVID-19 住院成年和老年患者中肌肉减少症预测的频率和相关因素。这是一项在巴西东北部 8 家医院的病房和重症监护病房(ICU)住院的成年和老年患者中进行的队列嵌套横断面研究。该研究于 2020 年 6 月至 2021 年 6 月进行。收集了社会人口学、经济、生活方式以及当前和既往临床病史变量。肌肉减少症预测通过远程营养不良 APP(R-MAPP)中的 Strength、行走辅助、从椅子上站起来、爬楼梯和跌倒(SARC-F)问卷确定。当最终得分为≥4 分时,患者被诊断为肌肉减少症。该研究纳入了 214 名患者,平均年龄为 61.76±16.91 岁,其中 52.3%为女性,57.5%为老年人。样本中肌肉减少症的患病率为 40.7%。单因素分析显示,老年人、不进行体育活动、高血压患者、糖尿病患者和 ICU 住院患者发生肌肉减少症的概率更大。在多因素模型中,住院类型仍与肌肉减少症预测相关,与接受临床治疗的患者相比,ICU 住院患者发生肌肉减少症的可能性高 1.43 倍(95%CI:1.04;1.97)。肌肉减少症预测与患者结局(出院、转科或死亡)无关(p=0.332)。该研究强调了 COVID-19 患者中肌肉减少症预测的重要比例,特别是 ICU 住院患者。应开展更多研究以更好地了解和制定早期诊断策略,以协助管理 COVID-19 肌肉减少症患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/104f/9443615/0349119ff992/gr1_lrg.jpg

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