Araújo Vanessa A, Souza Jefferson S, Giglio Bruna M, Lobo Patrícia C B, Pimentel Gustavo D
Faculty of Nutrition, Federal University of Goiás, Goiânia 74605080, Brazil.
Diseases. 2024 May 8;12(5):97. doi: 10.3390/diseases12050097.
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).
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/m, 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.
A total of 208 older adults diagnosed with COVID-19 admitted to ICU were included, of which 84% ( = 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.
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).
新型冠状病毒肺炎（COVID-19）是一种以严重分解代谢和炎症状态为特征的传染病，可导致肌肉量减少。肌肉量评估有助于识别营养风险并辅助早期管理，尤其是在营养风险较高的老年人中。本研究旨在评估小腿围度（CC）与入住重症监护病房（ICU）的老年COVID-19患者的临床和生化指标及死亡率之间的关联。
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，分别减少3、7或12 cm，女性CC < 33 cm且男性CC < 34 cm时分类为降低。进行BMI与CC之间的Pearson相关性分析以评估变量之间的关联。回归分析对性别、年龄和BMI变量进行了调整。采用Cox回归评估与CC相关的生存率。
共纳入208例入住ICU的确诊COVID-19老年患者，其中84%（n = 176）被分类为CC降低。与CC正常的组相比，这些患者年龄更大，BMI更低，营养风险更高，存在营养不良，尿素及尿素-肌酐比值（UCR）浓度更高。在Cox回归中，无论是否对混杂因素进行调整，有营养风险的水肿患者和营养不良患者与CC降低之间均存在关联。
CC与入住ICU的老年COVID-19患者的病情严重程度、生化指标或死亡率无关，但与通过主观全面评定法（SGA）评估的中度营养不良患者有关。
