Nutritional and Functional Impact of Acute SARS-CoV-2 Infection in Hospitalized Patients
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Participants
2.3. Study Variables
2.4. Statistical Analysis
3. Results
3.1. Participant Characteristics
3.2. Prevalence of Malnutrition, Sarcopenia and Frailty
3.3. Determinants of Malnutrition, Sarcopenia and Frailty
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variable | Total (n = 101) n (% col) | Malnutrition (n = 50) n (% row) | p * | Sarcopenia (n = 33) n (% row) | p * | Frailty (n = 29) n (% row) | p * |
---|---|---|---|---|---|---|---|
Age in years, mean 66.3 (95% CI 50.8–81.8) | |||||||
≤60 years | 38 (37.6) | 12 (31.6) | 0.014 | 6 (15.8) | <0.001 | 4 (10.5) | <0.001 |
61–74 years | 32 (31.7) | 21 (65.7) | 8 (25.0) | 7 (21.9) | |||
≥75 years | 31 (30.7) | 17 (54.8) | 19 (61.3) | 18 (58.1) | |||
Sex | |||||||
Male | 68 (67.3) | 35 (51.5) | 0.57 | 20 (29.4) | 0.32 | 17 (25) | 0.236 |
Female | 33 (32.7) | 15 (45.5) | 13 (39.4) | 12 (36.4) | |||
Comorbidities | |||||||
Hypertension | 59 (58.4) | 27 (45.8) | 0.37 | 23 (39) | 0.11 | 22 (37.3) | 0.024 |
Dyslipidemia | 35 (35.6) | 20 (55.6) | 0.37 | 15 (41.7) | 0.15 | 13 (36.1) | 0.22 |
Obesity | 31 (30.7) | 11 (35.5) | 0.061 | 6 (19.4) | 0.058 | 9 (36.1) | 0.96 |
Diabetes mellitus | 20 (19.8) | 12 (60) | 0.30 | 10 (50) | 0.065 | 11 (55) | 0.004 |
COPD | 15 (14.9) | 9 (60) | 0.38 | 6 (40) | 0.51 | 7 (46.7) | 0.096 |
Chronic kidney disease | 10 (9.9) | 6 (60) | 0.48 | 6 (60) | 0.052 | 6 (60) | 0.021 |
Heart failure | 10 (9.9) | 7 (70) | 0.17 | 6 (60) | 0.052 | 6 (60) | 0.021 |
Asthma | 6 (5.9) | 3 (50) | 0.98 | 1 (16.7) | 0.39 | 1 (16.7) | 0.30 |
Immunocompromised | 4 (3.9) | 1 (25) | 0.32 | 0 | 0.16 | 0 | 0.20 |
Liver disease | 3 (2.9) | 1 (33) | 0.57 | 1 (33) | 0.98 | 1 (33) | 0.86 |
HIV | 2 (1.9) | 0 | 0.37 | 0 | 0.28 | 1 (50) | 0.24 |
Barthel index, median 100 points (IQR 87.5–100) | |||||||
≤60 points (dependent) | 21 (20.8) | 14 (66.7) | 0.077 | 18 (85.7) | <0.001 | 17 (81.0) | <0.001 |
>60 points (autonomous) | 80 (79.2) | 36 (45.0) | 15 (18.7) | 12 (15.0) | |||
Length of hospital stay, median 16 days (IQR 8–26.5) | |||||||
<30 days | 83 (82.2) | 35 (42.2) | 0.002 | 25 (30.1) | 0.12 | 20 (24.1) | 0.028 |
≥30 days | 18 (17.2) | 15 (83.3) | 8 (44.4) | 9 (50) | |||
Admission to ICU | |||||||
Yes | 25 (24.8) | 18 (72.0) | 0.010 | 8 (32.0) | 0.93 | 7 (28.0) | 0.33 |
No | 76 (75.2) | 32 (42.1) | 25 (32.9) | 22 (28.9) | |||
FINE-Pneumonia Severity Index † on admission | |||||||
I | 11 (10.9) | 3 (27.3) | 0.042 | 0 (0) | 0.004 | 0 (0) | 0.010 |
II | 32 (31.7) | 13 (40.6) | 6 (18.8) | 5 (15.6) | |||
III | 29 (28.7) | 13 (44.8) | 11 (37.9) | 8 (27.6) | |||
IV | 23 (22.8) | 16 (69.6) | 13 (56.5) | 13 (56.5) | |||
V | 6 (5.9) | 5 (83.3) | 3 (50.0) | 3 (50.0) | |||
CURB-65 ‡ pneumonia severity score on admission (points) | |||||||
0 | 29 (28.7) | 7 (24.1) | 0.002 | 3 (10.3) | 0.001 | 2 (6.9) | 0.001 |
1 | 36 (35.6) | 17 (47.2) | 10 (27.8) | 9 (25.0) | |||
2 | 28 (27.2) | 20 (71.4) | 14 50.0) | 13 (46.4) | |||
3 | 8 (7.9) | 6 (75.0) | 6 (66.7) | 5 (62.5) | |||
ARDS on admission | |||||||
Yes | 39 (38.6) | 24 (61.5) | 0.055 | 10 (25.6) | 0.196 | 11 (28.2) | 0.59 |
No | 62 (61.4) | 26 (41.9) | 23 (37.1) | 18 (29.5) |
Malnutrition GLIM (n = 50) n (%) | Sarcopenia SARC-F (n = 33) n (%) | Frailty FRAIL (n = 29) n (%) | |
---|---|---|---|
Malnutrition GLIM | 24 (72.7) | 21 (72.4) | |
Moderate | - | 17 (51.5) | 13 (44.8) |
Severe | - | 7 (21.2) | 8 (27.6) |
Weight loss > 5% | - | 18 (54.5) | 14 (48.3) |
BMI < 20 kg/m2 | - | 3 (9.1) | 2 (6.9) |
Sarcopenia | |||
SARC-F | 24 (48.0) | - | 23 (79.3) |
Diminished strength on dynamometry | 26 (52.0) | 27 (81.8) | 24 (82.6) |
Reduced calf circumference | 26 (52.0) | 20 (60.6) | 19 (65.5) |
Frailty (FRAIL) | |||
Pre-frail | 26 (52.0) | 10 (30.3) | - |
Frail | 21 (42.0) | 23 (69.7) | - |
Variable | Malnutrition | Sarcopenia | Frailty | |||
---|---|---|---|---|---|---|
OR (95% CI) | p | OR (95% CI) | p | OR (95% CI) | p | |
Age | 1.25 (0.52–3.03) | 0.62 | 1.21 (0.48–3.06) | 0.63 | 2.37 (0.76–7.36) | 0.17 |
Sex | * | * | * | |||
Hypertension | * | * | 1.74 (0.30–9.97) | 0.53 | ||
Dyslipidemia | * | * | * | |||
Obesity | 0.38 (0.13–1.06) | 0.064 | 0.20 (0.04–0.90) | 0.036 | * | |
Diabetes | * | 1.65 (0.34–8.09) | 0.54 | 1.30 (0.24–7.05) | 0.76 | |
COPD | * | * | 0.34 (0.06–1.88) | 0.22 | ||
Chronic kidney disease | * | * | 0.19 (0.01–2.73) | 0.22 | ||
Heart failure | * | 2.82 (0.40–20.00) | 0.30 | 1.53 (0.11–22.29) | 0.76 | |
Asthma | * | * | * | |||
Immunocompromised | * | * | * | |||
Liver disease | * | * | * | |||
HIV | * | * | * | |||
Barthel index ≤ 60 points | 1.90 (0.47–7.72) | 0.37 | 29.52 (4.51–193.16) | <0.001 | 32.27 (4.53–229.93) | 0.001 |
Length of stay ≥ 30 days | 3.27 (0.53–20.34) | 0.20 | * | 9.11 (1.80–46.02) | 0.008 | |
ICU admission | 5.23 (0.71–38.61) | 0.11 | * | * | ||
FINE-PSI on admission | 0.48 (0.03–8.22) | 0.61 | 1.45 (0.15–14.38) | 0.751 | 0.85 (0.51–14.01) | >0.99 |
CURB-65 on admission | 2.61 (1.06–6.41) | 0.036 | * | 0.62 (0.19–2.04) | 0.43 | |
ARDS on admission | 1.25 (0.52–3.03) | 0.62 | 1.13 (0.43–2.97) | 0.069 | * |
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Gómez-Uranga, A.; Guzmán-Martínez, J.; Esteve-Atiénzar, P.J.; Wikman-Jorgensen, P.; Núñez-Cruz, J.M.; Espinosa-del-Barrio, L.; Hernández-Isasi, I.; Pomares-Gómez, F.J.; Perelló-Camacho, E.; Fernández-García, N.; et al. Nutritional and Functional Impact of Acute SARS-CoV-2 Infection in Hospitalized Patients. J. Clin. Med. 2022, 11, 2424. https://doi.org/10.3390/jcm11092424
Gómez-Uranga A, Guzmán-Martínez J, Esteve-Atiénzar PJ, Wikman-Jorgensen P, Núñez-Cruz JM, Espinosa-del-Barrio L, Hernández-Isasi I, Pomares-Gómez FJ, Perelló-Camacho E, Fernández-García N, et al. Nutritional and Functional Impact of Acute SARS-CoV-2 Infection in Hospitalized Patients. Journal of Clinical Medicine. 2022; 11(9):2424. https://doi.org/10.3390/jcm11092424
Chicago/Turabian StyleGómez-Uranga, Angie, Javier Guzmán-Martínez, Pedro Jesús Esteve-Atiénzar, Philip Wikman-Jorgensen, Juan Manuel Núñez-Cruz, Leticia Espinosa-del-Barrio, Isidro Hernández-Isasi, Francisco J. Pomares-Gómez, Eva Perelló-Camacho, Nuria Fernández-García, and et al. 2022. "Nutritional and Functional Impact of Acute SARS-CoV-2 Infection in Hospitalized Patients" Journal of Clinical Medicine 11, no. 9: 2424. https://doi.org/10.3390/jcm11092424