Clinical outcome and associated factors in patients with COVID-19 admitted to an Intensive Care Unit.
DOI:
https://doi.org/10.12873/424oliveiraKeywords:
COVID-19, Coronavírus, Terapia Nutricional, Cuidados Críticos, Evolução ClínicaAbstract
Introduction: The Corona Virus Disease (COVID-19) is a
highly transmissible infection and is associated with greater
susceptibility to the development of malnutrition. Thus, enteral nutritional therapy must be integrated into the global
treatment of this condition.
Objective: To analyze the clinical, nutritional and biochemical factors associated with the clinical outcome of patients
with COVID-19 admitted to an Intensive Care Unit (ICU).
Methods: This is a case series, carried out from March to
July 2020, with data recorded in the nutritional monitoring
records of patients hospitalized with COVID-19. The variables
analyzed were: demographic (age and sex); clinical (comorbidities, underlying disease and outcome), anthropometric,
biochemical and nutritional support.
Results: The sample consisted of 102 patients, 65.7% had
the severe acute respiratory syndrome, the main underlying
disease observed was heart disease (23.5%) and 69.3% of
patients were discharged from the ICU. Regarding nutritional
variables, approximately 50% of patients received enteral
feeding and 73.3% started early. Concerning biochemical
markers, patients who died had higher C-reactive protein
(CRP)/albumin ratios (p=0.024) and CRP concentrations
(p=0.012) when compared to those who progressed to discharge from the ICU. In addition, it is observed that the elderly (adjusted HR = 3.62; 95%CI 1.19 – 10.97) and early initiation of enteral nutritional therapy (adjusted HR = 10.62;
95%CI 2.41 – 46 .87) were factors related to ICU discharge.
Conclusion: Monitoring the inflammatory process using
different markers seems to be a good parameter for the
clinical evolution of these patients. In addition, the benefits
of early enteral nutrition therapy may be associated with
better clinical outcomes and reduced complications during
hospitalization.
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