Perfil nutricional y metabólico de pacientes con COVID-19 crítico en una unidad de cuidados intensivos

Abel Arroyo Sánchez

doi:10.35454/rncm.v6n2.460

Autores

Abel Arroyo Sánchez Antenor Orrego Private University https://orcid.org/0000-0001-6022-6894

DOI:

https://doi.org/10.35454/rncm.v6n2.460

Palavras-chave:

Distúrbios nutricionais, doenças metabólicas, síndrome do desconforto respiratório, COVID-19, unidade de terapia intensiva

Resumo

Introdução: a desnutrição está associada à gravidade e mortalidade da COVID-19.

Objetivo: descrever as características e resultados nutricionais e metabólicos de pacientes com COVID-19 crítico.

Métodos: estudo observacional e retrospectivo de pacientes com COVID-19 crítico tratados com ventilação mecânica (VM) em uma unidade de terapia intensiva no Peru. Foram incluídos pacientes com idade ≥18 anos, COVID-19 confirmado e critérios de síndrome do desconforto respiratório moderado ou grave, excluindo pacientes com COVID-19 anterior. A avaliação nutricional e metabólica incluiu: presença de obesidade e diabetes mellitus; escore NUTRIC modificado; valores de: glicose, albumina e bilirrubina total; se você necessitou de insulina; o uso de relaxante muscular e VM em pronação. As variáveis foram apresentadas em frequências absolutas e percentuais, medidas de tendência central com suas dispersões; as variáveis entre vivos e falecidos foram comparadas considerando p <0,05 como significativo.

Resultados: foram incluídos 35 pacientes, com média de idade de 49,1±12,9 anos, sexo masculino predominante (71,4%). Obesidade e diabetes mellitus foram as comorbidades mais frequentes (51,4% e 22,9%, respectivamente), 11,4% apresentavam alto risco nutricional. Os valores médios de glicemia foram 146,60±46,98 mg/dL, albumina 3,26±0,38 mg/dL e bilirrubina total 0,58±0,22 mg/ dL. A dexametasona foi utilizada em 91,4%, insulinoterapia em 20%, relaxante muscular em 94,3% e VM prona em 82,9%.

Conclusões: obesidade, diabetes mellitus, hiperglicemia e hipoalbuminemia foram as características mais relevantes em pacientes com COVID-19 crítico. O escore de risco nutricional e a frequência de pacientes de alto risco nutricional, pelo NUTRIC modificado, foram baixos.

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