ABSTRACT
Introduction: Coronavirus disease 2019 causes severe complications in subjects with risk factors: advanced age, diabetes, hypertension, obesity, among others. Patients with COVID-19 with severe disease have prolonged hospital stays, which causes dynapenia, muscle depletion, and sarcopenia, this induce a worse disease evolution and poor prognosis. Objective(s): Evaluate lung function in recovered COVID-19 with sarcopenia patients. Method(s): Cross-sectional study. 102 patients recovered from COVID-19 who required hospitalization wereincluded. Lung function was assessed using PIMAX, PEMAX, DLCO2 spirometry. Body composition was evaluated by electrical bioimpedance. Sarcopenia was diagnosed by appendicular muscle mass index (men: <7 kg / m, women <5.5 kg) and hand strength (men <27 kg, women <16 kg). Result(s): The population's average age was 44 years +/- 11.66, 58.88% were men, the subjects with sarcopenia had a higher prevalence of diabetes (26.32% vs 7.81%, p=0.039) hypertension (28.95% vs 12.5%, p = 0.039) compared with those without sarcopenia. Subjects with sarcopenia had worse respiratory parameters of FEV1(2.73lt vs 3.19lt, p=0.003), FEV1 post (2.70lt vs 3.24 lt, p=0.0005), FVC (3.19lt vs 3.9lt, p<0.001), FVCpost (3.22lt vs 3.90lt, p<0.001), FEV1/FVC (81.83 vs 84.17, p=0.040), DLCO (25.21 vs 31.83, p<0.001), and exercise tolerance (464.16 m vs 535.84 m, p<0.001) compared to the subjects withoout sarcopenia. Conclusion(s): COVID-19 recovered patients with a higher amount and sarcopenia developed a worse pulmonary and probably poor prognosis.
ABSTRACT
Introduction: SARS-COV-2 infection has generated high mortality. Symptomatology manifests in the respiratory, gastrointestinal tract and others, such as the hematopoietic system. Altered cell counts have been observed, such as lymphopenia standing out within hematological disorders. The cytokine storm together with the use of hepatotoxic drugs prolongs the inflammatory process and increases liver damage. Objective(s): To assess hematological and hepatic alterations in patients hospitalized for SARS-COV-2 who survived. Method(s): Cross-sectional study was conducted, including patients > 18 years, with positive test for SARS-COV-2. Serial measurements of hematological and hepatic parameters were carried out during the period of hospitalization. Those who did not require hospitalization were excluded. Result(s): Patients who died were older (62.71+/-13.52 vs 54.34+/-12.43, p=<0.001), required invasive mechanical ventilation (94.6% vs 86 78.9%, p=0.009) with peak pressure (29.27+/-5.26 vs 26.17+/-5.13, p=0.002) and showing decrease in Kirby index (128.39+/-49.14 vs 153.07+/-49.01, p=0.004) unlike those who survived. There was higher mortality in patients with lymphopenia (0.7 [0.45-1.15] vs 1 [0.7-1.5], p=<0.001), anemia (11.38+/-2.54 vs 12.38+/-2.48, p 0.018) and borderline ranges for platelets (265 vs 329, p=0.003) respectively. Regarding the liver profile, those patients who died had lower total proteins (5.38+/-0.81 vs 5.86+/-0.69, p <0.001), albumin (2.41 +/- 0.50 vs 2.83+/-0.49, p <0.001) and direct bilirubin (0.16 [0.1-0.25] vs 0.14 [0.1 - 0.23], p 0.006). Conclusion(s): Hematological and liver alterations are markers of higher mortality in patients with COVID-19 as an expression of multiorgan disease.