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1.
ssrn; 2023.
Preprint in English | PREPRINT-SSRN | ID: ppzbmed-10.2139.ssrn.4505277

ABSTRACT

Save the Children has warned that the world is facing the biggest global hunger crisis of the 21st century, as it is estimated that 5.7 million children under five are on the edge of starvation across the globe. (Save the Children 2021). The number of people affected by hunger globally rose to as many as 828 million in 2021, an increase of about 46 million since 2020 and 150 million since the outbreak of the COVID-19 pandemic. According to a United Nations report; the world is moving further away from its goal of ending hunger, food insecurity and malnutrition in all its forms by 2030 (FAO 2022). The threat is that the rate of the problem trends promptly, while the maximum rate of those who are affected being children. This article navigates on the situation through a descriptive analysis mode, in order to detect the basics of the situation of hunger globally, how hunger mostly distresses children, actions performed in battling the problematic state and calling every individual to participate to care for the suffering children.


Subject(s)
Malnutrition , COVID-19
2.
Cell Host Microbe ; 31(6): 851-855, 2023 Jun 14.
Article in English | MEDLINE | ID: covidwho-20234451

ABSTRACT

The coronavirus disease has swept the world, bringing scientists from multiple disciplines together to work on a focused cause. In this forum, we discuss different roles that microbiota, malnutrition, and immunity have on severity of coronavirus disease and the importance of studying them from a gut-systemic perspective using multi-omics approaches.


Subject(s)
COVID-19 , Gastrointestinal Microbiome , Malnutrition , Microbiota , Humans , Malnutrition/complications
3.
researchsquare; 2023.
Preprint in English | PREPRINT-RESEARCHSQUARE | ID: ppzbmed-10.21203.rs.3.rs-3084276.v1

ABSTRACT

Background and aims: Considering that nutritional status is one of the influential factors in the process of infection and recovery of patients with covid-19, this study was conducted to determine the nutritional status of covid-19 patients and its relationship with clinical outcomes.Methods This cross-sectional study included 155 patients diagnosed with covid-19 disease (aged 18 to 80 years) with PCR tests and Chest CT scans. The nutritional status of participants was assessed using the Mini Nutritional Assessment (MNA) questionnaire, Global Leadership Initiative on Malnutrition (GLIM) criteria, and the NUTRIC score tool.Results The analysis performed on the collected data from 81 men (52.3%) and 74 women (47.7%) showed that, based on the results of the MNA tool, 30 participants (19.4%) and based on the GLIM criteria, 42 participants (27.1%) were suffering from malnutrition. Also, systolic and diastolic blood pressure (GLIM SBP, DBP p-value = 0.038, 0.008 and MNA: SBP, DBP p-value = 0.04, 0.01) and blood oxygen saturation (MNA p-value = 0.01 and GLIM p-value = 0.012) was significantly associated with nutritional status of the participants. In addition, the results from the MNA and GLIM questionnaires showed a relative agreement with a value of 0.35 and p-value < 0.0001.Conclusion This study revealed that nutritional status is a critical factor that affects the clinical condition of covid-19 patients, which can affect the recovery process. In addition, the GLIM criterion is a practical and reliable tool to measure the nutritional status for diagnosis and prognosis of patients with Covid-19.


Subject(s)
Malnutrition , COVID-19
5.
BMC Pregnancy Childbirth ; 23(1): 366, 2023 May 19.
Article in English | MEDLINE | ID: covidwho-2323299

ABSTRACT

OBJECTIVE: The present study explored the relationship between maternal copper and zinc levels and preterm labor. DESIGN: The design of the present study was a case-control. Two groups were matched in terms of early-pregnancy body mass index (BMI), pregnancy and childbirth rating, education level, income, and employment status. Blood samples were taken from mothers after meeting the inclusion criteria when admitted to the maternity ward to check copper and zinc serum levels. Demographic and midwifery data were also collected using a questionnaire and patient records. The data were analyzed in SPSS26 using independent-samples T-test, chi-square, Fisher exact test, and regression analysis, and the p < 0.05 was considered statistically significant. SETTING: Bohloul Hospital in Gonabad, Iran. PARTICIPANTS: The subjects were 86 pregnant women visiting the hospital in two cases (preterm delivery) and control (term delivery) groups. RESULTS: The mean serum level of zinc in the case group (preterm delivery) (44.97 ± 13.06 µg/dl) was significantly lower than the control group (term) (52.63 ± 21.51 µg/dl), and the mean serum level of copper in the case group (149.82 ± 53.13 µg/dl) was significantly lower than the control group (183.97 ± 71.40 µg/dl). CONCLUSION: As the findings showed, copper and zinc serum levels in mothers with preterm delivery were significantly lower than mothers with term delivery, which shows the biological role of these elements in the pathogenesis of preterm delivery.


Subject(s)
Malnutrition , Obstetric Labor, Premature , Premature Birth , Infant, Newborn , Pregnancy , Female , Humans , Copper , Pregnant Women , Case-Control Studies , Obstetric Labor, Premature/epidemiology , Zinc , Parturition
6.
authorea preprints; 2023.
Preprint in English | PREPRINT-AUTHOREA PREPRINTS | ID: ppzbmed-10.22541.au.168534603.31449160.v1

ABSTRACT

Abstract Introduction Somalia faced significant COVID-19 exposure due to limited lab capacity for pathogen detection. The country’s healthcare system is strained by poverty, conflict, malnutrition, and outbreaks. Urgent action was required to enhance COVID-19 detection, save lives, and support nationwide vaccination and healthcare efforts. Methods With WHO and other partners, the Ministry of Health formed the COVID-19 incident management committee to address infections. Testing was initiated at the National Public Health Laboratory, and through training and investment, expanded to 11 additional sites. Genomic surveillance was established to monitor circulating genotypes. A comprehensive data management system was implemented to track infections from patient to reporting, ensuring effective monitoring and response. Results The enhanced laboratory capacity identified 26,439 confirmed SARS-CoV-2 cases, resulting in 1,361 deaths and a case fatality rate (CFR) of 5.15%. A total of 344,002 suspected samples were tested within the country. Genomic surveillance was initiated in March, 2022, and the first results were reported in Agoust, 2022. The e-SPAR tool assessment demonstrated a significant improvement in laboratory capacity, rising from 27% in 2018 to 56% in 2021, marking an overall improvement of 210%. Discussion Somalia has made notable strides in enhancing and expanding in-country molecular diagnostic capacity, enabling swift COVID-19 diagnosis. This capacity is being expanded to encompass other pathogens as part of an integrated disease surveillance program. The objective is to enhance response capabilities to emerging pathogen outbreaks. The implementation of a data management system has improved data monitoring and evaluation, serving as a crucial foundation for Labs


Subject(s)
Malnutrition , COVID-19 , Infections
8.
Lancet ; 401(10387): 1486-1487, 2023 05 06.
Article in English | MEDLINE | ID: covidwho-2319874
9.
Nutrients ; 15(9)2023 Apr 27.
Article in English | MEDLINE | ID: covidwho-2319027

ABSTRACT

BACKGROUND: Patients receiving extracorporeal membrane oxygenation (ECMO) support are at high risk for malnutrition. There are currently no general nutrition guidelines for coronavirus disease 2019 (COVID-19) patients during ECMO therapy. METHODS: We conducted a retrospective analysis of COVID-19 patients requiring venovenous ECMO support at a large tertiary hospital center. Nutrition goals were calculated using 25 kcal/kg body weight (BW)/day. Associations between nutrition support and outcome were evaluated using Kaplan-Meier and multivariable Cox regression analyses. RESULTS: Overall, 102 patients accounted for a total of 2344 nutrition support days during ECMO therapy. On 40.6% of these days, nutrition goals were met. Undernutrition was found in 40.8%. Mean daily calorie delivery was 73.7% of calculated requirements, mean daily protein delivery was 0.7 g/kg BW/d. Mean energy intake of ≥70% of calculated targets was associated with significantly lower ICU mortality independently of age, disease severity at ECMO start and body mass index (adjusted hazard ratio: 0.372, p = 0.007). CONCLUSIONS: Patients with a mean energy delivery of ≥70% of calculated targets during ECMO therapy had a better ICU survival compared to patients with unmet energy goals. These results indicate that adequate nutritional support needs to be a major priority in the treatment of COVID-19 patients requiring ECMO support.


Subject(s)
COVID-19 , Extracorporeal Membrane Oxygenation , Malnutrition , Humans , COVID-19/therapy , Retrospective Studies , Malnutrition/therapy , Intensive Care Units
10.
Nutrients ; 15(7)2023 Apr 01.
Article in English | MEDLINE | ID: covidwho-2317797

ABSTRACT

Advancements in cancer treatments over the past several decades have led to improved cancer survival in adolescents and young adults (AYAs, ages 15-39 years). However, AYA cancer survivors are at an increased risk for "late effects", including cardiovascular, pulmonary and bone diseases as well as fatigue, infertility and secondary cancers. The treatments for cancer may also alter taste, lead to nutritional deficiencies and increase financial burdens that, when taken together, may increase the risk of food and nutrition security in AYA cancer survivors. Furthermore, although AYAs are often merged together in cancer survivorship studies, adolescents and young adults have distinct developmental, psychosocial and pathophysiological differences that may modify their risk of nutritional challenges. In this narrative review and "Call to Action", rationale is provided for why there is a need to better understand nutritional challenges and food insecurity in AYA cancer survivors as a special population. Then, recommendations for next steps to advance knowledge and policy in this field are provided. In particular, integrating screening for food and nutrition insecurity and enhancing awareness of existing resources (e.g., the Supplemental Nutrition Assistance Program, SNAP) might help AYA cancer survivors combat nutritional deficiencies and reduce late effects while improving their overall survival and quality of life.


Subject(s)
Cancer Survivors , Malnutrition , Neoplasms , Humans , Adolescent , Young Adult , Adult , Cancer Survivors/psychology , Quality of Life/psychology , Neoplasms/epidemiology , Malnutrition/etiology , Food Insecurity
11.
Endocrinol Diabetes Nutr (Engl Ed) ; 70(4): 245-254, 2023 Apr.
Article in English | MEDLINE | ID: covidwho-2307842

ABSTRACT

INTRODUCTION: In 2020 the pandemic caused by SARS-COV-2 demanded an enormous number of healthcare resources in order to guarantee adequate treatment and support for those patients. This study aims to assess caloric and protein intake and evaluate its associations with relevant clinical outcomes in critically ill with coronavirus disease (COVID-19) patients. METHODS: A nationwide, multicentre prospective observational study including twelve Argentinian intensive care units (ICUs,) was conducted between March and October 2020. INCLUSION CRITERIA: Adult ICU patients>18 years admitted to the ICU with COVID-19 diagnosis and mechanical ventilation for at least 48h. Statistical analysis was carried out using IBM-SPSS© 24 programme. RESULTS: One hundred and eighty-five patients were included in the study. Those who died had lower protein intake (0.73g/kg/day (95% confidence interval (CI) 0.70-0.75 vs 0.97g/kg/day (CI 0.95-0.99), P<0.001), and lower caloric intake than those who survived (12.94kcal/kg/day (CI 12.48-13.39) vs 16.47kcal/kg/day (CI 16.09-16.8), P<0.001). A model was built, and logistic regression showed that factors associated with the probability of achieving caloric and protein intake, were the early start of nutritional support, modified NUTRIC score higher than five points, and undernutrition (Subjective Global Assessment B or C). The patients that underwent mechanical ventilation in a prone position present less caloric and protein intake, similar to those with APACHE II>18. CONCLUSIONS: Critically ill patients with COVID-19 associated respiratory failure requiring mechanical ventilation who died in ICU had less caloric and protein intake than those who survived. Early start on nutritional support and undernutrition increased the opportunity to achieve protein and caloric goals, whereas the severity of disease and mechanical ventilation in the prone position decreased the chance to reach caloric and protein targets.


Subject(s)
COVID-19 , Malnutrition , Adult , Humans , Critical Illness/therapy , Argentina , COVID-19 Testing , SARS-CoV-2 , Malnutrition/epidemiology , Malnutrition/etiology , Malnutrition/therapy
12.
Obes Surg ; 33(4): 1245-1252, 2023 04.
Article in English | MEDLINE | ID: covidwho-2302494

ABSTRACT

INTRODUCTION: Single anastomosis sleeve ileal bypass (SASI) is a combined bariatric metabolic technique, in which few studies have shown its outcomes efficacy. However, this technique has a high risk of malnutrition due to long biliopancreatic limb. Single anastomosis sleeve jejunal bypass (SASJ) has a shorter limb. Therefore, it seems to have a lower risk of nutrient deficiency. Furthermore, this technique is relatively new, and little is known about the efficacy and safety of SASJ. We aim to report our mid-term follow-up of SASJ from a high-volume center for bariatric metabolic surgery in the Middle East region. METHODS: For the current study, the 18-month follow-up data of 43 patients with severe obesity who underwent SASJ was collected. The primary outcome measures were demographic data, weight change variables according to ideal body mass index (BMI) of 25 kg/m2 at 6, 12, and 18 months, laboratory assessments, remission of obesity-associated medical problems, and other potential bariatric metabolic complications after the surgery. RESULTS: No patient was lost due to follow-up. After 18 months, patients lost 43.4 ± 11 kg of their weight and 68 ± 14% of their excess weight, and their BMI decreased from 44.9 ± 4.7 to 28.6 ± 3.8 kg/m2 (p < 0.001). The percentage of total weight loss till 18 months was 36.3%. The T2D remission rate at 18 months was 100%. Patients neither faced deficiency in significant markers for nutrition state nor represented major bariatric metabolic surgery complications. CONCLUSION: SASJ bypass achieved satisfactory weight loss and remissions in obesity-associated medical problems within 18 months after surgery without major complications and malnutrition.


Subject(s)
Gastric Bypass , Malnutrition , Obesity, Morbid , Humans , Obesity, Morbid/surgery , Follow-Up Studies , Obesity/surgery , Anastomosis, Surgical/methods , Gastrectomy/methods , Weight Loss , Malnutrition/surgery , Gastric Bypass/methods , Retrospective Studies , Treatment Outcome
13.
BMC Infect Dis ; 23(1): 234, 2023 Apr 17.
Article in English | MEDLINE | ID: covidwho-2301987

ABSTRACT

BACKGROUND: Children under age five years, particularly those living with HIV (CLHIV), are at risk for rapid progression of tuberculosis (TB). We aimed to describe TB clinical presentations, diagnostic pathways and treatment outcomes in CLHIV compared to children without HIV in Cameroon and Kenya. METHODS: This sub-analysis of a cluster-randomized trial evaluating the integration of pediatric TB services from May 2019 to March 2021 enrolled children age < 5 years with TB. We estimated the HIV infection rate with 95% confidence interval (CI). We compared TB clinical presentations, diagnostic pathways and treatment outcomes in CLHIV and children without HIV. Finally, we investigated whether HIV infection was associated with a shorter time to TB diagnosis (≤ 3 months from symptoms onset) after adjusting for covariates. Univariable and multivariable logistic regression analysis were performed with adjusted odds ratios (AORs) presented as measures of the association of covariates with HIV status and with shorter time to TB diagnosis. RESULTS: We enrolled 157 children with TB (mean age was 1.5 years) and 22/157 (14.0% [9.0-20.4%]) were co-infected with HIV. CLHIV were more likely to initially present with acute malnutrition (AOR 3.16 [1.14-8.71], p = 0.027). Most TB diagnoses (140/157, 89%) were made clinically with pulmonary TB being the most common presentation; however, there was weak evidence of more frequent bacteriologic confirmation of TB in CLHIV, 18% vs. 9% (p = 0.067), due to the contribution of lateral-flow urine lipoarabinomannan to the diagnosis. HIV positivity (AOR: 6.10 [1.32-28.17], p = 0.021) was independently associated with a shorter time to TB diagnosis as well as fatigue (AOR: 6.58 [2.28-18.96], p = 0.0005), and existence of a household contact diagnosed with TB (AOR: 5.60 [1.58-19.83], p = 0.0075), whereas older age (AOR: 0.35 [0.15-0.85], p = 0.020 for age 2-5 years), night sweats (AOR: 0.24 [0.10-0.60], p = 0.0022) and acute malnutrition (AOR: 0.36 [0.14-0.92], p = 0.034) were associated with a delayed diagnosis. The case fatality rate was 9% (2/22) in CLHIV and 4% (6/135) in children without HIV, p = 0.31. CONCLUSIONS: These results altogether advocate for better integration of TB services into all pediatric entry points with a special focus on nutrition services, and illustrate the importance of non-sputum-based TB diagnostics especially in CLHIV. TRIAL REGISTRATION: NCT03862261, first registration 05/03/2019.


Subject(s)
HIV Infections , Malnutrition , Tuberculosis, Pulmonary , Tuberculosis , Humans , Child , Child, Preschool , Infant , HIV Infections/complications , HIV Infections/diagnosis , HIV Infections/epidemiology , Tuberculosis/diagnosis , Tuberculosis/epidemiology , Tuberculosis/drug therapy , Tuberculosis, Pulmonary/diagnosis , Treatment Outcome , Malnutrition/complications
14.
Nutrients ; 15(7)2023 Apr 04.
Article in English | MEDLINE | ID: covidwho-2300895

ABSTRACT

Multisystem inflammatory syndrome is associated with COVID-19 and can result in reduced food intake, increased muscle catabolism, and electrolyte imbalance. Therefore COVID-19 patients are at high risk of being malnourished and of refeeding syndrome. The present study aimed to determine the prevalence and correlates of malnutrition and refeeding syndrome (RS) among COVID-19 patients in Hanoi, Vietnam. This prospective cohort study analyzed data from 1207 patients who were treated at the COVID-19 hospital of Hanoi Medical University (HMUH COVID-19) between September 2021 and March 2022. Nutritional status was evaluated by the Global Leadership Initiative on Malnutrition (GLIM) and laboratory markers. GLIM-defined malnutrition was found in 614 (50.9%) patients. Among those with malnutrition, 380 (31.5%) and 234 (19.4%) had moderate and severe malnutrition, respectively. The prevalence of risk of RS was 346 (28.7%). Those with severe and critical COVID symptoms are more likely to be at risk of RS compared to those with mild or moderate COVID, and having severe and critical COVID-19 infection increased the incidence of RS by 2.47 times, compared to mild and moderate disease. There was an association between levels of COVID-19, older ages, comorbidities, the inability of eating independently, hypoalbuminemia and hyponatremia with malnutrition. The proportion of COVID-19 patients who suffered from malnutrition was high. These results underscore the importance of early nutritional screening and assessment in COVID-19 patients, especially those with severe and critical infection.


Subject(s)
COVID-19 , Malnutrition , Refeeding Syndrome , Humans , Nutritional Status , Refeeding Syndrome/epidemiology , Vietnam/epidemiology , Nutrition Assessment , Prospective Studies , COVID-19/epidemiology , Malnutrition/epidemiology , Hospitals
15.
PLoS One ; 18(4): e0283596, 2023.
Article in English | MEDLINE | ID: covidwho-2300347

ABSTRACT

OBJECTIVES: The objectives of this study were 1) to investigate the prevalence and co-existence of frailty and malnutrition and 2) to identify factors related to frailty (including malnutrition) according to the level of frailty. METHODS: Data collection was conducted from July 11, 2021, to January 23, 2022, in 558 older adults residing in 16 long-term care facilities (LTCFs) in Korea. The FRAIL-NH and Mini-Nutritional Assessment short form were used to measure frailty and nutrition, respectively. The data analysis included descriptive statistics and a multivariate logistic regression. RESULTS: The mean age of the participants was 83.68 (± 7.39) years. Among 558 participants, 37 (6.6%), 274 (49.1%), and 247 (44.3%) were robust, prefrail, and frail, respectively. At the same time, 75.8% were categorized as having malnutrition status (malnourished: 18.1%; risk of malnutrition: 57.7%), and 40.9% had co-existing malnutrition and frailty. In the multivariate analysis, malnutrition was identified as the major frailty-related factor. Compared with a normal nutritional status, the incidence of frailty in the malnutrition group was 10.35 times (95% CI: 3.78-28.36) higher than the incidence of robustness and 4.80 times (95% CI: 2.69-8.59) higher than the incidence of prefrail. CONCLUSION: The prevalence of frailty and malnutrition, and their co-existence, among older adults residing in LTCFs was high. Malnutrition is a major factor that increases the incidence of frailty. Therefore, active interventions are needed to improve the nutritional status of this population.


Subject(s)
Frailty , Malnutrition , Humans , Aged , Aged, 80 and over , Frailty/complications , Frailty/epidemiology , Long-Term Care , Geriatric Assessment , Malnutrition/complications , Malnutrition/epidemiology , Nutritional Status , Nutrition Assessment , Republic of Korea/epidemiology , Frail Elderly
16.
Nutrients ; 15(8)2023 Apr 20.
Article in English | MEDLINE | ID: covidwho-2306658

ABSTRACT

Hospitalized patients with respiratory failure due to SARS-CoV-2 pneumonia are at increased risk of malnutrition and related mortality. The predictive value of the Mini-Nutritional Assessment short form (MNA-sf®), hand-grip strength (HGS), and bioelectrical impedance analysis (BIA) was determined with respect to in-hospital mortality or endotracheal intubation. The study included 101 patients admitted to a sub-intensive care unit from November 2021 to April 2022. The discriminative capacity of MNA-sf, HGS, and body composition parameters (skeletal mass index and phase angle) was assessed computing the area under the receiver operating characteristic curves (AUC). Analyses were stratified by age groups (<70/70+ years). The MNA-sf alone or in combination with HGS or BIA was not able to reliably predict our outcome. In younger participants, HGS showed a sensitivity of 0.87 and a specificity of 0.54 (AUC: 0.77). In older participants, phase angle (AUC: 0.72) was the best predictor and MNA-sf in combination with HGS had an AUC of 0.66. In our sample, MNA- sf alone, or in combination with HGS and BIA was not useful to predict our outcome in patients with COVID-19 pneumonia. Phase angle and HGS may be useful tools to predict worse outcomes in older and younger patients, respectively.


Subject(s)
COVID-19 , Malnutrition , Humans , Aged , Nutritional Status , SARS-CoV-2 , Hand Strength , Electric Impedance , COVID-19/diagnosis , Malnutrition/diagnosis , Nutrition Assessment , Geriatric Assessment/methods
17.
Clin Nutr ESPEN ; 55: 357-363, 2023 06.
Article in English | MEDLINE | ID: covidwho-2294910

ABSTRACT

BACKGROUND AND AIMS: This study aimed at evaluating associations between nutritional status and outcomes in patients with Covid-19 and to identify statistical models including nutritional parameters associated with in-hospital mortality and length of stay. METHODS: Data of 5707 adult patients hospitalized in the University Hospital of Lausanne between March 2020 and March 2021 were screened retrospectively 920 patients (35% female) with confirmed Covid-19 and complete data including nutritional risk score (NRS 2002), were included. This cohort was divided into three subgroups: NRS <3: no risk of malnutrition; NRS ≥3 to <5: moderate risk malnutrition; and NRS ≥5: severe risk of malnutrition. The primary outcome was the percentage of in-hospital deaths in the different NRS subgroups. The secondary outcomes were the length of hospital stay (LOS), the percentage of admissions to intensive care units (ICU), and the length of stay in the ICU (ILOS). Logistic regression was performed to identify risk factors associated with in-hospital mortality and hospital stay. Multivariate clinical-biological models were developed to study predictions of mortality and very long length of stay. RESULTS: The mean age of the cohort was 69.7 years. The death rate was 4 times higher in the subgroup with a NRS ≥ 5 (44%), and 3 times higher with a NRS ≥ 3 to <5 (33%) compared to the patients with a NRS<3 (10%) (p < 0.001). LOS was significantly higher in the NRS ≥ 5 and NRS ≥ 3 to <5 subgroups (26.0 days; CI [21; 30.9]; and 24.9; CI [22.5; 27.1] respectively) versus 13.4; CI [12; 14.8] for NRS<3 (p < 0.001). The mean ILOS was significantly higher in the NRS ≥ 5 (5.9 days; versus 2.8 for NRS ≥ 3 to <5, and 1.58 for NRS<3 (p < 0.001)). In logistic regression, NRS ≥ 3 was significantly associated with the risk of mortality (OR: 4.8; CI [3.3; 7.1]; p < 0.001) and very long in-hospital stay (>12 days) (OR: 2.5; CI [1.9; 3.3]; p < 0.001). Statistical models that included a NRS ≥ 3 and albumin revealed to be strong predictors for mortality and LOS (area under the curve 0.800 and 0.715). CONCLUSION: NRS was found to be an independent risk factor for in-hospital death and LOS in hospitalized Covid-19 patients. Patients with a NRS ≥ 5 had a significant increase in ILOS and mortality. Statistical models including NRS are strong predictors for an increased risk of death and LOS.


Subject(s)
COVID-19 , Malnutrition , Adult , Humans , Female , Aged , Male , Length of Stay , Nutrition Assessment , Hospital Mortality , Retrospective Studies , Risk Factors
18.
Rev Endocr Metab Disord ; 24(3): 563-583, 2023 06.
Article in English | MEDLINE | ID: covidwho-2292113

ABSTRACT

Bioelectrical impedance analysis (BIA) is the most widely used technique in body composition analysis. When we focus the use of phase sensitive BIA on its raw parameters Resistance (R), Reactance (Xc) and Phase Angle (PhA), we eliminate the bias of using predictive equations based on reference models. In particular PhA, have demonstrated their prognostic utility in multiple aspects of health and disease. In recent years, as a strong association between prognostic and diagnostic factors has been observed, scientific interest in the utility of PhA has increased. In the different fields of knowledge in biomedical research, there are different ways of assessing the impact of a scientific-technical aspect such as PhA. Single frequency with phase detection bioimpedance analysis (SF-BIA) using a 50 kHz single frequency device and tetrapolar wrist-ankle electrode placement is the most widely used bioimpedance approach for characterization of whole-body composition. However, the incorporation of vector representation of raw bioelectrical parameters and direct mathematical calculations without the need for regression equations for the analysis of body compartments has been one of the most important aspects for the development of research in this area. These results provide new evidence for the validity of phase-sensitive bioelectrical measurements as biomarkers of fluid and nutritional status. To enable the development of clinical research that provides consistent results, it is essential to establish appropriate standardization of PhA measurement techniques. Standardization of test protocols will facilitate the diagnosis and assessment of the risk associated with reduced PhA and the evaluation of changes in response to therapeutic interventions. In this paper, we describe and overview the value of PhA in biomedical research, technical and instrumental aspects of PhA research, analysis of Areas of clinical research (cancer patients, digestive and liver diseases, critical and surgical patients, Respiratory, infectious, and COVID-19, obesity and metabolic diseases, Heart and kidney failure, Malnutrition and sarcopenia), characterisation of the different research outcomes, Morphofunctional assessment in disease-related malnutrition and other metabolic disorders: validation of PhA with reference clinical practice techniques, strengths and limitations. Based on the detailed study of the measurement technique, some of the key issues to be considered in future PhA research. On the other hand, it is important to assess the clinical conditions and the phenotype of the patients, as well as to establish a disease-specific clinical profile. The appropriate selection of the most critical outcomes is another fundamental aspect of research.


Subject(s)
COVID-19 , Malnutrition , Humans , Body Composition/physiology , Nutritional Status , Biomarkers , Electric Impedance
19.
Rev. Nutr. (Online) ; 35: e220015, 2022. tab, graf
Article in English | WHO COVID, LILACS (Americas) | ID: covidwho-2282237

ABSTRACT

ABSTRACT Objective To evaluate the nutritional and functional status, swallowing disorders, and musculoskeletal manifestations of patients with Post-Covid-19 Syndrome, stratified by the Appendicular Skeletal Muscle Mass Index. Methods This is a cross-sectional study with patients diagnosed with Post-Covid-19 Syndrome after discharge from the intensive care unit of a university hospital. The evaluated outcomes were: nutritional status (Mini Nutritional Assessment, bioimpedance and anthropometry), swallowing disorders (Dysphagia Risk Evaluation Protocol), functional status (Post-Covid-19 Functional Status Scale), and musculoskeletal manifestations. According to the Appendicular Skeletal Muscle Mass Index, patients were stratified in terms of loss or not loss of muscle mass. Results Thirty-eight patients were included in the study, 20 stratified into the no loss of muscle mass group (17 females; 49.45±12.67 years) and 18 into the loss of muscle mass group (18 males; 61.89±12.49 years). Both groups were at risk of malnutrition (Mini Nutritional Assessment scores between 17-23.5 points; No Loss of Muscle Mass Group: 21.82±3.93; Loss of Muscle Mass Group: 23.33±3.41) and obesity (No Loss of Muscle Mass Group: 33.76±6.34; Loss of Muscle Mass Group: 30.23±3.66). The groups differed in terms of bioimpedance parameters (except fat mass) and age. However, there were no differences in swallowing alterations, functional status, and musculoskeletal manifestations. Conclusion Patients with Post-Covid-19 Syndrome, stratified according to the Appendicular Skeletal Muscle Mass Index, were at risk of malnutrition and obesity. The persistence of fatigue, weakness, myalgia and arthralgia at 6 months after hospital discharge is noteworthy. These findings emphasize the importance of comprehensive care for patients with Post-Covid-19 Syndrome.


RESUMO Objetivo Avaliar o estado nutricional, status funcional, alterações de deglutição e manifestações musculoesqueléticas de pacientes com Síndrome Pós-Covid-19, estratificados pelo Índice de Massa Muscular Esquelética Apendicular. Métodos Estudo transversal composto por pacientes diagnosticados com a Síndrome Pós-Covid-19 que estiveram internados na Unidade de Terapia Intensiva de um hospital universitário. Os desfechos avaliados foram: estado nutricional (Mini Avaliação Nutricional; bioimpedância e antropometria), alterações de deglutição (Protocolo Fonoaudiológico de Avaliação do Risco de Disfagia), status funcional (Post-Covid-19 Functional Status Scale) e manifestações musculoesqueléticas. Os pacientes foram classificados, quanto à perda de massa muscular conforme o Índice de Massa Muscular Esquelética Apendicular, em grupo sem e com perda de massa muscular. Resultados Foram inseridos no estudo 38 pacientes, 20 no grupo sem perda de massa muscular (17 deles do sexo feminino; 49,45±12,67 anos) e 18 no grupo com perda de massa muscular (todos do sexo masculino; 61,89±12,49 anos). Os pacientes de ambos os grupos apresentaram risco de desnutrição (escores Mini Avaliação Nutricional entre 17-23.5 pontos; Grupo Sem Perda de Massa Muscular: 21,82±3,93; Grupo Com Perda de Massa Muscular: 23,33±3,41) e obesidade (Grupo Sem Perda de Massa Muscular: 33,76±6,34; Grupo Com Perda de Massa Muscular: 30,23±3,66). Os grupos diferiram quanto aos parâmetros da bioimpedância (exceto massa gorda) e idade. Entretanto, não foram observadas diferenças na deglutição, status funcional e manifestações musculoesqueléticas. Conclusão Os pacientes com Síndrome Pós-Covid-19, estratificados conforme o Índice de Massa Muscular Esquelética Apendicular, apresentaram risco de desnutrição e obesidade. Destaca-se a persistência de fadiga, fraqueza, mialgia e artralgia após seis meses da alta hospitalar. Esses achados ressaltam a importância do cuidado integral ao paciente com a Síndrome Pós-Covid-19.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Young Adult , Muscle, Skeletal/physiopathology , Malnutrition/physiopathology , COVID-19/complications , Obesity/physiopathology , Deglutition Disorders/physiopathology , Cross-Sectional Studies/methods , Functional Status , Hospitals, University , Intensive Care Units
20.
Trends Pharmacol Sci ; 43(12): 994-997, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-2263250

ABSTRACT

Together with climate change, both the geopolitical events in Ukraine and social disruptions in supply chains from the COVID-19 pandemic could produce global food shortages or even mass starvation events. Promising new interventions include vaccines to prevent infectious causes of malnutrition or infections disproportionately causing death among the malnourished.


Subject(s)
COVID-19 , Malnutrition , Vaccines , Humans , Pandemics/prevention & control , COVID-19/prevention & control , Malnutrition/prevention & control , Malnutrition/epidemiology , Malnutrition/etiology
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