RESUMO
OBJECTIVE: To assess the effect of SARS-CoV-2 infection on the health conditions and functional capacity of older adults living in long-term care units in Maceió City - Alagoas State. METHODS: A prospective cohort was conducted with institutionalized older adults of both sexes. Older adults were assessed for clinical conditions (diagnosis of chronic diseases and biochemical tests), functional capacity, and nutritional status. All assessments were repeated on two occasions, maintaining a 6-month interval between them. RESULTS: The sample was composed of 289 older adults. Of the total, 98 (33.9%) were positive for COVID-19 and eight died (2.8%). Men were more likely to have COVID-19 (OR = 3.50; p < 0.01). It was observed that the disease contributed to increasing the frequency of dependent older adults after six months (OR = 1.38; p-interaction < 0.01). It was also observed that after six months of positive diagnosis for COVID-19, there was greater weight loss (p < 0.01), reduced BMI (p < 0.01), increased mean SBP (p = 0.04), and DBP (p = 0.03). CONCLUSION: Effects of COVID-19 in institutionalized older adults go beyond acute complications and compromise blood pressure control, functional capacity, and favor weight loss.
Assuntos
COVID-19 , Masculino , Feminino , Humanos , Idoso , SARS-CoV-2 , Estudos Prospectivos , Estado Nutricional , Redução de PesoRESUMO
Resumo Objetivo Verificar se o risco de sarcopenia em pessoas idosas diagnosticadas com covid-19 associa-se com demanda por cuidados intensivos, ventilação mecânica e óbito. Método Estudo multicêntrico do tipo coorte, que incluiu pessoas idosas (≥65 anos) com diagnóstico laboratorial confirmado de covid-19. Foram coletados dados relacionados às características sociodemográficas, clínicas e nutricionais. O risco de sarcopenia foi avaliado pelo questionário Sarcopenia Risk Screening. As variáveis de desfecho foram: necessidade de terapia intensiva, ventilação mecânica e óbito. Foram realizadas regressões logísticas para verificar a associação dos desfechos clínicos e o risco de sarcopenia, com as seguintes variáveis de ajuste: idade, sexo, renda familiar, atividade física, hipertensão, diabetes, doença cardiovascular doença pulmonar obstrutiva crônica e índice de massa corporal. Resultados Foram incluídas no estudo 264 pessoas idosas com covid-19, com média de idade de 71,7 (±8,2) anos. Cento e quarenta e oito pessoas idosas (56,1%) tinham risco de sarcopenia. Hipertensão, diabetes e doença cardiovascular foram as principais comorbidades identificadas nas pessoas idosas, respectivamente, 75,4%, 45,5% e 28,4%. O risco de sarcopenia nas pessoas idosas hospitalizadas com covid-19 aumentou em mais de 2 vezes as chances de internamento na UTI (OR: 2,71 [1,57;4,68], p<0,001), em cerca de 5 vezes as chances de ventilação mecânica (OR: 5,19 [2,75;9,78], p<0,001) e em mais de 3 vezes as chances de óbito (OR: 4,05 [2,05;7,98], p<0,001). Conclusão Em pessoas idosas hospitalizadas com covid-19, a pré-existência do risco de sarcopenia foi preditor de desfechos clínicos desfavoráveis.
Abstract Objective To investigate whether the risk of sarcopenia in older adults diagnosed with covid-19 is associated with the need for intensive care, mechanical ventilation, and mortality. Method A multicenter cohort study was conducted, including older adults (≥65 years) with laboratory-confirmed covid-19 diagnosis. Data related to sociodemographic, clinical, and nutritional characteristics were collected. The risk of sarcopenia was assessed using the Sarcopenia Risk Screening questionnaire. Outcome variables included the need for intensive care, mechanical ventilation, and mortality. Logistic regressions were performed to assess the association between clinical outcomes and the risk of sarcopenia, adjusting for the following variables: age, gender, family income, physical activity, hypertension, diabetes, cardiovascular disease, chronic obstructive pulmonary disease, and body mass index. Results The study included 264 older adults with covid-19, with an average age of 71.7 (±8.2) years. One hundred and forty-eight older adults (56.1%) were at risk of sarcopenia. Hypertension, diabetes, and cardiovascular disease were the most common comorbidities identified in older adults, at 75.4%, 45.5%, and 28.4%, respectively. The presence of sarcopenia risk in hospitalized older adults with covid-19 increased the odds of ICU admission by more than 2-fold (OR: 2.71 [1.57; 4.68], p<0.001), nearly 5-fold for mechanical ventilation (OR: 5.19 [2.75; 9.78], p<0.001), and over 3-fold for mortality (OR: 4.05 [2.05; 7.98], p<0.001). Conclusion In hospitalized older adults with covid-19, pre-existing risk of sarcopenia was a predictor of unfavorable clinical outcomes.
RESUMO
ABSTRACT Objective: To assess the effect of SARS-CoV-2 infection on the health conditions and functional capacity of older adults living in long-term care units in Maceió City - Alagoas State. Methods: A prospective cohort was conducted with institutionalized older adults of both sexes. Older adults were assessed for clinical conditions (diagnosis of chronic diseases and biochemical tests), functional capacity, and nutritional status. All assessments were repeated on two occasions, maintaining a 6-month interval between them. Results: The sample was composed of 289 older adults. Of the total, 98 (33.9%) were positive for COVID-19 and eight died (2.8%). Men were more likely to have COVID-19 (OR = 3.50; p < 0.01). It was observed that the disease contributed to increasing the frequency of dependent older adults after six months (OR = 1.38; p-interaction < 0.01). It was also observed that after six months of positive diagnosis for COVID-19, there was greater weight loss (p < 0.01), reduced BMI (p < 0.01), increased mean SBP (p = 0.04), and DBP (p = 0.03). Conclusion: Effects of COVID-19 in institutionalized older adults go beyond acute complications and compromise blood pressure control, functional capacity, and favor weight loss.
RESUMEN Objetivo: Evaluar el efecto de la infección por SARS-CoV-2 sobre las condiciones de salud y la capacidad funcional de personas mayores que viven en unidades de cuidados a largo plazo en la ciudad de Maceió - Alagoas. Métodos: Se realizó una cohorte prospectiva con ancianos institucionalizados de ambos sexos. Los ancianos fueron evaluados en cuanto a condiciones clínicas (diagnóstico de enfermedades crónicas y pruebas bioquímicas), capacidad funcional y estado nutricional. Todas las evaluaciones se repitieron en dos ocasiones, manteniendo un intervalo de 6 meses entre ellas. Resultados: La muestra estuvo compuesta por 289 personas mayores. Del total, 98 (33,9%) dieron positivo a la COVID-19 y ocho fallecieron (2,8%). Los hombres tenían más probabilidades de tener COVID-19 (OR = 3,50; p <0,01). Se observó que la enfermedad contribuyó al aumento de la frecuencia de ancianos dependientes después de seis meses (OR = 1,38; interacción p < 0,01). Se observó que la enfermedad contribuyó al aumento de la frecuencia de ancianos dependientes después de seis meses (OR = 1,38; interacción p < 0,01). También se observó que después de seis meses de diagnóstico positivo para COVID-19, hubo mayor pérdida de peso (p < 0,01), reducción del IMC (p < 0,01), aumento de la PAS media (p = 0,04) y la PAD (p = 0,03). Conclusión: Los efectos del COVID-19 en ancianos institucionalizados van más allá de las complicaciones agudas y comprometen el control de la presión arterial, la capacidad funcional, favoreciendo la pérdida de peso.
RESUMO Objetivo: Avaliar o efeito da infecção pelo SARS-CoV-2 nas condições de saúde e capacidade funcional de idosos residentes em unidades de longa permanência na cidade de Maceió - Alagoas. Métodos: Foi realizada uma coorte prospectiva com idosos institucionalizados de ambos os sexos. Os idosos foram avaliados quanto às condições clínicas (diagnóstico de doenças crônicas e exames bioquímicos), capacidade funcional e estado nutricional. Todas as avaliações foram repetidas em duas ocasiões, mantendo um intervalo de 6 meses entre elas. Resultados: A amostra foi composta por 289 idosos. Do total, 98 (33,9%) deram positivo para COVID-19 e oito faleceram (2,8%). Os homens tiveram maior probabilidade de ter COVID-19 (OR = 3,50; p < 0,01). Observou-se que a doença contribuiu para o aumento da frequência de idosos dependentes após seis meses (OR = 1,38; interação de p <0,01). Observou-se também que após seis meses de diagnóstico positivo para COVID-19, houve maior perda de peso (p < 0,01), redução do IMC (p < 0,01), aumento da média da PAS (p = 0,04) e da PAD (p = 0,03). Conclusão: Os efeitos da COVID-19 em idosos institucionalizados vão além das complicações agudas e comprometem o controle da pressão arterial, a capacidade funcional, favorecendo a perda de peso.