Risco de sarcopenia e associação com desfechos clínicos em idosos hospitalizados com Covid-19: estudo de coorte multicêntrico no Nordeste brasileiro

Abstract

Physiological alterations of aging, such as immunosenescence, changes in the respiratory system and the burden of chronic non-communicable diseases, were related to the mortality of this population during the pandemic caused by the coronavirus. In addition, sarcopenia can also be related to unfavorable outcomes in this population. It is known that the presence of sarcopenia in hospitalized patients can contribute to a longer hospital stay, higher incidence of infections and mortality. Thus, the elderly population seems to be more susceptible to severe COVID-19 and its worst clinical outcomes. This dissertation is structured in three sections, being an introduction chapter, a literature review chapter and a chapter composed of a scientific article. The original article entitled “Association between risk of sarcopenia and clinical complications of covid-19 in hospitalized elderly people: results of a multicenter study”, aimed to verify whether the risk of sarcopenia assessed by the Sarcopenia Risk Screening questionnaire, in elderly people diagnosed with COVID19 is associated with demand for intensive care, mechanical ventilation and death. This is a multicenter cohort study carried out in all states in the northeast region of Brazil. Which included elderly people (> 65 years old) hospitalized with laboratoryconfirmed COVID-19. The study sample consisted of 264 elderly people hospitalized with COVID-19, with a mean age of 71.7 ± 8.28 years, most of whom were male (n=143; 53.8%). Hypertension, diabetes and cardiovascular disease were the main comorbidities identified in elderly patients, respectively, 75.4%, 45.5% and 28.4%. The risk of sarcopenia was present in most patients (n=148; 56.1%). The risk of sarcopenia in elderly hospitalized with COVID-19 increased the odds of ICU admission by more than 2 times (OR= 2.71 [1.57;4.68]), by about 5 times the odds of mechanical ventilation (OR=5.19 [2.75;9.78]) and more than 3 times the chances of death (OR=4.05 [2.05;7.98]). Thus, it is concluded that the pre-existing risk of sarcopenia was a predictor of unfavorable clinical outcomes in elderly people hospitalized with COVID-19.