Resposta inflamatória e risco de sarcopenia após infecção por COVID-19 em pacientes diabéticos renais crônicos com sobrepeso/obesidade, em hemodiálise

Abstract

INTRODUCTION: Diabetic nephropathy is the main pathology that leads patients to hemodialysis. At this time of pandemic by COVID-19, diabetic patients, especially those obese, are part of the risk group for more severe presentation of the disease. In this group of obese, diabetic and chronic kidney disease patients, the inflammatory process occurs in an exacerbated manner, rising inflammatory cytokines and eventually leading to fatal outcome. The sarcopenia present in this specific population emerges as a complicating factor of COVID-19, with repercussions still uncertain in the post-infection scenario. OBJECTIVE: To investigate the inflammatory response and risk of sarcopenia after COVID19 infection in participants with chronic kidney disease and overweight/obesity, diabetics, undergoing hemodialysis. MATERIALS AND METHODS: The sample consisted of 32 patients, both sexes, assisted by tree different nephrology services in Maceió, Alagoas. The participants were divided into two groups; A: Those with confirmed Infection by SARS-CoV-2 and B: Those without SARS-CoV-2 infection. Demographic and laboratory data were collected, as well as markers of inflammatory activity, IL-1β, IL-6, IL-8 and TNF-alpha. The risk of sarcopenia was evaluated by the application of SARC-F and by bioimpedance in addition to static muscle strength analysis. RESULTS: Groups A and B showed no differences in demographic variables, gender, age, dialysis time and BMI. Similarly, there was no significant difference between laboratory variables (hematocrit, hemoglobin, Ca, P. Urea, Creatinine, Albumin, Globulins and Ferritin), nor was there any difference between inflammatory markers. Data of body composition, SARC-F and static strength were also similar between both groups. The only statistically different variable between the groups was the PTH (p = 0.008), higher in group A. CONCLUSION: No significant difference was found among inflammatory markers or any analyzed variables between groups A and B, except for PTH, this isolated data is not sufficient for a definitive correlation.