Obesidade diagnosticada de forma visual em pacientes críticos com COVID-19: reflexo dos primeiros quinze meses da pandemia em um hospital de referência.

Abstract

The Coronavirus 2 pandemic in Brazil spread quickly across the country, changing the routine of the population, and causing thousands of deaths. To contain and combat this pandemic, many health professionals began to perform some activities remotely, leading to incomplete or deficient assessments, such as nutritional diagnosis at hospital admission. This study aimed to describe nutritional care, clinical and nutritional characteristic of patients with COVID-19 admitted to intensive care units (ICU), as well as to verify whether there is an association between visually diagnosed obesity and the outcome of these patients. Retrospective cohort study with critically ill patients with COVID-19 who received nutritional therapy for at least 48 hours. The exposure variable was the nutritional diagnosis obtained by visual examination at the time of admission to the ICU and the main outcome was the patient's evolution (discharge or death). Descriptive statistics were performed and Pearson Qui-square, Mann-Whitney and Student's t tests were used to compare the groups. P values <0.05 were considered significant. We studied 643 patients with a mean (standard deviation) of 63 (16) years, 58.2% of whom were male. The most frequent complaints were respiratory difficulty (79.8%) and fever (48.7%) and comorbidities, arterial hypertension (61.1%) and diabetes mellitus (41.4%). Only 300 (46.7%) of these patients had nutritional diagnosis and 145 (48.3%) had a diagnosis of obesity. When compared according to the presence or absence of obesity, it was found that the former was younger [59 (16) x 62 (17) years; p=0.046], had a shorter median length of stay [11 (6 – 18) x 13 (8 – 23) days; p=0.025], but the same percentage of death (89.0% x 87.7%; p=0.741). In conclusion, more than half of the patients did not have a nutritional diagnosis on admission and the obese patients died earlier.