Low muscle strength and low phase angle predicts greater risk to mortality than severity scales (APACHE, SOFA, and CURB-65) in adults hospitalized for SARS-CoV-2 pneumonia
IntroductionThe acute physiology and chronic health evaluation (APACHE), sepsis-related organ failure assessment (SOFA), score for pneumonia severity (CURB-65) scales, a low phase angle (PA) and low muscle strength (MS) have demonstrated their prognostic risk for mortality in hospitalized adults. Ho...
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Frontiers Media S.A.
2022-12-01
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| Series: | Frontiers in Nutrition |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fnut.2022.965356/full |
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| author | Oscar Rosas-Carrasco Gisela Núñez-Fritsche Miriam Teresa López-Teros Pamela Acosta-Méndez Juan Carlos Cruz-Oñate Ada Yuseli Navarrete-Cendejas Gerardo Delgado-Moreno |
| author_facet | Oscar Rosas-Carrasco Gisela Núñez-Fritsche Miriam Teresa López-Teros Pamela Acosta-Méndez Juan Carlos Cruz-Oñate Ada Yuseli Navarrete-Cendejas Gerardo Delgado-Moreno |
| author_sort | Oscar Rosas-Carrasco |
| collection | DOAJ |
| description | IntroductionThe acute physiology and chronic health evaluation (APACHE), sepsis-related organ failure assessment (SOFA), score for pneumonia severity (CURB-65) scales, a low phase angle (PA) and low muscle strength (MS) have demonstrated their prognostic risk for mortality in hospitalized adults. However, no study has compared the prognostic risk between these scales and changes in body composition in a single study in adults with SARS-CoV-2 pneumonia. The great inflammation and complications that this disease presents promotes immobility and altered nutritional status, therefore a low PA and low MS could have a higher prognostic risk for mortality than the scales. The aim of the present study was to evaluate the prognostic risk for mortality of PA, MS, APACHE, SOFA, and CURB-65 in adults hospitalized with SARS-CoV-2 pneumonia.MethodologyThis was a longitudinal study that included n = 104 SARS-CoV-2-positive adults hospitalized at General Hospital Penjamo, Guanajuato, Mexico, the PA was assessed using bioelectrical impedance and MS was measured with manual dynamometry. The following disease severity scales were applied as well: CURB-65, APACHE, and SOFA. Other variables analyzed were: sex, age, CO-RADS index, fat mass index, body mass index (BMI), and appendicular muscle mass index. A descriptive analysis of the study variables and a comparison between the group that did not survive and survived were performed, as well as a Cox regression to assess the predictive risk to mortality.ResultsMean age was 62.79 ± 15.02 years (31–96). Comparative results showed a mean PA of 5.43 ± 1.53 in the group that survived vs. 4.81 ± 1.72 in the group that died, p = 0.030. The mean MS was 16.61 ± 10.39 kg vs. 9.33 ± 9.82 in the group that died, p = 0.001. The cut-off points for low PA was determined at 3.66° and ≤ 5.0 kg/force for low grip strength. In the Cox multiple regression, a low PA [heart rate (HR) = 2.571 0.726, 95% CI = 1.217–5.430] and a low MS (HR = 4.519, 95% CI = 1.992–10.252) were associated with mortality.ConclusionPhase angle and MS were higher risk predictors of mortality than APACHE, SOFA, and CURB-65 in patients hospitalized for COVID-19. It is important to include the assessment of these indicators in patients positive for SARS-CoV-2 and to be able to implement interventions to improve them. |
| first_indexed | 2024-04-11T05:36:15Z |
| format | Article |
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| language | English |
| last_indexed | 2024-04-11T05:36:15Z |
| publishDate | 2022-12-01 |
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| series | Frontiers in Nutrition |
| spelling | doaj.art-caf16d8278144fd389cbcc241b6a58162022-12-22T12:46:29ZengFrontiers Media S.A.Frontiers in Nutrition2296-861X2022-12-01910.3389/fnut.2022.965356965356Low muscle strength and low phase angle predicts greater risk to mortality than severity scales (APACHE, SOFA, and CURB-65) in adults hospitalized for SARS-CoV-2 pneumoniaOscar Rosas-Carrasco0Gisela Núñez-Fritsche1Miriam Teresa López-Teros2Pamela Acosta-Méndez3Juan Carlos Cruz-Oñate4Ada Yuseli Navarrete-Cendejas5Gerardo Delgado-Moreno6Department of Health, Universidad Iberoamericana, Mexico City, MexicoDepartment of Health, Universidad Iberoamericana, Mexico City, MexicoDepartment of Health, Universidad Iberoamericana, Mexico City, MexicoGeneral Hospital Penjamo, Guanajuato, MexicoGeneral Hospital Penjamo, Guanajuato, MexicoGeneral Hospital Penjamo, Guanajuato, MexicoGeneral Hospital Penjamo, Guanajuato, MexicoIntroductionThe acute physiology and chronic health evaluation (APACHE), sepsis-related organ failure assessment (SOFA), score for pneumonia severity (CURB-65) scales, a low phase angle (PA) and low muscle strength (MS) have demonstrated their prognostic risk for mortality in hospitalized adults. However, no study has compared the prognostic risk between these scales and changes in body composition in a single study in adults with SARS-CoV-2 pneumonia. The great inflammation and complications that this disease presents promotes immobility and altered nutritional status, therefore a low PA and low MS could have a higher prognostic risk for mortality than the scales. The aim of the present study was to evaluate the prognostic risk for mortality of PA, MS, APACHE, SOFA, and CURB-65 in adults hospitalized with SARS-CoV-2 pneumonia.MethodologyThis was a longitudinal study that included n = 104 SARS-CoV-2-positive adults hospitalized at General Hospital Penjamo, Guanajuato, Mexico, the PA was assessed using bioelectrical impedance and MS was measured with manual dynamometry. The following disease severity scales were applied as well: CURB-65, APACHE, and SOFA. Other variables analyzed were: sex, age, CO-RADS index, fat mass index, body mass index (BMI), and appendicular muscle mass index. A descriptive analysis of the study variables and a comparison between the group that did not survive and survived were performed, as well as a Cox regression to assess the predictive risk to mortality.ResultsMean age was 62.79 ± 15.02 years (31–96). Comparative results showed a mean PA of 5.43 ± 1.53 in the group that survived vs. 4.81 ± 1.72 in the group that died, p = 0.030. The mean MS was 16.61 ± 10.39 kg vs. 9.33 ± 9.82 in the group that died, p = 0.001. The cut-off points for low PA was determined at 3.66° and ≤ 5.0 kg/force for low grip strength. In the Cox multiple regression, a low PA [heart rate (HR) = 2.571 0.726, 95% CI = 1.217–5.430] and a low MS (HR = 4.519, 95% CI = 1.992–10.252) were associated with mortality.ConclusionPhase angle and MS were higher risk predictors of mortality than APACHE, SOFA, and CURB-65 in patients hospitalized for COVID-19. It is important to include the assessment of these indicators in patients positive for SARS-CoV-2 and to be able to implement interventions to improve them.https://www.frontiersin.org/articles/10.3389/fnut.2022.965356/fullphase anglesepsis-related organ failure assessment (SOFA)score for pneumonia severity (CURB-65)APACHE IIdynapenialow grip strength |
| spellingShingle | Oscar Rosas-Carrasco Gisela Núñez-Fritsche Miriam Teresa López-Teros Pamela Acosta-Méndez Juan Carlos Cruz-Oñate Ada Yuseli Navarrete-Cendejas Gerardo Delgado-Moreno Low muscle strength and low phase angle predicts greater risk to mortality than severity scales (APACHE, SOFA, and CURB-65) in adults hospitalized for SARS-CoV-2 pneumonia Frontiers in Nutrition phase angle sepsis-related organ failure assessment (SOFA) score for pneumonia severity (CURB-65) APACHE II dynapenia low grip strength |
| title | Low muscle strength and low phase angle predicts greater risk to mortality than severity scales (APACHE, SOFA, and CURB-65) in adults hospitalized for SARS-CoV-2 pneumonia |
| title_full | Low muscle strength and low phase angle predicts greater risk to mortality than severity scales (APACHE, SOFA, and CURB-65) in adults hospitalized for SARS-CoV-2 pneumonia |
| title_fullStr | Low muscle strength and low phase angle predicts greater risk to mortality than severity scales (APACHE, SOFA, and CURB-65) in adults hospitalized for SARS-CoV-2 pneumonia |
| title_full_unstemmed | Low muscle strength and low phase angle predicts greater risk to mortality than severity scales (APACHE, SOFA, and CURB-65) in adults hospitalized for SARS-CoV-2 pneumonia |
| title_short | Low muscle strength and low phase angle predicts greater risk to mortality than severity scales (APACHE, SOFA, and CURB-65) in adults hospitalized for SARS-CoV-2 pneumonia |
| title_sort | low muscle strength and low phase angle predicts greater risk to mortality than severity scales apache sofa and curb 65 in adults hospitalized for sars cov 2 pneumonia |
| topic | phase angle sepsis-related organ failure assessment (SOFA) score for pneumonia severity (CURB-65) APACHE II dynapenia low grip strength |
| url | https://www.frontiersin.org/articles/10.3389/fnut.2022.965356/full |
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