Fat mass affects nutritional status of ICU COVID-19 patients
Fat mass affects nutritional status of ICU COVID-19 patients
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DOI：
10.1186/s12967-020-02464-z
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发表时间：
2020-08-03
影响因子：
7.4
通讯作者：
Gualtieri, Paola
中科院分区：
文献类型：
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作者：
De Lorenzo, Antonino;Tarsitano, Maria Grazia;Gualtieri, Paola
研究背景肥胖和脂肪变性与新冠肺炎重症肺炎相关。促炎细胞因子水平升高和免疫反应降低是这些患者的典型特征。特别是，脂肪组织是发挥关键作用的器官。因此，有必要评估脂肪质量，而不是简单的身体质量指数(BMI)，因为BMI让一部分肥胖人口无法识别。方法对22例新冠肺炎肺炎患者进行前瞻性观察研究，按Fm%和年龄(de Lorenzo分级)将患者分为瘦胖组(10例)和肥胖组(12例)。结果肥胖患者存在脂肪变性、肝功能受损、免疫反应减退和炎症加重。此外，他们还降低了ICU患者的预后营养指数(PNI)和营养生存指数。结论本研究首次评估了新冠肺炎患者的FM%。我们强调了肥胖的特征，可能预后很差，并对肥胖进行了严重的错误分类。不可忽略的是，体重指数正常的患者实际上可能有过量的脂肪组织，因此会产生不利的结果，如肥胖。是基于疾病分期的基本个性化患者营养。
BackgroundObesity and steatosis are associated with COVID-19 severe pneumonia. Elevated levels of pro-inflammatory cytokines and reduced immune response are typical of these patients. In particular, adipose tissue is the organ playing the crucial role. So, it is necessary to evaluate fat mass and not simpler body mass index (BMI), because BMI leaves a portion of the obese population unrecognized. The aim is to evaluate the relationship between Percentage of Fat Mass (FM%) and immune-inflammatory response, after 10 days in Intensive Care Unit (ICU).MethodsProspective observational study of 22 adult patients, affected by COVID-19 pneumonia and admitted to the ICU and classified in two sets: (10) lean and (12) obese, according to FM% and age (De Lorenzo classification). Patients were analyzed at admission in ICU and at 10th day.ResultsObese have steatosis, impaired hepatic function, compromise immune response and higher inflammation. In addition, they have a reduced prognostic nutritional index (PNI), nutritional survival index for ICU patients.ConclusionThis is the first study evaluating FM% in COVID-19 patient. We underlined obese characteristic with likely poorly prognosis and an important misclassification of obesity. A not negligible number of patients with normal BMI could actually have an excess of adipose tissue and therefore have an unfavorable outcome such as an obese. Is fundamental personalized patients nutrition basing on disease phases.