Metabolic changes associated with COVID-19 in patients admitted to the intensive care unit of a university hospital
DOI:
https://doi.org/10.33448/rsd-v12i11.43774Keywords:
SARS-CoV-2; Pandemics; Public health; Unified health system; Severe acute respiratory syndrome.Abstract
Objective: To evaluate the relationship between laboratory parameters and the clinical outcome of patients with COVID-19 admitted to an intensive care unit of a university hospital. Methodology: Observational, retrospective, descriptive, comparative and quantitative study, ethically approved, carried out in the intensive care unit of a university hospital operating during the COVID-19 pandemic, carried out through an analysis of laboratory parameters present in the electronic medical records of infected patients by coronavirus, associating them with clinical outcomes and employing a statistical evaluation using the unpaired Student's T test to evaluate the mean and standard error of the mean of the parameters and application of the Receiver Operating Characteristic Curve (ROC) test to identify cutoff points more sensitive and specific parameters that could associate them with the outcome of death, considering significance p<0.05. Results and discussion: With 278 participants, 63% were men, based on the laboratory evaluation of parameters upon admission, glucose and urea obtained statistical significance; the average length of stay was longer among male individuals (16 ± 0.9), in addition, for the parameters for clinical outcome, it was observed that glucose, hemoglobin, leukocytes, creatinine and urea were significantly higher than the references , for the analysis of the ROC, urea levels were more sensitively and specifically associated with the outcome of death. Conclusion: There was a prevalence of men in the sample; laboratory parameters of glucose, hemoglobin, leukocytes, creatinine and urea were more associated with the worsening of COVID-19, having a direct relationship with the clinical outcome of death.
References
Aleebrahim-Dehkordi, E., Reyhanian, A., Saberianpour, S., & Hasanpour-Dehkordi, A. (2020). Acute kidney injury in COVID-19: a review on current knowledge. J Nephropathol, 9(4): e31.
Ayres, J. S. A metabolic handbook for the COVID-19 pandemic. (2020). Nat Metab, 2, 572–585.
Brandão, S. C. S., Godoi, E. T. A., Cordeiro, L. H. de O., Bezerra, C. S., Ramos, J. de O. X., Arruda, G. F. A. de., & Lins, E. M. (2020). Obesidade e risco de COVID-19: grave (1a ed.). Recife: Câmara Brasileira do Livro.
Bwire, G. M. (2020). Coronavirus: why men are more vulnerable to COVID-19 than women? SN Compr Clin Med, 2(7): 874–876.
Cao, Y., Li, Q., Chen, J., Guo, X., Miao, C., Yang, H., Chen, Z., Li, C., & Li, L. (2020). Hospital emergency management plan during the COVID‐19 epidemic. Academic Emergency Medicine, 27(4), 309–311.
Cevik, M., Kuppalli, K., Kindrachuk, J., & Peiris, M. (2020). Virology, transmission, and patogenesis of SARS-CoV-2. BMJ, 371: m3862.
Chen, F., Hao, L., Zhu, S., Yang, X., Shi, W., Zheng, K., Wang, T., & Chen, H. (2021). Potential adverse effects of dexamethasone therapy on COVID-19 patients: review and recommendations. Infectious diseases and therapy, 10(4), 1907–1931.
Clerkin, K. J., Fried, J. A., Raikhelkar, J., Sayer, G., Griffin, J. M., Masoumi, A., Jain, S. S., Burkhoff, D., Kumaraiah, D., Rabbani, L., Schwartz, A., & Uriel, N. (2020). COVID-19 and cardiovascular disease. Circulation, 141(20), 1648–1655.
Creswell, J. W., & Creswell, J. D. (2021). Projeto de pesquisa: métodos quantitativo, qualitativo e misto. (5a ed.). Penso.
Danielsen, A. C., Lee, K. M. N., Boulicault, M., Rushovich, T., Gompers, A., Tarrant, A., Reiches, M., Shattuck-Heidorn, H., Miratrix, L. W., & Richardson, S. S. (2022). Sex disparities in COVID-19 outcomes in the united states: quantifying and contextualizing variation. Social science & medicine, 294, 1–12.
Dowd, J. B., Andriano, L., Brazel, D. M., Rotondi, V., Block, P., Ding, X., Liu, Y., & Mills, M. C. (2020). Demographic science aids in understanding the spread and fatality rates of COVID-19. Proceedings of the National Academy of Sciences of the United States of America, 117(18), 9696–9698.
Estrela, C. (2018). Metodologia científica: ciência, ensino, pesquisa. (3a. ed.). Porto Alegre: Artes Médicas.
Freitas, A. R. R., Napimoga, M., & Donalisio, M. R.. (2020). Análise da gravidade da pandemia de COVID-19. Epidemiol. Serv. Saúde, 29(2), e2020119.
Garcia, P. J., Ferreira, C. J., & Patino, M. C. (2021). Análise ROC: uma aliada na pandemia. J Bras Pneumol, 47(2): e20210139.
Ghobadi, H., Kalan, M. E., Mohammad-Shahi, J., Taleb, Z. B., Kalan, A. E., Fazlzadeh, M. (2020). COVID-19 and acute kidney injury: a case report. J Renal Inj Prev, 9: e26.
Gomes, G. G. C., Bisco, N. C. B., Paulo, M. F., Fabrin, S. C. V., Fioco, E. M., Verri, E. D., & Regalo, S. C. H. (2020). Perfil epidemiológico da nova doença infecciosa do coronavírus - COVID-19 (SARS-CoV-2) no mundo: estudo descritivo, janeiro-junho de 2020. Brazilian Journal of Health Review, 3(4), 7993–8007.
Gordon, D. E., Jang, G. M., Bouhaddou, M., Xu, J., Obernier, K., White, K. M., O’Meara, M. J., Rezelj, V. V., Guo, J. Z., Swaney, D. L., Tummino, T. A., Hüttenhain, R., Kaake, R. M., Richards, A. L., Tutuncuoglu, B., Foussard, H., Batra, J., Haas, K., Modak, M., Kim, M., Haas, P., Polacco, B. J., Braberg, H., Fabius, J. M., Eckhardt, M., Soucheray, M., Bennett, M. J., Cakir, M., McGregor, M. J., Li, Q., Meyer, B., Roesch, F., Vallet, T., Kain, A. M., Miorin, L., Moreno, E., Naing, Z. Z. C., Zhou, Y., Peng, S., Shi, Y., Zhang, Z., Shen, W. Kirby, I. T., Melnyk, J. E., Chorba, J. S., Lou, K., Dai, S. A., Barrio-Hernandez, I., Memon, D., Hernandez-Armenta, C., Lyu, J., Mathy, C. J. P., Perica, T., Pilla, K. B., Ganesan, S. J., Saltzberg, D. J., Rakesh, R., Liu, X., Rosenthal, S. B., Calviello, L.,Venkataramanan, S., Liboy-Lugo, J., Lin, Y., Huang, X., Liu, Y., Wankowicz, S. A., Bohn, M., Safari, M., Ugur, F. S., Koh, C., Savar, N. S., Tran, Q. D., Shengjuler, D., Fletcher, S. J., O’Neal, M. C., Cai, Y., Chang, J. C. J., Broadhurst, D. J., Klippsten, S., Sharp, P. P., Wenzell, N. A., Kuzuoglu-Ozturk, D., Wang, H., Trenker, R., Young, J. M., Cavero, D. A., Hiatt, J., Roth, T. L., Rathore, U., Subramanian, A., Noack, J., Hubert, M., Stroud, R. M., Frankel, A. D., Rosenberg, O. S., Verba, K. A., Agard, D. A., Ott, M., Emerman, M., Jura, N., Zastrow, M. V., Verdin, E. Ashworth, A., Schwartz, O., D’Enfert, C., Mukherjee, S., Jacobson, M., Malik, H. S., Fujimori, D. G., Ideker, T., Craik, C. S., Floor, S. N., Fraser, J. S., Gross, J. D., Sali, A., Roth, B. L., Ruggero, D., Taunton, J., Kortemme, T., Beltrao, P., Vignuzzi, M., García-Sastre, A., Shokat, K. M., Shoichet, B. K., & Krogan, N. J. (2020). A SARS-CoV-2 protein interaction map reveals targets for drug repurposing. Nature, 583, 459–468.
Guo, W., Li, M., Dong, Y., Zhou, H., Zhang, Z., Tian, C., Qin, R., Wang, H., Shen, Y., Du, K., Zhao, L., Fan, H., Luo, S., & Hu, D. (2020). Diabetes is a risk factor for the progression and prognosis of COVID-19. Diabetes Metab Res Rev, 36(7), e3319.
Hoffmann, M., Kleine-Weber, H., Schroeder, S., Krüger, N., Herrler, T., Erichsen, S., Schiergens, T. S., Herrler, G., Wu, N. H., Nitsche, A., Müller, M. A., Drosten, C., & Pöhlmann, S. (2020). SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor. Cell, 181(2), 271–280. e8.
Li, B., Yang, J., Zhao, F., Zhi, L., Wang, X., Liu, L., Bi, Z., & Zhao, Y. (2020). Prevalence and impact of cardiovascular metabolic diseases on COVID-19 in China. Clinical research in cardiology, 109(5), 531–538.
Lim, S., Shin, S. M., Nam, G. E., Jung, C. H., & Koo, B. K. (2020). Proper management of people with obesity during the COVID-19 pandemic. Journal of obesity & metabolic syndrome, 29 (2), 84–98.
Mohamed, M. S., Moulin, T. C., & Schiöth, H. B. (2021). Sex differences in COVID-19: the role of androgens in disease severity and progression. Endocrine, 71(1), 3–8.
Moreira, A. G., Mota, N. R. da, Pereira, D. M., Santa Rosa, V. A. C., & Pires, C. A. A. (2022). Aspectos clínicos e epidemiológicos de pacientes com COVID-19 atendidos em um centro de referência na Amazônia. Conjecturas, 22(1), 585–597.
Nogueira, S. Á. R., Oliveira, S. C. S., Carvalho, A. F. M., Neves, J. M. C., Silva, L. S. V. D., Silva Junior, G. B. D., & Nobre, M. E. P. (2020). Renal changes and acute kidney injury in COVID-19: a systematic review. Revista da Associacao Medica Brasileira, 66Suppl 2(Suppl 2), 112–117.
Oliveira, J. M. de, Valle, I. M. R., Naue, C. R., Santos, I., Lima, R. S. de, & Guimarães, M. D. (2021). Clinical, epidemiological and laboratory profile of patients with severe acute respiratory syndromes (SARS) and COVID-19, admitted to a university hospital in the São Francisco sub-middle region. Research, Society and Development, 10(16), e412101623691.
Paula, M. F. de., Vannuchi, M. T. O., Rossaneis, M. A., Haddad, M. do C. F. L., Fernandes, K. B. P., & Pissinat, P. de S. C. (2021). Sobrevida e fatores associados à mortalidade de pacientes com instalações de longa permanência. Enferm Foco, 12(4): 682-7.
Remuzzi, A., & Remuzzi, G. (2020). COVID-19 and Italy: what next?. The Lancet, 395, 1225-1228.
Santos, P. S. A., Mateus, S. R. M., Silva, M. F. de O., Figueiredo, P. T. de S., & Campolino, R. G. (2021). Perfil epidemiológico da mortalidade de pacientes internados por COVID-19 na unidade de terapia intensiva de um hospital universitário. Brazilian Journal of Development, 7(5), 45981–45992.
Schiffrin, E. L., Flack, J. M., Ito, S., Muntner, P., & Webb, R. C. (2020). Hypertension and COVID-19. American journal of hypertension, 33 (5), 373–374.
Sharifi, M., Hasan, A., Nanakali, N. M. Q., Salihi, A., Qadir, F. A., Muhammad, H. A., Shekha, M. S., Aziz, F. M., Amen, K. M., Najafi, F., Yousefi-Manesh, H., & Falahati, M. (2020). Combined chemo-magnetic field-photothermal breast cancer therapy based on porous magnetite nanospheres. Sci Rep, 10, 5925.
Silva, E. B. (2023). Efeitos da variabilidade glicêmica em pacientes criticamente doentes com COVID-19: estudo observacional retrospectivo. (Dissertação de Mestrado). Universidade Federal do Rio Grande do Sul – UFRGS. Porto Alegre, RS, Brasil.
Silva, G. F. R. da, Callante, A. A., Nascimento, D. P. do, Araújo, I. P. de, Ribeiro, C. H. M. A. ., & Lo Prete, A. C. (2022). Comparison of the biochemical and hematological profiles of patients with COVID-19 in their different outcomes: hospital discharge and death. Research, Society and Development, 11(2), e25611225772.
Silva, L. C. F. da, & Benchaya, A. de A. (2021). Atuação do farmacêutico bioquímico no setor laboratorial em tempo de pandemia da COVID-19. Brazilian Journal of Development, 7(11), 106543–106560.
Sociedade Brasileira de Diabetes. (2023). Diretriz da Sociedade Brasileira de Diabetes – Update 2/2023. Porto Alegre.
Teich, V. D., Klajner, S., Almeida, F. A. S., Dantas, A. C. B., Laselva, C. R., Torritesi, M. G., Canero, T. R., Berwanger, O., Rizzo, L. V., Reis, E. P., & Cendoroglo Neto, M. (2020). Características epidemiológicas e clínicas dos pacientes com COVID-19 no Brasil. Einstein, 18, eAO6022.
Wambier, C. G., Goren, A., Vaño-Galván, S., Ramos, P. M., Ossimetha, A., Nau, G., Herrera, S., & McCoy, J. (2020). Androgen sensitivity gateway to COVID‐19 disease severity. Drug development research, 81(7), 771-776.
Werneck, G. L., & Carvalho, M. S. (2020). A pandemia de COVID-19 no Brasil: crônica de uma crise sanitária anunciada. Cadernos de Saúde Pública, 36, e00068820.
Wu, C. T., Lidsky, P. V., Xiao, Y., Lee, I. T., Cheng, R., Nakayama, T., Jiang, S., Demeter, J., Bevacqua, R. J., Chang, C. A., Whitener, R. L., Stalder, A. K., Zhu, B., Chen, H., Goltsev, Y., Tzankov, A., Nayak, J. V., Nolan, G. P., Matter, M. S., Andino, R., & Jackson, P. K. (2021). SARS-CoV-2 infects human pancreatic β cells and elicits β cell impairment. Cell metabolism, 33(8), 1565–1576. e5.
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