Nutritional and Inflammatory Markers Associated with SARS-CoV-2 Infection in the Elderly
João Ismael Budelon Gonçalves, Fernanda Muller Lermen, Júlia Budelon Gonçalves, Gabriele Zanirati, Denise Cantarelli Machado, Helena Morsch Marques, Helena Scartassini Erwig, Bruno Maestri Becker, Fernanda Wagner, Marina Ottmann Boff, Murilo Gomes Rocha, Jaderson Costa Da Da Costa, Daniel Marinowic
International Journal of Molecular Sciences, doi:10.3390/ijms25147749
The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has posed unprecedented challenges to global health systems, particularly among vulnerable populations such as the elderly. Understanding the interplay between anthropometric markers, molecular profiles, and disease severity is crucial for effective clinical management and intervention strategies. We conducted a cohort study comprising 43 elderly COVID-19 patients admitted to São Lucas Hospital, PUCRS, Brazil. Anthropometric measurements, including calf circumference (CC) and abdominal circumference (AC), were assessed alongside molecular analyses of peripheral blood samples obtained within 48 h of hospital admission. Sociodemographic data were collected from electronic medical records for comprehensive analysis. Our findings revealed a possible relationship between overweight status, increased abdominal adiposity, and prolonged hospitalization duration, alongside heightened disease severity. We also found no significant correlations between BMI, vitamin D levels, and clinical outcomes. Elevated oxygen requirements were observed in both normal and overweight individuals, with the latter necessitating prolonged oxygen therapy. Molecular analyses revealed changes in the inflammatory profile regarding the outcome of the patients. Our study highlights the critical importance of both anthropometric and molecular markers in predicting disease severity and clinical outcomes in elderly individuals with COVID-19.
References
Ben-Eltriki, Hopefl, Wright, Deb, Association between Vitamin D Status and Risk of Developing Severe COVID-19 Infection: A Meta-Analysis of Observational Studies, J. Am. Nutr. Assoc,
doi:10.1080/07315724.2021.1951891
Berri, N'guyen, Callon, Lebreil, Glenet et al., The Reims COVID-19 Study Group. Early plasma interferon-β levels as a predictive marker of COVID-19 severe clinical events in adult patients, J. Med. Virol,
doi:10.1002/jmv.28361
Charoenngam, Holick, Immunologic Effects of Vitamin D on Human Health and Disease, Nutrients,
doi:10.3390/nu12072097
Chen, Wu, Guo, Cao, Huang et al., Clinical and immunological features of severe and moderate coronavirus disease 2019, J. Clin. Investig,
doi:10.1172/JCI137244
Cheung, Poon, Ng, Luk, Sia et al., Cytokine responses in severe acute respiratory syndrome coronavirus-infected macrophages in vitro: Possible relevance to pathogenesis, J. Virol,
doi:10.1128/JVI.79.12.7819-7826.2005
De Hipertensão, De Diabetes, Da Obesidade, I Brazilian guidelines on diagnosis and treatment of metabolic syndrome, Arq. Bras. Cardiol
De Siqueira, Almeida, Zica, Brum, Barceló et al., Impact of obesity on hospitalizations and mortality, due to COVID-19: A systematic review, Obes. Res. Clin. Pract,
doi:10.1016/j.orcp.2020.07.005
Gao, Ding, Dong, Zhang, Kursat Azkur et al., Risk factors for severe and critically ill COVID-19 patients: A review, Allergy,
doi:10.1111/all.14657
Gonçalves, Horie, Gonçalves, Bacchi, Bailer et al., Diretriz BRASPEN de terapia nutricional no envelhecimento, Braspen J
Grant, Lahore, Mcdonnell, Baggerly, French et al., Evidence that Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths, Nutrients,
doi:10.3390/nu12040988
Gérard, Mahmutovic, Malgras, Michot, Scheyer et al., Long-Term Evolution of Malnutrition and Loss of Muscle Strength after COVID-19: A Major and Neglected Component of Long COVID-19, Nutrients,
doi:10.3390/nu13113964
Haldane, De Foo, Abdalla, Jung, Tan et al., Health systems resilience in managing the COVID-19 pandemic: Lessons from 28 countries, Nat. Med,
doi:10.1038/s41591-021-01381-y
Jamalimoghadamsiahkali, Zarezade, Koolaji, Seyedalinaghi, Zendehdel et al., Safety and effectiveness of high-dose vitamin C in patients with COVID-19: A randomized open-label clinical trial, Eur. J. Med. Res,
doi:10.1186/s40001-021-00490-1
Li, Ding, Serum 25-Hydroxyvitamin D and the risk of mortality in adult patients with Sepsis: A meta-analysis, BMC Infect Dis,
doi:10.1186/s12879-020-4879-1
Mahallawi, Khabour, Zhang, Makhdoum, Suliman, MERS-CoV infection in humans is associated with a pro-inflammatory Th1 and Th17 cytokine profile, Cytokine,
doi:10.1016/j.cyto.2018.01.025
Martineau, Jolliffe, Hooper, Greenberg, Aloia et al., Vitamin D supplementation to prevent acute respiratory tract infections: Systematic review and metaanalysis of individual participant data, BMJ,
doi:10.1136/bmj.i6583
Miyah, Benjelloun, Lairini, Lahrichi, COVID-19 Impact on Public Health, Environment, Human Psychology, Global Socioeconomy, and Education. Sci. J,
doi:10.1155/2022/5578284
Morales, Montserrat-De La Paz, Leon, Rivero-Pino, Effects of Malnutrition on the Immune System and Infection and the Role of Nutritional Strategies Regarding Improvements in Children's Health Status: A Literature Review, Nutrients,
doi:10.3390/nu16010001
Moreno-Fernandez, Ochoa, Ojeda, Nogales, Carreras et al., Inflammation and oxidative stress, the links between obesity and COVID-19: A narrative review, J. Physiol. Biochem,
doi:10.1007/s13105-022-00887-4
Pereira, Dantas Damascena, Galvão Azevedo, De Almeida Oliveira, Da Mota Santana, Vitamin D deficiency aggravates COVID-19: Systematic review and meta-analysis, Crit. Rev. Food Sci. Nutr,
doi:10.1080/10408398.2020.1841090
Petrakis, Margină, Tsarouhas, Tekos, Stan et al., Obesity-A risk factor for increased COVID-19 prevalence, severity and lethality (Review), Mol. Med. Rep,
doi:10.3892/mmr.2020.11127
Radujkovic, Hippchen, Tiwari-Heckler, Dreher, Boxberger et al., Vitamin D Deficiency and Outcome of COVID-19 Patients, Nutrients,
doi:10.3390/nu12092757
Silverio, Gonçalves, Andrade, Seelaender, Coronavirus Disease 2019 (COVID-19) and Nutritional Status: The Missing Link?, Adv. Nutr,
doi:10.1093/advances/nmaa125
Tan, Ho, Kalimuddin, Cherng, Teh et al., Cohort study to evaluate the effect of vitamin D, magnesium, and vitamin B12 in combination on progression to severe outcomes in older patients with coronavirus (COVID-19), Nutrition,
doi:10.1016/j.nut.2020.111017
Thomas, Patel, Bittel, Wolski, Wang et al., Effect of High-Dose Zinc and Ascorbic Acid Supplementation vs Usual Care on Symptom Length and Reduction Among Ambulatory Patients With SARS-CoV-2 Infection: The COVID A to Z Randomized Clinical Trial, JAMA Netw Open,
doi:10.1001/jamanetworkopen.2021.0369
Wierdsma, Kruizenga, Konings, Krebbers, Jorissen et al., Poor nutritional status, risk of sarcopenia and nutrition related complaints are prevalent in COVID-19 patients during and after hospital admission, Clin Nutr ESPEN,
doi:10.1016/j.clnesp.2021.03.021
{ 'indexed': {'date-parts': [[2024, 7, 16]], 'date-time': '2024-07-16T00:21:48Z', 'timestamp': 1721089308345},
'reference-count': 0,
'publisher': 'MDPI AG',
'issue': '14',
'license': [ { 'start': { 'date-parts': [[2024, 7, 15]],
'date-time': '2024-07-15T00:00:00Z',
'timestamp': 1721001600000},
'content-version': 'vor',
'delay-in-days': 0,
'URL': 'https://creativecommons.org/licenses/by/4.0/'}],
'content-domain': {'domain': [], 'crossmark-restriction': False},
'abstract': '<jats:p>The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has posed unprecedented '
'challenges to global health systems, particularly among vulnerable populations such as the '
'elderly. Understanding the interplay between anthropometric markers, molecular profiles, and '
'disease severity is crucial for effective clinical management and intervention strategies. We '
'conducted a cohort study comprising 43 elderly COVID-19 patients admitted to São Lucas '
'Hospital, PUCRS, Brazil. Anthropometric measurements, including calf circumference (CC) and '
'abdominal circumference (AC), were assessed alongside molecular analyses of peripheral blood '
'samples obtained within 48 h of hospital admission. Sociodemographic data were collected from '
'electronic medical records for comprehensive analysis. Our findings revealed a possible '
'relationship between overweight status, increased abdominal adiposity, and prolonged '
'hospitalization duration, alongside heightened disease severity. We also found no significant '
'correlations between BMI, vitamin D levels, and clinical outcomes. Elevated oxygen '
'requirements were observed in both normal and overweight individuals, with the latter '
'necessitating prolonged oxygen therapy. Molecular analyses revealed changes in the '
'inflammatory profile regarding the outcome of the patients. Our study highlights the critical '
'importance of both anthropometric and molecular markers in predicting disease severity and '
'clinical outcomes in elderly individuals with COVID-19.</jats:p>',
'DOI': '10.3390/ijms25147749',
'type': 'journal-article',
'created': {'date-parts': [[2024, 7, 15]], 'date-time': '2024-07-15T22:17:32Z', 'timestamp': 1721081852000},
'page': '7749',
'source': 'Crossref',
'is-referenced-by-count': 0,
'title': 'Nutritional and Inflammatory Markers Associated with SARS-CoV-2 Infection in the Elderly',
'prefix': '10.3390',
'volume': '25',
'author': [ { 'given': 'João Ismael',
'family': 'Budelon Gonçalves',
'sequence': 'first',
'affiliation': [ { 'name': 'Brain Institute of Rio Grande do Sul (BraIns), Pontifical '
'Catholic University of Rio Grande do Sul (PUCRS), 90610-000, '
'Porto Alegre, RS, Brazil'}]},
{ 'given': 'Fernanda Muller',
'family': 'Lermen',
'sequence': 'additional',
'affiliation': [ { 'name': 'Brain Institute of Rio Grande do Sul (BraIns), Pontifical '
'Catholic University of Rio Grande do Sul (PUCRS), 90610-000, '
'Porto Alegre, RS, Brazil'},
{ 'name': 'Graduate Program in Biomedical Gerontology, School of Medicine, '
'Pontifical Catholic University of Rio Grande do Sul (PUCRS), '
'90619-900, Porto Alegre, RS, Brazil'}]},
{ 'given': 'Júlia Budelon',
'family': 'Gonçalves',
'sequence': 'additional',
'affiliation': [ { 'name': 'Brain Institute of Rio Grande do Sul (BraIns), Pontifical '
'Catholic University of Rio Grande do Sul (PUCRS), 90610-000, '
'Porto Alegre, RS, Brazil'}]},
{ 'given': 'Gabriele',
'family': 'Zanirati',
'sequence': 'additional',
'affiliation': [ { 'name': 'Brain Institute of Rio Grande do Sul (BraIns), Pontifical '
'Catholic University of Rio Grande do Sul (PUCRS), 90610-000, '
'Porto Alegre, RS, Brazil'}]},
{ 'ORCID': 'http://orcid.org/0000-0002-9371-5886',
'authenticated-orcid': False,
'given': 'Denise Cantarelli',
'family': 'Machado',
'sequence': 'additional',
'affiliation': [ { 'name': 'Brain Institute of Rio Grande do Sul (BraIns), Pontifical '
'Catholic University of Rio Grande do Sul (PUCRS), 90610-000, '
'Porto Alegre, RS, Brazil'},
{ 'name': 'Graduate Program in Biomedical Gerontology, School of Medicine, '
'Pontifical Catholic University of Rio Grande do Sul (PUCRS), '
'90619-900, Porto Alegre, RS, Brazil'}]},
{ 'given': 'Helena Morsch',
'family': 'Marques',
'sequence': 'additional',
'affiliation': [ { 'name': 'Brain Institute of Rio Grande do Sul (BraIns), Pontifical '
'Catholic University of Rio Grande do Sul (PUCRS), 90610-000, '
'Porto Alegre, RS, Brazil'}]},
{ 'given': 'Helena Scartassini',
'family': 'Erwig',
'sequence': 'additional',
'affiliation': [ { 'name': 'Brain Institute of Rio Grande do Sul (BraIns), Pontifical '
'Catholic University of Rio Grande do Sul (PUCRS), 90610-000, '
'Porto Alegre, RS, Brazil'}]},
{ 'ORCID': 'http://orcid.org/0009-0002-2338-5997',
'authenticated-orcid': False,
'given': 'Bruno Maestri',
'family': 'Becker',
'sequence': 'additional',
'affiliation': [ { 'name': 'Brain Institute of Rio Grande do Sul (BraIns), Pontifical '
'Catholic University of Rio Grande do Sul (PUCRS), 90610-000, '
'Porto Alegre, RS, Brazil'}]},
{ 'ORCID': 'http://orcid.org/0009-0007-9017-319X',
'authenticated-orcid': False,
'given': 'Fernanda',
'family': 'Wagner',
'sequence': 'additional',
'affiliation': [ { 'name': 'Brain Institute of Rio Grande do Sul (BraIns), Pontifical '
'Catholic University of Rio Grande do Sul (PUCRS), 90610-000, '
'Porto Alegre, RS, Brazil'}]},
{ 'given': 'Marina Ottmann',
'family': 'Boff',
'sequence': 'additional',
'affiliation': [ { 'name': 'Brain Institute of Rio Grande do Sul (BraIns), Pontifical '
'Catholic University of Rio Grande do Sul (PUCRS), 90610-000, '
'Porto Alegre, RS, Brazil'}]},
{ 'given': 'Murilo Gomes',
'family': 'Rocha',
'sequence': 'additional',
'affiliation': [ { 'name': 'Brain Institute of Rio Grande do Sul (BraIns), Pontifical '
'Catholic University of Rio Grande do Sul (PUCRS), 90610-000, '
'Porto Alegre, RS, Brazil'}]},
{ 'ORCID': 'http://orcid.org/0000-0001-6776-1515',
'authenticated-orcid': False,
'given': 'Jaderson Costa Da',
'family': 'Da Costa',
'sequence': 'additional',
'affiliation': [ { 'name': 'Brain Institute of Rio Grande do Sul (BraIns), Pontifical '
'Catholic University of Rio Grande do Sul (PUCRS), 90610-000, '
'Porto Alegre, RS, Brazil'}]},
{ 'given': 'Daniel',
'family': 'Marinowic',
'sequence': 'additional',
'affiliation': [ { 'name': 'Brain Institute of Rio Grande do Sul (BraIns), Pontifical '
'Catholic University of Rio Grande do Sul (PUCRS), 90610-000, '
'Porto Alegre, RS, Brazil'},
{ 'name': 'Graduate Program in Biomedical Gerontology, School of Medicine, '
'Pontifical Catholic University of Rio Grande do Sul (PUCRS), '
'90619-900, Porto Alegre, RS, Brazil'}]}],
'member': '1968',
'published-online': {'date-parts': [[2024, 7, 15]]},
'container-title': 'International Journal of Molecular Sciences',
'original-title': [],
'language': 'en',
'link': [ { 'URL': 'https://www.mdpi.com/1422-0067/25/14/7749/pdf',
'content-type': 'unspecified',
'content-version': 'vor',
'intended-application': 'similarity-checking'}],
'deposited': { 'date-parts': [[2024, 7, 15]],
'date-time': '2024-07-15T22:41:15Z',
'timestamp': 1721083275000},
'score': 1,
'resource': {'primary': {'URL': 'https://www.mdpi.com/1422-0067/25/14/7749'}},
'subtitle': [],
'short-title': [],
'issued': {'date-parts': [[2024, 7, 15]]},
'references-count': 0,
'journal-issue': {'issue': '14', 'published-online': {'date-parts': [[2024, 7]]}},
'alternative-id': ['ijms25147749'],
'URL': 'http://dx.doi.org/10.3390/ijms25147749',
'relation': {},
'ISSN': ['1422-0067'],
'subject': [],
'container-title-short': 'IJMS',
'published': {'date-parts': [[2024, 7, 15]]}}