Abstract
Background: Malnutrition status, body composition indicators, and bioelectrical impedance analysis (BIA) parameters have been associated with increased risk of death in several pathologies. The aim of this study was to describe the associations between phase angle (PhA) indicators obtained by BIA with length of hospital stay, days on mechanical ventilation, and 60-day mortality in critically ill patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
Methods: This is a prospective cohort of mechanically ventilated patients with coronavirus disease 2019 (COVID-19). We assessed nutrition risk and body composition with BIA within 48 h from intensive care unit admission. Logistic and linear regression models were used to analyze the association between variables and clinical outcomes. Survival analysis by PhA value was performed using Kaplan-Meier curves.
Results: Sixty-seven patients were included. PhA (odds ratio [OR], 0.36; P = .002), standardized PhA (SPA) (OR, 0.45; P = .001), and extracellular water/total body water ratio (OR, 3.25; P = .002) were significant predictors of 60-day mortality. PhA <3.85° in females and <5.25° in males showed good and fair discrimination, respectively, for mortality prediction. Using cutoff values, low PhA was associated with a significantly increased risk of 60-day mortality (hazard ratio, 3.08; 95% CI, 1.12-8.41; P = .02). No association was detected for SPA.
Conclusion: Low PhA values could be a predictor of 60-day mortality in critically ill patients with COVID-19. This biological marker could be incorporated as part of nutrition and mortality risk assessment in this population.
Keywords: COVID-19; bioelectrical impedance; mechanical ventilation; mortality; nutrition risk; nutrition status; phase angle.
【저자키워드】 COVID-19, Mortality, mechanical ventilation, bioelectrical impedance, nutrition risk, nutrition status, phase angle., 【초록키워드】 coronavirus disease, severe acute respiratory syndrome coronavirus 2, SARS-CoV-2, Coronavirus disease 2019, coronavirus, intensive care, mechanical ventilation, risk, severe acute respiratory syndrome Coronavirus, mechanically ventilated patients, clinical outcomes, Risk assessment, Critically ill, male, female, Patient, death, body composition, predictor, prospective cohort, Malnutrition, Pathologies, Admission, critically ill patients, association, intensive care unit admission, mortality risk, Analysis, survival analysis, Odds ratio, Hospital stay, water, Critically ill patient, acute respiratory syndrome, 95% CI, acute respiratory syndrome coronavirus, increased risk, hazard ratio, Kaplan-Meier curves, Cutoff, Bioelectrical Impedance Analysis, parameter, Linear regression model, variable, Extracellular, body water, significantly increased, was performed, were used, biological marker, mechanically ventilated patient, on mechanical ventilation, with COVID-19, 【제목키워드】 Critically ill patient, with COVID-19,