Associação entre composição corporal pela análise de impedância bioelétrica, função pulmonar e força inspiratória após alta hospitalar de pacientes com covid-19: estudo transversal randomizado

Abstract

Patients during the hospitalization period with Covid-19 evolve with severe weight loss and respiratory sequelae after clinical resolution of the disease. Studies evaluate body composition through Bioelectric Impedance (BEI) during hospitalization period, but there is a poor evidence of the evaluation of body composition in the post-hospital discharge period of Covid-19 and little evidence of the association of body composition variables with lung capacity and volumes. Objectives: - Primary: to measure the associations between body composition by The BEI and pulmonary function in patients with COVID-19 after hospital discharge; - Secondary: measuring associations between body composition by BEI and inspiratory muscle strength in patients with COVID-19 after hospital discharge; evaluate the mortality rate in patients with COVID-19 after hospital discharge. Methods: The design of this study is randomized cross-sectional, approved by the Ethics and Research Committee of UNIFAP, n.: 40801920.8.0000.003. Inclusion criteria: Adults in covid-19 post-infection with undetectable viral load with 48h post-hospital discharge. Exclusion criteria: Patients who underwent endotracheal intubation during hospitalization and the refuse to participate in the study. Outcomes evaluated: Forced vital capacity (FVC), expiratory flow peak (PEF), and forced expiratory volume in the 1st second (VEF1) through spirometry; maximum inspiratory muscle strength (Pimax) by means of manovacuometry and body composition through BEI. Statistics: D'Agostino and Pearson test was used for normality, simple linear regression to estimate associations between pulmonary function/Pimax and BEI. Statistical analyses were performed using the BioEstat 5.3 software. Results: 25 patients were included in this study, 52% were female with mean age of 49.1 years and 48% used noninvasive ventilation (NIV). The most frequent symptom was dyspnea (88%) with a mean 2.8 points on the respiratory distress scale ranging from 0 to 10. The level of association between FVC and BEI was higher with skeletal muscle mass with R2 (adjusted) = 0.2137 and p = 0.0112; between PEF and BEI was segmental AEC rate (trunk) with R2 = 0.2607 and p = 0.0054; between Pimax and BEI was in protein with R2 = 0.2349 and p = 0.0081. There was no death. Conclusion: Among the BEI variables investigated, skeletal muscle mass was the one with the highest association with FVC, trunk AEC rate was the one with the highest association with PEF, and protein was the one with the highest association with Pimax. No BEI variable was associated with VEF1.