David Mathew Daniel, (2023) Lifestyle Determinants of Severity of SARS COVID 19 Infection. Masters thesis, Christian Medical College, Vellore.
Full text not available from this repository.Abstract
OBJECTIVES: Primary: 1. To corelate the clinical severity of patients with COVID-19 infection with lifestyle practice (nutrition, physical activity and stress questionnaires). LIFESTYLE VARIABLES: 1. Nutrition, a. 24 hours recall, b. Food frequency questionnaire, c. Nutrition Biomarkers – Serum vitamin D and Zinc. 2. Physical activity a. IPAQ questionnaire. 3. Stress. a. Perceived stress scale questionnaire. Secondary: To corelate the clinical severity of COVID-19 infection with age, gender, co-morbidities, addictions – nicotine, alcohol, others; nutritional parameters such as calories, macro-nutrients – carbohydrate (simple & complex), protein (plant Vs animal source) and fats (saturated Vs unsaturated), fibers, carotenoids and vitamins. METHODS: This was a hospital based prospective observational study using pre-validated questionnaires as well as laboratory assessment of biochemical samples. This study included patients 18 years of age and above who were admitted to the Level 1 COVID wards of a tertiary care hospital in South India, that is, the patients not requiring oxygen at admission. 175 patients had samples collected at day 1 of admission of which complete details including dietary, exercise and stress questionnaires were complete for 124 and demographic details and Vitamin D and Zinc levels were assessed for all 175 patients as per the sample size. This study was done as a prospective cohort study where patients were assessed with respect to their baseline nutrition assessed in terms of 24 hour food recall, food frequency questionnaire and laboratory assessment of nutritional biomarkers (Vitamin D and Zinc); physical activity assessed in terms of IPAQ questionnaires and psychological stress assessed in terms of the Perceived stress scale. Those patients who were unable to be assessed during hospital stay were telephonically contacted after discharge for completion of 24 hour food recall, physical activity and stress questionnaires. Demographic details, addictions and comorbidities were identified through hospital records of the patients. Patients were followed up through their course in the hospital to determine the progression in disease severity, assessed in terms of staying in level 1 wards(not requiring supplemental oxygen) to shift outs to level 2 wards( requiring oxygen to maintain saturation ). Lifestyle factors and disease were analysed to see if patient’s lifestyle factors played a role in the severity of manifestation of COVID 19 infection. Secondary end points include analysing a relation between age, comorbidities and addictions on disease severity of COVID 19. RESULTS: This was a hospital based prospective cohort study done in a tertiary care hospital in South India between July 2020 to July 2022 using pre-validated questionnaires and laboratory analysis of collected samples. 175 patients admitted to the level 1 COVID wards of this hospital were recruited to this study and followed up to assess the severity of their disease with respect to oxygen requirement. The patients were recruited during the first and the second COVID 19 waves where admissions in view of the same peaked in the hospital. This study showed that 27 out of 88 diabetics (30.68%) required oxygen while only 11 out of 87 (12.79%) required oxygen among the non-diabetic patients. It also showed that showed that 38 out of 150 (25.33%) of the patients with low vitamin D (< 30 ng/ml) required oxygen while none of the patients with normal Vitamin D (>/= 30 ng/ml) required oxygen during hospital stay. Animal proteins were found to have a protective role with the group that consumed more animal protein (mean of 12.74 ± 4.25 g) having less oxygen requirement that the group that consumed less animal protein (mean of 10.83 ± 3.75 g). The p value for the above was significant at 0.069. We found that the patients who consumed more carotenoids (mean intake of 7228.48± 626.83 mcg) had less requirement of oxygen than the group that consumed less carotenoids (mean intake of 6941.26± 681.86 mcg). In the multivariate analysis, we found that patients with diabetes mellitus were 2.97 more times at risk of developing severe SARS COVID 19 disease as compared to non-diabetic patients. (Unadjusted OR 2.97 (1.38, 6.39), p = 0.005). We also found that low Vitamin D levels (< 30 ng/ml) was associated with increased severity of disease with respect to oxygen requirement (adjusted OR 12.24 (0.69, 217.93), P = 0.088). Stress levels had a direct relationship with the severity of COVID in terms of oxygen requirement with the percentage of people requiring oxygen showing a graded increase from 14.29 to 16.67 to 25 percent in the low, moderate and high stress categories respectively, however the p value for this correlation was 0.782. Thus, diabetes mellitus and low vitamin D levels were found to predispose to more severe SARS COVID 19 disease while animal protein intake and carotenoids had a protective role.
| Item Type: | Thesis (Masters) |
|---|---|
| Additional Information: | 200120500006 |
| Uncontrolled Keywords: | Lifestyle Determinants, Severity, SARS COVID 19 Infection. |
| Subjects: | MEDICAL > General Medicine > MEDICAL > General Medicine |
| Depositing User: | Subramani R |
| Date Deposited: | 24 Jun 2021 12:55 |
| Last Modified: | 31 Jan 2024 03:19 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/17565 |
Actions (login required)
 |
View Item |
