Most hospitalized COVID-19 pneumonia patients are older adults and/or have nutrition-related issues. Many are bedridden in intensive care units (ICU), a well-documented cause of malnutrition, muscle wasting, and functional impairment. Objectives: To assess the effectiveness of an intensive rehabilitation program over the nutritional/functional status of patients recovering from COVID-19 pneumonia. Post-COVID-19 pneumonia patients underwent a 30-day intensive interdisciplinary rehabilitation program including a personalized nutritional intervention designed to achieve a minimum intake of 30 kcal/kg/day and 1 g protein/kg/day. The nutritional and functional status was assessed in each patient at three different moments. Each assessment included Body Mass Index (BMI), Mid Upper Arm Circumference (MUAC), Mid Arm Muscle Circumference (MAMC), Tricipital Skinfold (TSF), Hand Grip Strength (HGS), and Mini Nutritional Assessment (MNA^®). The study included 118 patients, with ages in the range 41–90 years old. BMI increased linearly over time (0.642 units, F-test = 26.458, p < 0.001). MUAC (0.322 units, F-test = 0.515, p = 0.474) and MAMC status (F-test = 1.089, p = 0.299) improved slightly, whereas TSF decreased (F-test = 1.885, p = 0.172), but all these arm anthropometry trends did not show significant variations, while HGS (4.131 units, F-test = 82.540, p < 0.001) and MNA^® (1.483 units, F-test = 217.726, p < 0.001) reported a meaningful improvement. Post-COVID-19 pneumonia patients presented malnutrition and functional impairment. An interdisciplinary rehabilitation program, including personalized nutritional intervention, was effective for post-hospital COVID-19 pneumonia nutritional/functional rehabilitation.

Introdução: O delirium é frequente nos doentes idosos internados. Define-se como uma alteração aguda e flutuante ao nível da cognição, atenção e consciência, geralmente reversível e de etiologia multifactorial, com aumento da morbimortalidade e dos custos, mas que permanece sub-diagnosticada. Neste sentido, avaliou-se a ocorrência de delirium numa enfermaria de Medicina Interna, os principais factores de risco e o impacto no episódio de internamento e após 3 meses. Materiais e Métodos: estudo prospectivo observacional de 3 meses num serviço de um hospital terciário, com aplicação da escala de sedação e agitação de Richmond adaptada e do Método de Avaliação da Confusão para o rastreio e diagnóstico de delirium, confirmadas pelos critérios do Diagnostic and Statistical Manual of Mental Disorders, 5ª edição. Avaliaram-se os principais factores de risco, segundo as guidelines, e o impacto no internamento e sobrevida aos 3 meses. Resultados/Discussão: Numa amostra de 297 doentes, a ocorrência de delirium foi de 26%, na sua maioria à admissão (73%) e na forma hiperactiva (50%). Estes doentes eram mais idosos, com mais comorbilidades, nomeadamente demência, e menos autonomia. Identificou-se a contenção física, a limitação da autonomia e as alterações do potássio como factores independentes para a ocorrência de delirium. Este associou-se a maior mortalidade no internamento e aos 3 meses, com maior sobrecarga dos profissionais de saúde. A aplicação das escalas permitiu um maior reconhecimento desta patologia (12% para 26%), nomeadamente as formas hipoactivas. Conclusão: O delirium foi frequente e com elevado impacto nos doentes e profissionais de saúde.

Background/Objectives: Malnutrition and muscle weakness are prevalent after stroke. We assessed nutritional status, evaluated low handgrip strength (HGS) on the non-affected side, and compared Strength, Assistance with walking, Rise from a chair, Climb stairs, and Falls (SARC-F) and canonical SARC-F combined with calf circumference (SARC-CalF) classifications during subacute institutional rehabilitation. Methods: This cross-sectional study included 86 subacute stroke survivors across four long-term care units (mean age 72.5 ± 11.4 years; 1.0–4.0 months post-stroke). Nutritional assessment used the Mini Nutritional Assessment Full Form (MNA-FF) and Global Leadership Initiative on Malnutrition (GLIM) criteria. Canonical SARC-CalF incorporated sex-specific calf circumference cutoffs (≤34 cm in men; ≤33 cm in women). Non-affected-side HGS was classified by EWGSOP2 thresholds. Multivariable models were adjusted for age, sex, and time since stroke, including Firth-penalized logistic sensitivity analyses. Results: GLIM-defined malnutrition and low HGS affected 75.6% and 67.4% of participants, respectively. SARC-F and SARC-CalF positivity rates were 88.4% and 81.4%, demonstrating fair agreement (κ = 0.28; exact McNemar p = 0.210), which persisted in participants aged ≥65 years (κ = 0.30). Both scores correlated inversely with HGS (rho = −0.399 and −0.387; p < 0.001), while MNA-FF correlated positively (r = 0.47; p < 0.001). Adjusted HGS coefficients were −5.90 kg (95% CI −11.22 to −0.59; p = 0.030) for SARC-F and −2.54 kg (95% CI −7.02 to 1.95; p = 0.264) for SARC-CalF. Firth-adjusted GLIM odds ratios were 13.75 (95% CI 2.76–99.21) and 3.21 (95% CI 0.95–11.00), respectively. Conclusions: Malnutrition and low HGS were frequent despite relatively preserved mean body mass index. SARC-F and SARC-CalF yielded discordant classifications. Because neurological severity and muscle quantity were not directly assessed, differing weightings of functional limitations and anthropometry may partly explain this pattern, but this interpretation remains hypothesis-generating without establishing confirmed sarcopenia or distinct causal mechanisms.

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