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COVID-19 caused by SARS-CoV-2 infection is a highly contagious disease affecting both the higher and lower portions of the respiratory tract. This disease reached over 265 million people and has been responsible for over 5.25 million deaths worldwide. Skeletal muscle quality and total mass seem to be predictive of COVID-19 outcome. This systematic review aimed at providing a critical analysis of the studies published so far reporting on skeletal muscle mass in patients with COVID-19, with the intent of examining the eventual association between muscle status and disease severity. A meta-analysis was performed to evaluate whether skeletal muscle quantity, quality and function were related to disease severity. Systematic reviews and meta-analyses were conducted according to the guidelines of the Cochrane Handbook for Systematic Reviews of Interventions and reported according to the guidelines of the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guide. From a total of 1,056 references found, 480 were selected after removing duplicates. Finally, only 7 met the specified inclusion criteria. The results of this meta-analysis showed that skeletal muscle quality, rather than quantity, was associated with COVID-19 severity, as confirmed by lower skeletal muscle density and lower handgrip strength in patients with severe disease. Muscle function assessment can thus be a valuable tool with prognostic value in COVID-19.

BACKGROUND: Weight loss and body composition changes are common in patients with pancreatic cancer. Computed tomography (CT) images are helpful to investigate body composition and its changes and to discriminate the different kinds of body tissues. Patients with pancreatic cancer routinely undergo CT scans. OBJECTIVE: To verify the association of muscle mass and visceral fat measured by CT with toxicity and survival of patients with pancreatic cancer. METHODS: We evaluated the imaging of the abdomen of all consecutive adult patients with pancreatic cancer treated between October 2007 and September 2015 in our service, to assess skeletal muscle mass and fat, intramuscular fat and visceral fat. We graded treatment toxicity symptoms according to the Common Toxicity Criteria of the United States National Cancer Institute (version 2.0). RESULTS: The study involved 17 patients, with a mean age of 63 (±10) years (range: 51-73 years). Eleven (65%) were male. The mean initial body mass index (BMI) was 26 kg/m2 (±3) and 23 kg/m2 (±3) after treatment. The mean weight loss was 10.0 kg (±6.8; 13%). Sarcopenia was present in 47% of patients, and it was not associated with significant differences in muscle mass, visceral fat, toxicity or survival. The mean skeletal muscle attenuation was 36 Hounsfield units, not associated with survival or treatment toxicity. Mean muscle mass was not associated with toxicity either. However, there was a significant inverse association between toxicity and visceral fat. CONCLUSION: Muscle mass had no impact on the survival or on treatment toxicity among the patients with pancreatic cancer. However, the visceral fat exerted a protective effect against the treatment toxicity. We stress the importance of further studies on visceral fat associated with prognosis and toxicity in cancer patients.

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Introduction There are few studies on the behavior of vitamin D in patients undergoing Hematopoietic Stem Cell Transplantation (HSCT), although vitamin D serum levels are associated with use of corticosteroids and immunosuppressive drugs. In some studies, vitamin D deficiency in patients after HSCT is associated with reduced bone density, increased of parathyroid hormone and GVHD. Objectives To study vitamin D deficiency in patients undergoing to HSCT. Methods 51 patients who underwent HSCT at Albert Einstein Hospital, São Paulo, Brazil, were studied (28 male, 23 female) with a mean age of 50 ± 16 years, in the period from 2012 to 2013. Results 54 % had serum levels of vitamin D ≤ 50 nmol/l. And, 12% had serum levels of vitamin D ≤ 25 nmol/l. A multivariate analysis showed that more age and higher Body Mass Index (BMI) were significantly associated to lower serum levels of vitamin D. A negative correlation was found between BMI and serum level of vitamin D (rp=0,37). Conclusion The use of corticosteroids, immunosuppressive drugs and less lack of sun exposure during the HSCT and during the first year post-HSCT are associated with a greater tendency to deficiency of vitamin D. This deficiency can cause muscle and bone diseases, which can be prevented with diagnosis and early treatment. The deficiency of vitamin D should be carefully investigated in the elderly and obese patients. Disclosures: No relevant conflicts of interest to declare.

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Cancer is the second leading cause of death in Brazil. This study aimed to review the nutrition role in prevention and post-treatment of cancer as a health promoter. Regarding prevention, when analyzing lifestyle (obesity and physical activity), there was a positive correlation between body mass index and body fat with incidence in several types of cancer; physical activity shown an inverse correlation. Ethanol consumption, frying, red meat and processed meats eaten carefully or even avoided. Differently, the consumption of fruits and vegetables should be stimulated. Bioactive compounds are shown with well elucidated actions, and also as a healthy eating habit. In relation to survivors, the healthy lifestyle is capable of ensuring a better quality of life for this population, as well as preventing them from new diseases. This review highlights the importance of adequate lifestyle and eating habits, stimulates public health policy and more scientific research in this field.