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Background and aims Several factors that worsen the prognosis of the new coronavirus SARS-CoV-2 have been identified, such as obesity or diabetes. However, despite that nutrition may change in a lockdown situation, little is known about the influence of malnutrition among subjects hospitalized due to COVID-19. Our study aimed to assess whether the presence of malnutrition among patients admitted due to COVID-19 had any impact on clinical outcomes compared with patients with the same condition but well nourished. Methods 75 patients admitted to hospital due to COVID-19 were analyzed cross-sectionally. Subjective Global Assessment (SGA) was completed by phone interview. Clinical parameters included were extracted from the electronic medical record. Results According to the SGA, 27 admitted due to a COVID-19 infection had malnutrition. Patients not well nourished were older than patients with a SGA grade A (65±14.1 vs 49±15.1 years; p<0.0001). Length of hospital stay among poorly nourished patients was significantly higher (18.4±15.6 vs 8.5±7.7 days; p=0.001). Mortality rates and admission to ICU were greater among subjects with any degree of malnutrition compared with well-nourished patients (7.4% vs 0%; p=0.05 and 44.4% vs 6.3%; p<0.0001). CRP (120.9±106.2 vs 60.8±62.9mg/l; p=0.03), D-dimer (1516.9±1466.9 vs 461.1±353.7ng/ml; p<0.0001) and ferritin (847.8±741.1 vs 617.8±598.7mcg/l; p=0.03) were higher in the group with malnutrition. Haemoglobin (11.6±2.1 vs 13.6±1.5g/dl; p<0.0001) and albumin 3.2±0.7 vs 4.1±0.5g/dl; p<0.0001) were lower in patients with any degree of malnutrition. Conclusions The presence of a poor nutritional status is related to a longer stay in hospital, a greater admission in the ICU and a higher mortality.

Background and aims The clinical spectrum of the SARS-CoV-2 infection is very broad, ranging from asymptomatic infection to severe pneumonia. However, the majority of fatalities related to COVID-19 have involved old, frail and patients with comorbidities, such as obesity, groups that also have high rates of a poor nutritional status. To assess the impact on clinical outcomes of the coexistence of any degree of obesity and low albumin levels on admission among patients with COVID-19. Methods This is a sub-analysis of a former study where 75 patients admitted due to COVID-19 were evaluated cross-sectionally. In this analysis, patients were divided in two groups, according to the presence of obesity and albumin levels on admission lower than 3.5 g/dl. Results 11 out 75 patients evaluated (14.7%) had obesity and albumin levels lower than 3.5 g/dl. Patients with obesity and hypoalbuminemia were older than patients without these two conditions (65.3 ± 7.7 vs 54.2 ± 17 years; p = 0.01). CRP (141.4 ± 47.9 vs 70.1 ± 60.6 mg/l; p = 0.002), D-dimer (2677.3 ± 2358.3 vs 521.7 ± 480.3 ng/ml; p = 0.001), fibrinogen (765.9 ± 123.9 vs 613.5 ± 158gr/L; p = 0.007) ferritin levels (903.1 ± 493 vs 531.4 ± 418.9 mcg/l; p = 0.01) and procalcitonin (3.5 ± 0.6 vs 1.1 ± 0.7 ng/ml; p = 0.009) were significantly higher in the group with obesity and hypoalbuminemia. Among patients with low albumin and obesity, length of hospital was higher (21.9 ± 18.7 vs 10.5 ± 9.5 days; p = 0.004) and the proportion of subjects admitted to ICU was greater (81.8% vs 11.5%; p < 0.0001). However, mortality rates were comparable between the two groups (3.8% vs 0%; p = 0.5). Conclusions The combination of obesity and hypoalbuminemia may worsen the prognosis of patients with a SARS-CoV-2 infection. Therefore, prompt identification and amelioration of nutritional status could be beneficial.

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