Effect of Undernutrition and Obesity on Clinical Outcomes in Adults with Community-Acquired Pneumonia

Viasus, Diego; Pérez-Vergara, Valentina; Carratalà, Jordi

doi:10.3390/nu14153235

Cited by 8 publications

(5 citation statements)

References 66 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…To the best of our knowledge, this is the first study to provide evidence of an "obesity paradox" five years after an acute infectious disease [46]. These findings contribute to previous studies that primarily had short-term follow-up available [19,47,48], as well as to a study of patients with severe sepsis demonstrating survival benefits in obese patients at one year [49].…”

Section: Discussionsupporting

confidence: 64%

Does the “Obesity Paradox” Have an Expiration Date? A Retrospective Cohort Study

Elkan,

Kofman,

Minha

et al. 2023

JCM

View full text Add to dashboard Cite

(1) Background: The “obesity paradox” refers to a protective effect of higher body mass index (BMI) on mortality in acute infectious disease patients. However, the long-term impact of this paradox remains uncertain. (2) Methods: A retrospective study of patients diagnosed with community-acquired acute infectious diseases at Shamir Medical Center, Israel (2010–2020) was conducted. Patients were grouped by BMI: underweight, normal weight, overweight, and obesity classes I–III. Short- and long-term mortality rates were compared across these groups. (3) Results: Of the 25,226 patients, diverse demographics and comorbidities were observed across BMI categories. Short-term (90-day) and long-term (one-year) mortality rates were notably higher in underweight and normal-weight groups compared to others. Specifically, 90-day mortality was 22% and 13.2% for underweight and normal weight respectively, versus 7–9% for others (p < 0.001). Multivariate time series analysis revealed underweight individuals had a significantly higher 5-year mortality risk (HR 1.41 (95% CI 1.27–1.58, p < 0.001)), while overweight and obese categories had a reduced risk (overweight—HR 0.76 (95% CI 0.72–0.80, p < 0.001), obesity class I—HR 0.71 (95% CI 0.66–0.76, p < 0.001), obesity class II—HR 0.77 (95% CI 0.70–0.85, p < 0.001), and obesity class III—HR 0.79 (95% CI 0.67–0.92, p = 0.003)). (4) Conclusions: In this comprehensive study, obesity was independently associated with decreased short- and long-term mortality. These unexpected results prompt further exploration of this counterintuitive phenomenon.

show abstract

Section: Discussionsupporting

confidence: 64%

Does the “Obesity Paradox” Have an Expiration Date? A Retrospective Cohort Study

Elkan,

Kofman,

Minha

et al. 2023

JCM

View full text Add to dashboard Cite

show abstract

“…This finding is in line with other research on the effects of malnutrition on immune function, acute infection, 34 and the risk of death. 35 The papers reviewed in this study suggested potential mechanisms to explain the relationship between malnutrition and diminished immune function including impairment of gut-barrier function, decreased secretion of protective exocrine substances, decreased levels of plasma complement, atrophy of lymphatic tissues such as the thymus, decreased antibody production in response to vaccination, and cytokine patterns favouring a Th2-response.…”

Section: Malnutrition Is a Risk Factormentioning

confidence: 91%

Diet and Nutritional Factors in the Prevention and Treatment of COVID-19: An Umbrella Review

Murphy,

Aucoin,

Barbaro

2023

CANDJ

View full text Add to dashboard Cite

Background: There is growing interest in the use of natural therapies for the prevention and treatment of COVID-19 and related illnesses. The aim of this review was to identify and examine the systematic and narrative reviews reporting on the relationship between diet or nutritional status and COVID-19. Methods: This paper is part of an umbrella review of studies related to natural health products and therapies for the prevention or treatment of COVID-19, as a follow-up to a live review that was conducted by the World Naturopathic Federation. PubMed and Google Scholar were searched for systematic and narrative reviews. Results: Seven narrative reviews and four systematic reviews were included. The reviews included evidence suggesting that dietary patterns and nutritional status are important modifiable risk factors relevant to the prevention and treatment of COVID-19. Three systematic reviews reported an association between poor nutritional status and greater COVID-19 severity or death. Narrative reviews suggested a possible benefit of the Mediterranean diet, fibre-rich diets, and antioxidant-rich fruits and vegetables. Conclusion: The research suggests that nutrition status is a significant factor in the progression of COVID-19 infection. While more clinical and interventional evidence is needed to precisely understand the impact of diet, dietary constituents, and nutritional status on modifying COVID-19 risk, the findings of this review highlight the importance of following existing dietary guidelines to support healthy immune function.

show abstract

“…Malnutrition generally implies undernutrition and refers to deviations from adequate and optimal nutritional status [ 9 ]. As a modifiable patient-related risk factor, it is associated with poor outcomes in various diseases [ 10 , 11 ]. To date, several studies have also preliminarily investigated the effects of malnutrition on clinical outcomes following primary TJA, reporting impaired wound healing and greater susceptibility to infection, as well as an increase in other complications [ 12 , 13 , 14 , 15 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

Moderate-to-Severe Malnutrition Identified by the Controlling Nutritional Status (CONUT) Score Is Significantly Associated with Treatment Failure of Periprosthetic Joint Infection

Maimaiti

et al. 2022

Nutrients

View full text Add to dashboard Cite

The prevalence and role of malnutrition in periprosthetic joint infection (PJI) remain unclear. This study aimed to use measurable nutritional screening tools to assess the prevalence of malnutrition in PJI patients during two-stage exchange arthroplasty and to explore the association between malnutrition and treatment failure. Our study retrospectively included 183 PJI cases who underwent 1st stage exchange arthroplasty and had available nutritional parameters, of which 167 proceeded with 2nd stage reimplantation. The recently proposed Musculoskeletal Infection Society (MSIS) Outcome Reporting Tool was used to determine clinical outcomes. The Controlling Nutritional Status (CONUT), Nutritional Risk Index (NRI), and Naples Prognostic Score (NPS) were used to identify malnutrition at 1st and 2nd stage exchange, respectively. Multivariate logistic regression analyses were performed to determine the association between malnutrition and treatment failure. Restricted cubic spline models were further used to explore the dose–response association. Additionally, risk factors for moderate-to-severe malnutrition were evaluated. Malnourished patients identified by CONUT, NPS, and NRI accounted for 48.1% (88/183), 98.9% (181/183), and 55.7% (102/183) of patients at 1st stage, and 9.0% (15/167), 41.9% (70/167), and 43.1% (72/167) at 2nd stage, indicating a significant improvement in nutritional status. We found that poorer nutritional status was a predictor of treatment failure, with CONUT performing best as a predictive tool. Moderate-to-severe malnutrition at 1st stage identified by CONUT was significantly related to treatment failure directly caused by PJI (odds ratio [OR] = 5.86), while the OR was raised to 12.15 at 2nd stage (OR = 12.15). The linear dose–response associations between them were also confirmed (P for nonlinearity at both 1st and 2nd stage > 0.05). As for total treatment failure, moderate-to-severe malnutrition as determined by CONUT was associated with a 1.96-fold and 8.99-fold elevated risk at the 1st and 2nd stages, respectively. Age ≥ 68 years (OR = 5.35) and an increased number of previous surgeries (OR = 2.04) may be risk factors for moderate-to-severe malnutrition. Overall, the prevalence of malnutrition in PJI patients is very high. Given the strong association between moderate-to-severe malnutrition identified by CONUT and PJI treatment failure, COUNT could be a promising tool to evaluate the nutritional status of PJI patients to optimize treatment outcomes.

show abstract

Effect of Undernutrition and Obesity on Clinical Outcomes in Adults with Community-Acquired Pneumonia

Cited by 8 publications

References 66 publications

Does the “Obesity Paradox” Have an Expiration Date? A Retrospective Cohort Study

Does the “Obesity Paradox” Have an Expiration Date? A Retrospective Cohort Study

Diet and Nutritional Factors in the Prevention and Treatment of COVID-19: An Umbrella Review

Moderate-to-Severe Malnutrition Identified by the Controlling Nutritional Status (CONUT) Score Is Significantly Associated with Treatment Failure of Periprosthetic Joint Infection

Contact Info

Product

Resources

About