mNUTRIC score as a predictor of the lethal outcome in critically ill patients with COVID-19: systematic review and meta-analysis

Abstract

The objective was to assess the predictive value of nutritive risk mNUTRIC score in relation to the lethal outcome in ICU patients suffering from COVID-19.Materials and methods. The systematic review and meta-analysis were performed based on the Preferred Reporting Items for Systematic and Meta-Analysis protocols. All observational (crossover and cohort) and prospective studies were included. The search was carried out in PubMed electronic database and was limited to 2019–2023. Conditions for inclusion into the study were: 1) a positive result of the SARS-CoV-2 polymerase chain reaction test; 2) patients admitted to ICU; 3) age ≥18 years old; 4) the evaluation according to the mNUTRIC score within the first 48 hours of hospitalization to ICU.Results. The number of subjects included into the study was equal to 1130 patients, the number of those included into the quantitative synthesis (meta-analysis) was 403. In the performed meta-analysis, the chances of in-hospital mortality of critically ill patients with COVID-19 increased by 1.8-fold at mNUTRIC score ≥5. Heterogeneity of studies was insignificant (I2 = 0%, p = 0.22). The analysis of 28-day ICU mortality in patients with mNUTRIC score ≥5 found a 2.11-fold increase of the risk (95% CI: 1.38–3.22, p = 0.005). All the observed changes were statistically significant (p < 0.00001 and p = 0.00005, correspondingly).Conclusion. In the available literature, we have not found a systematic review or meta-analysis that would reflect the capability of the mNUTRIC score to predict an unfavorable outcome in critically ill patients with COVID-19. Our study has shown that this score can predict the in-hospital and 28-day mortality in ICU. Further studies are required for a more precise assessment of the lethal outcome in this category of patients.