Nutritional risk and clinical outcomes in critically ill adult patients with COVID-19

Martinuzzi, Andrés; Manzanares, William; Quesada, Eliana; Reberendo, María Jimena; Baccaro, Fernando; Aversa, Irina; Kecskes, Caludia Elisabeth; Magnífico, Lorena; González, Victoria; Bolzico, Daniela; Baraglia, Nancy; Navarrete, Priscila; Manrique, Ezequiel; Cascarón, María Fernanda; Dietrich, Ailen; Asparch, Jesica; Peralta, Leticia Betiana; Galleti, Cayetano; Capria, Maria; Lombi, Yamila; Rodríguez, Marian Celia; Luna, Camila Ester; Chapela, Sebastián Pablo

doi:10.20960/nh.03749

Cited by 18 publications

(19 citation statements)

References 36 publications

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“…Furthermore, mild malnutrition patients presented a significant hazard ratio with greater potential to discharge compared to malnourished patients. These results were similar to those evidenced by Martinuzzi et al ( 29 ) showing that longer hospital length of stay and longer ICU stay resulted from poor nutritional status as measured by subjective global assessment (SGA) and nutritional risk screening 2002 (NRS 2002).…”

Section: Discussionsupporting

confidence: 89%

Prognostic Nutritional Index and Oxygen Therapy Requirement Associated With Longer Hospital Length of Stay in Patients With Moderate to Severe COVID-19: Multicenter Prospective Cohort Analyses

et al. 2022

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PurposeTo evaluate whether the prognostic nutritional index (PNI) is related to the oxygen therapy requirement at hospital admission and to ascertain the prognostic effect of the PNI and the oxygen therapy requirement as predictors of hospital length of stay in patients with moderate to severe coronavirus disease 2019 (COVID-19).MethodsThis is a post-hoc analysis in hospitalized patients with moderate to severe COVID-19. The participants were categorized: (1) non-oxygen therapy (moderate COVID-19 not requiring oxygen therapy); (2) nasal cannula therapy (severe COVID-19 requiring nasal cannula oxygen therapy); and (3) high-flow therapy (severe COVID-19 requiring high-flow oxygen therapy). PNI was calculated for each patient according to the following equation: serum albumin [g/dL] × 10 + total lymphocyte count [per mm3] × 0.005. The participants were categorized into malnutrition (PNI <40), mild malnutrition (PNI 40–45), and non-malnutrition (PNI > 45).ResultsAccording to PNI, malnutrition was more prevalent in the high-flow therapy group (94.9%; P < 0.001) with significantly lower PNI compared to both groups even after adjusting for the center and C-reactive protein. Patients in the high-flow therapy group [9 days (95% CI 7.2, 10.7), P < 0.001] and malnutrition status [7 days (95% CI 6.6, 7.4), P = 0.016] showed a significant longer hospital length of stay compared to their counterparts. The multivariable Cox proportional hazard models showed significant associations between both oxygen therapy requirement and PNI categories and hospital discharge.ConclusionIn addition to oxygen therapy requirement, low PNI was associated with longer hospital length of stay. Our findings suggest that PNI could be useful in the assessment of nutritional status related to the prognosis of patients with moderate to severe COVID-19.

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Section: Discussionsupporting

confidence: 89%

Prognostic Nutritional Index and Oxygen Therapy Requirement Associated With Longer Hospital Length of Stay in Patients With Moderate to Severe COVID-19: Multicenter Prospective Cohort Analyses

et al. 2022

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“…Li et al [29] showed that NUTRIC independently predicted the risk of hospital death (OR: 1.19, p=0.006) and the length of stay, but not considering obesity. Additionally, Martinuzzi et al [30] demonstrated that non-survivors had higher rates of comorbidities and higher nutritional score values (NRS, 2002) even when adjusted by obesity, as observed in our sample.…”

Section: Discussionsupporting

confidence: 80%

Nutritional risk, not obesity, is associated with mortality in critically ill COVID-19 patients

Santos¹,

Japúr

Passos

et al. 2022

Obesity Research & Clinical Practice

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“…To minimise physical contact and the risk of nosocomial transmission, nutrition screening tools that do not require physical examination could be used to quantify malnutrition risk. Nutrition Risk Screening 2002 score ≥3 was associated with higher mortality risk in one prospective study (N=285) 7 but not in another retrospective study (N=286). 8 In the absence of a validated nutrition screening/ assessment tool that has good prognostic value and can be conducted without physical assessment, the utility of baseline nutrition screening/assessment can be questioned.…”

Section: Nutrition Assessmentmentioning

confidence: 80%

Nutrition support practices for critically ill patients with severe acute respiratory syndrome coronavirus-2: A multicentre observational study in Singapore

Lew

Wong

et al. 2022

Ann Acad Med Singap

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Introduction: To improve the nutritional care and resource allocation of critically ill patients with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), we described their characteristics, treatment modalities and clinical outcomes, and compared their nutrition interventions against the American Society for Parenteral and Enteral Nutrition (ASPEN) recommendations. Methods: This was a retrospective observational study conducted in 5 tertiary hospitals in Singapore. Characteristics, treatment modalities, clinical outcomes and nutrition interventions of critically ill patients with SARS-CoV-2 who received enteral and parenteral nutrition were collected between January and May 2020. Results: Among the 83 critically ill patients with SARS-CoV-2, 22 (28%) were obese, 45 (54%) had hypertension, and 21 (25%) had diabetes. Neuromuscular blockade, prone therapy and dialysis were applied in 70% (58), 47% (39) and 35% (29) of the patients, respectively. Refeeding hypophosphataemia and hospital mortality occurred respectively in 6% (5) and 18% (15) of the critically ill patients with SARS-CoV-2. Late enteral nutrition and cardiovascular comorbidities were associated with higher hospital mortality (adjusted relative risk 9.00, 95% confidence interval [CI] 2.25–35.99; 6.30, 95% CI 1.15–34.40, respectively). Prone therapy was not associated with a higher incidence of high gastric residual volume (≥250mL). The minimum caloric (15kcal/kg) and protein (1.2g/kg) recommendations of ASPEN were achieved in 54% (39) and 0% of the patients, respectively. Conclusion: The high obesity prevalence and frequent usage of neuromuscular blockade, prone therapy, and dialysis had considerable implications for the nutritional care of critically ill patients with SARS-CoV-2. They also did not receive adequate calories and protein. More audits should be conducted to refine nutritional interventions and guidelines for this ever-evolving disease. Keywords: COVID-19, critical illness, energy intake, enteral nutrition, nutrition support, protein intake

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Nutritional risk and clinical outcomes in critically ill adult patients with COVID-19

Abstract: Nutritional risk and clinical outcomes in critically ill adult patients with COVID-19Riesgo nutricional y resultados clínicos de pacientes adultos críticamente enfermos con

Cited by 18 publications

References 36 publications

Prognostic Nutritional Index and Oxygen Therapy Requirement Associated With Longer Hospital Length of Stay in Patients With Moderate to Severe COVID-19: Multicenter Prospective Cohort Analyses

Prognostic Nutritional Index and Oxygen Therapy Requirement Associated With Longer Hospital Length of Stay in Patients With Moderate to Severe COVID-19: Multicenter Prospective Cohort Analyses

Nutritional risk, not obesity, is associated with mortality in critically ill COVID-19 patients

Nutrition support practices for critically ill patients with severe acute respiratory syndrome coronavirus-2: A multicentre observational study in Singapore

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