Nutritional Risk, Micronutrient Status and Clinical Outcomes: A Prospective Observational Study in an Infectious Disease Clinic

Abstract

Malnutrition has been associated with increased morbidity and mortality. The objective of this study was to determine the nutritional status and micronutrient levels of hospitalized patients in an infectious disease clinic and investigate their association with adverse clinical outcomes. The nutritional status of the study participants was assessed using the Nutritional Risk Screening 2002 (NRS 2002) and micronutrient levels and routine biochemical parameters were tested within the first 24 h of the patient’s admission. The incidence of zinc, selenium, thiamine, vitamin B6, vitamin B12 deficiency were 66.7% (n = 40), 46.6% (n = 29), 39.7% (n = 27), 35.3% (n = 24), 14.1% (n = 9), respectively. Selenium levels were significantly higher in patients with urinary tract infections, but lower in soft tissue infections. Copper levels were significantly higher in patients with soft tissue infections. In the Cox regression models, lower albumin, higher serum lactate dehydrogenase levels and higher NRS-2002 scores were associated with increased death. Thiamine, selenium, zinc and vitamin B6 deficiencies but not chromium deficiencies are common in infectious disease clinics. New associations were found between micronutrient levels and infection type and their adverse clinical outcomes. Hypoalbuminemia and a high NRS-2002 score had the greatest accuracy in predicting death, systemic inflammatory response syndrome and sepsis on admission.

Serum Trace Elements and Heavy Metal Levels in Patients Diagnosed with Chronic Otitis Media and Their Association with Surgical Treatment Outcomes

“…Superoxide dismutase, one of the most important enzymatic antioxidants, also contains Zn and Cu [19] . Serum Cu levels are increased in some infections and inflammatory processes, as previously noted [7,20] . Recently, the serum Cu/Zn ratio was defined as an important inflammatory marker [21] .…”

Tea Bioactive Modulate Innate Immunity: In Perception to COVID-19 Pandemic

“…Although understanding the immune response in COVID-19 patients is in growing stage, observations reported till now showed apparent involvement of hyper-inflammation and vascular permeability contributing towards the disease severity (12,13,38). Mounting evidence suggested that micronutrients improve defense function, i.e., resistance to infection, by modulating immune regulation (48). This include inhibition of pro-inflammatory cytokines, promotion of anti-inflammatory functions, modulation of cell-mediated immunity, alteration of antigen-presenting cell functions, and communication between the innate and adaptive immune systems.…”

“…Micronutrients and vitamins are important component in the diet for an effective innate immune response (47). Although their status in COVID 19 patients is not yet known but earlier studies documented that selenium (Se), zinc (Zn), and vitamin B6 are associated with adverse clinical outcome in patients of infectious diseases (48). While the micronutrients and vitamin deficiency will lead to overall weakening of the innate immune response, the individual elements does play an important role in balancing immunity (47).…”

“…While the micronutrients and vitamin deficiency will lead to overall weakening of the innate immune response, the individual elements does play an important role in balancing immunity (47). Tea is also a source of these micronutrients and vitamins, but their contents; particularly micronutrients may vary with its geographical origin (48,49). Here, we consider seven essential micronutrients like copper (Cu), iron (Fe), manganese (Mn), selenium (Se), zinc (Zn), and vitamins (B 2 , B 12 ) which are present in tea infusion ( Table 2).…”

Thiamine Concentrations in Newly Hospitalized Elderly Patients with Infectious Diseases at a Community Hospital in Japan

“…Infection is known to be a risk factor of a reduced thiamine concentration due mainly to an insufficient oral intake of thiamine and increased metabolism (4,26). Experimental studies have shown that sepsis accelerates systemic glucose turnover, which uses thiamine as a cofactor for several enzymes (27,28).…”