Nutritional screening based on objective indices at admission predicts in-hospital mortality in patients with COVID-19

Song, Feier; Ma, Huan; Wang, Shouhong; Qin, Tiehe; Xu, Qing; Yuan, Huiqing; Li, Fēi; Wang, Zhonghua; Liao, Yu-Cai; Tan, Xiaoping; Song, Xiuchan; Zhang, Qing; Huang, Daozheng

doi:10.21203/rs.3.rs-108125/v1

Cited by 7 publications

(13 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[ 43 , 48 ]. Three studies used both traditional measures and calculated indices [ 34 , 45 , 55 ]. COVID-19 related outcomes addressed in these studies included disease severity [ 34 ], COVID-19 complications (such as renal/hepatic injury [ 45 ] and muscle dystrophy [ 41 ]), admission to the ICU [ 47 ], need for oxygen therapy [ 56 ], and in-hospital mortality [ 41 , 43 , 45 , 47 , 54 , 55 ].…”

Section: Measures Used For Nutritional Screening In Covid-19 Patiementioning

confidence: 99%

“…Three studies used both traditional measures and calculated indices [ 34 , 45 , 55 ]. COVID-19 related outcomes addressed in these studies included disease severity [ 34 ], COVID-19 complications (such as renal/hepatic injury [ 45 ] and muscle dystrophy [ 41 ]), admission to the ICU [ 47 ], need for oxygen therapy [ 56 ], and in-hospital mortality [ 41 , 43 , 45 , 47 , 54 , 55 ]. One study evaluated the length of hospital stay (LOS), hospital expenses, loss of appetite, and weight loss [ 34 ] while many studies evaluated the association between malnutrition and markers of inflammation [ 28 , 41 , 45 , 53 , 54 , 55 ].…”

Section: Measures Used For Nutritional Screening In Covid-19 Patiementioning

confidence: 99%

“…The Prognostic Nutritional Index (PNI) is calculated as 10 × serum albumin (g/dL) + 0.005 × total lymphocyte count (mm 3 ). PNI > 38, PNI of 35–38, PNI < 35, in order, reflect normal nutrition, moderate, and severe risk for malnutrition [ 54 , 55 ]. The controlling nutritional status (CONUT) score—calculated from lymphocyte count, total cholesterol, and serum albumin—is used for nutritional screening [ 41 , 45 , 54 ].…”

Section: Measures Used For Nutritional Screening In Covid-19 Patiementioning

confidence: 99%

“…In the meantime, the predictive capacity of NRS-2002 is less than that of the CONUT score and the combined CONUT-LDH-CRP (0.795%, vs. 0.813 and 0.923, respectively) in midlife and old COVID-19 patients (mean age = 58 years, range = 41–70 years) [ 45 ]. Moreover, higher CONUT scores correlate with age [ 41 , 45 , 55 ]—COVID-19 patients ≥61 years old with high CONUT score exhibit a 6.2-fold higher risk for adverse outcomes compared with counterparts with low CONUT score (relative risk = 6.191, 95% CI: 1.431–26.785) [ 47 ]. According to Table 1 , the majority of COVID-19 patients in most studies were elderly adults.…”

Section: Measures Used For Nutritional Screening In Covid-19 Patiementioning

confidence: 99%

“…Male gender is associated with increased occurrence of nutritional deficiency and adverse effects of COVID-19 [ 41 , 47 ]. According to Table 1 , most nutritional biomarkers/measures correlated with biomarkers of inflammation [ 28 , 41 , 55 , 56 ], weight loss [ 34 , 51 , 52 , 56 ], disease severity, prolonged LOS [ 28 , 34 ], preexisting comorbidities (e.g., diabetes [ 41 , 47 , 48 , 50 ], obesity [ 50 , 52 , 56 ], and hypertension [ 41 , 47 , 48 ]), acute myocardial injury [ 41 , 43 ], ICU admission [ 53 ], poor appetite [ 34 ], old age [ 47 ], incidence of ARDS, secondary infection, shock, and use of vasopressors [ 43 ]. Antibiotics, antiviral drugs, and bowel invasion by SARS-CoV-2 induce GI symptoms such as diarrhea, vomiting, and anorexia [ 33 , 34 , 35 , 54 , 61 ].…”

Section: Critical Risk Factors For Malnutrition In Covid-19mentioning

confidence: 99%

See 4 more Smart Citations

Approaches to Nutritional Screening in Patients with Coronavirus Disease 2019 (COVID-19)

Ali

Kunugi

2021

IJERPH

View full text Add to dashboard Cite

Malnutrition is common among severe patients with coronavirus disease 2019 (COVID-19), mainly elderly adults and patients with comorbidities. It is also associated with atypical presentation of the disease. Despite the possible contribution of malnutrition to the acquisition and severity of COVID-19, it is not clear which nutritional screening measures may best diagnose malnutrition in these patients at early stages. This is of crucial importance given the urgency and rapid progression of the disease in vulnerable groups. Accordingly, this review examines the available literature for different nutritional screening approaches implemented among COVID-19 patients, with a special focus on elderly adults. After a literature search, we selected and scrutinized 14 studies assessing malnutrition among COVID-19 patients. The Nutrition Risk Screening 2002 (NRS-2002) has demonstrated superior sensitivity to other traditional screening measures. The controlling nutritional status (CONUT) score, which comprises serum albumin level, cholesterol level, and lymphocytes count, as well as a combined CONUT-lactate dehydrogenase-C-reactive protein score expressed a predictive capacity even superior to that of NRS-2002 (0.81% and 0.92% vs. 0.79%) in midlife and elder COVID-19 patients. Therefore, simple measures based on routinely conducted laboratory investigations such as the CONUT score may be timely, cheap, and valuable alternatives for identifying COVID-19 patients with high nutritional risk. Mini Nutritional Assessment (MNA) was the only measure used to detect residual malnutrition and high malnutrition risk in remitting patients—MNA scores correlated with hypoalbuminemia, hypercytokinemia, and weight loss. Older males with severe inflammation, gastrointestinal symptoms, and pre-existing comorbidities (diabetes, obesity, or hypertension) are more prone to malnutrition and subsequently poor COVID-19 prognosis both during the acute phase and during convalescence. Thus, they are in need of frequent nutritional monitoring and support while detecting and treating malnutrition in the general public might be necessary to increase resilience against COVID-19.

show abstract

Section: Measures Used For Nutritional Screening In Covid-19 Patiementioning

confidence: 99%

Section: Measures Used For Nutritional Screening In Covid-19 Patiementioning

confidence: 99%

Section: Measures Used For Nutritional Screening In Covid-19 Patiementioning

confidence: 99%

Section: Measures Used For Nutritional Screening In Covid-19 Patiementioning

confidence: 99%

Section: Critical Risk Factors For Malnutrition In Covid-19mentioning

confidence: 99%

See 3 more Smart Citations

Approaches to Nutritional Screening in Patients with Coronavirus Disease 2019 (COVID-19)

Ali

Kunugi

2021

IJERPH

View full text Add to dashboard Cite

show abstract

Impact of malnutrition on clinical outcomes in patients diagnosed with COVID‐19

Ponce

Anzalone

Bailey

et al. 2022

J Parenter Enteral Nutr

View full text Add to dashboard Cite

Background Coronavirus disease 2019 (COVID‐19) is now the third leading cause of death in the United States. Malnutrition in hospitalized patients increases risk of complications. However, the effect of malnutrition on outcomes in patients infected is unclear. This study aims to identify the impact of malnutrition on mortality and adverse hospital events in patients hospitalized with COVID‐19. Methods This study used data from the National COVID Cohort Collaborative (N3C), a COVID‐19 repository containing harmonized, longitudinal electronic health record data from US health systems. Malnutrition was categorized into three groups based on condition diagnosis: (1) none documented, (2) history of malnutrition, and (3) hospital‐acquired malnutrition. Multivariable logistic regression was performed to determine whether malnutrition was associated with mortality and adverse events, including mechanical ventilation, acute respiratory distress syndrome, extracorporeal membrane oxygenation, and hospital‐acquired pressure injury, in hospitalized patients with COVID‐19. Results Of 343,188 patients hospitalized with COVID‐19, 11,206 had a history of malnutrition and 15,711 had hospital‐acquired malnutrition. After adjustment for potential confounders, odds of mortality were significantly higher in patients with a history of malnutrition (odds ratio [OR], 1.71; 95% confidence interval [CI], 1.63–1.79; P < 0.001) and hospital‐acquired malnutrition (OR, 2.5; 95% CI, 2.4–2.6; P < 0.001). Adjusted odds of adverse hospital events were also significantly elevated in both malnutrition groups. Conclusions Results indicate the risk of mortality and adverse inpatient events in adults with COVID‐19 is significantly higher in patients with malnutrition. Prevention, diagnosis, and treatment of malnutrition could be a key component in improving outcomes in these patients.

show abstract

Clinical significance of prognostic nutrition index in hospitalized patients with COVID‐19: Results from single‐center experience with systematic review and meta‐analysis

et al. 2021

View full text Add to dashboard Cite

Background: We aimed to ascertain risk indicators of in-hospital mortality and severity as well as to provide a comprehensive systematic review and metaanalysis to investigate the prognostic significance of the prognostic nutrition index (PNI) as a predictor of adverse outcomes in hospitalized coronavirus disease 2019 (COVID-19) patients. Methods: In this cross-sectional study, we studied patients with COVID-19 who were referred to our hospital from February 16 to November 1, 2020. Patients with either a real-time reverse-transcriptase polymerase chain reaction test that was positive for COVID-19 or high clinical suspicion based on the World Health Organization (WHO) interim guidance were enrolled. A parallel systematic review/meta-analysis (in PubMed, Embase, and Web of Science) was performed. Results: A total of 504 hospitalized COVID-19 patients were included in this study, among which 101 (20.04%) patients died during hospitalization, and 372

show abstract

Nutritional screening based on objective indices at admission predicts in-hospital mortality in patients with COVID-19

Cited by 7 publications

References 32 publications

Approaches to Nutritional Screening in Patients with Coronavirus Disease 2019 (COVID-19)

Approaches to Nutritional Screening in Patients with Coronavirus Disease 2019 (COVID-19)

Impact of malnutrition on clinical outcomes in patients diagnosed with COVID‐19

Clinical significance of prognostic nutrition index in hospitalized patients with COVID‐19: Results from single‐center experience with systematic review and meta‐analysis

Contact Info

Product

Resources

About