Poor nutritional status is associated with the severity of omicron infection in the older adults

Xiaohan Gu; Yongchao Guo; Yongmei Shi; Yaxiong Lu; Shihan Yang; Yongmei Jiang; Qianwen Jin; Qing Yun Li

doi:10.1186/s12879-023-08959-6

Poor nutritional status is associated with the severity of omicron infection in the older adults

BMC Infect Dis. 2024 Jan 15;24(1):88. doi: 10.1186/s12879-023-08959-6.

Authors

Xiaohan Gu¹, Yongchao Guo¹, Yongmei Shi^{2

3}, Yaxiong Lu¹, Shihan Yang¹, Yongmei Jiang¹, Qianwen Jin¹, Qing Yun Li⁴

Affiliations

¹ Department of Clinical Nutrition, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
² Department of Clinical Nutrition, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China. sym10659@rjh.com.
³ College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China. sym10659@rjh.com.
⁴ Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China. liqingyun68@hotmail.com.

Abstract

Background: The Omicron wave of Coronavirus disease 2019 (COVID-19) remains the dominant strain worldwide. The studies of nutritional status in geriatric people with COVID-19 Omicron variant are limited. Thus, the aim of this study was to investigate the incidence of poor nutritional status among Omicron infected older patients, and to explore the correlation between the nutritional status and the severity of Omicron infection in older patients.

Methods: This is a retrospective cross-sectional study. According to the clinical symptoms, patients were divided into two groups: mild and moderate to severe. Mini Nutritional Assessment short-form (MNA-SF) was conducted when patients were admitted and poor nutritional status was defined as MNA-SF score of 0-11. The inflammatory markers including neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR) and systemic inflammatory index (SII) were calculated and compared between two groups.

Results: Total of 324 patients were enrolled, with median [interquartile range (IQR)] age of 73 (17) years. Overall, 241 cases were mild, 83 cases were moderate to severe at the time of diagnosis and that 54.3% of patients had poor nutritional status. Patients with poor nutritional status were found to be older (P < 0.001) and less vaccinated (P < 0.001), with a longer virus shedding duration (P = 0.022), more comorbidities (≥ 2) (P = 0.004) and higher value of NLR (P < 0.001), PLR (P < 0.001) and SII (P = 0.012). Vaccination, cycle threshold value in ORF1ab gene (OR CT value) and female, higher MNA-SF score was negatively connected with probability of moderate to severe infection. For every 1 score increase in MNA-SF, the odds ratio of moderate to severe infection decreased by 14.8% [adjusted odds ratio (aOR), 0.852; 95% confidence interval (CI): 0.734-0.988; P = 0.034].

Conclusions: Older patients with poor nutritional status are more likely to develop moderate to severe Omicron infection.

Keywords: Coronavirus Disease 2019 (COVID-19); Disease severity; Nutritional status; Omicron.

MeSH terms

Aged
COVID-19* / epidemiology
Cross-Sectional Studies
Female
Humans
Malnutrition* / epidemiology
Nutrition Assessment
Nutritional Status
Retrospective Studies