Influence of nutritional status on clinical outcomes among hospitalized patients with COVID-19

Clin Nutr ESPEN. 2021 Jun:43:223-229. doi: 10.1016/j.clnesp.2021.04.013. Epub 2021 Apr 29.

Abstract

Background and aims: Several factors that worsen the prognosis of the new coronavirus SARS-CoV-2 have been identified, such as obesity or diabetes. However, despite that nutrition may change in a lockdown situation, little is known about the influence of malnutrition among subjects hospitalized due to COVID-19. Our study aimed to assess whether the presence of malnutrition among patients admitted due to COVID-19 had any impact on clinical outcomes compared with patients with the same condition but well nourished.

Methods: 75 patients admitted to hospital due to COVID-19 were analyzed cross-sectionally. Subjective Global Assessment (SGA) was completed by phone interview. Clinical parameters included were extracted from the electronic medical record.

Results: According to the SGA, 27 admitted due to a COVID-19 infection had malnutrition. Patients not well nourished were older than patients with a SGA grade A (65 ± 14.1 vs 49 ± 15.1 years; p < 0.0001). Length of hospital stay among poorly nourished patients was significantly higher (18.4 ± 15.6 vs 8.5 ± 7.7 days; p = 0.001). Mortality rates and admission to ICU were greater among subjects with any degree of malnutrition compared with well-nourished patients (7.4% vs 0%; p = 0.05 and 44.4% vs 6.3%; p < 0.0001). CRP (120.9 ± 106.2 vs 60.8 ± 62.9 mg/l; p = 0.03), D-dimer (1516.9 ± 1466.9 vs 461.1 ± 353.7 ng/mL; p < 0.0001) and ferritin (847.8 ± 741.1 vs 617.8 ± 598.7mcg/l; p = 0.03) were higher in the group with malnutrition. Haemoglobin (11.6 ± 2.1 vs 13.6 ± 1.5 g/dl; p < 0.0001) and albumin 3.2 ± 0.7 vs 4.1 ± 0.5 g/dl; p < 0.0001) were lower in patients with any degree of malnutrition.

Conclusions: The presence of a poor nutritional status is related to a longer stay in hospital, a greater admission in the ICU and a higher mortality.

Keywords: COVID-19; Malnutrition; SARS-CoV-2; SGA.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Albumins / metabolism
  • C-Reactive Protein / metabolism
  • COVID-19* / mortality
  • Communicable Disease Control / methods
  • Cross-Sectional Studies
  • Female
  • Ferritins / blood
  • Hemoglobins / metabolism
  • Hospital Mortality*
  • Hospitalization*
  • Humans
  • Intensive Care Units*
  • Length of Stay*
  • Male
  • Malnutrition / complications*
  • Malnutrition / mortality
  • Malnutrition / therapy
  • Middle Aged
  • Nutrition Assessment
  • Nutritional Status*
  • Pandemics
  • Prognosis
  • SARS-CoV-2
  • Severity of Illness Index

Substances

  • Albumins
  • Hemoglobins
  • C-Reactive Protein
  • Ferritins