Evaluation of Nutritional Risk and its Association With Mortality Risk in Severe and Critically Ill COVID-19 Patients

Link to article at PubMed

Zhao X, et al. JPEN J Parenter Enteral Nutr 2020.

ABSTRACT

BACKGROUND: The nutritional status of COVID-19 patients is unknown. This study evaluates the clinical and nutritional characteristics of severe and critically ill patients infected with SARS-CoV-2, and investigates the relationship between nutritional risk and clinical outcomes.

METHODS: A retrospective, observational study was conducted at West Campus of Union Hospital in Wuhan. Patients confirmed with SARS-CoV-2 infection by a nucleic acid-positive test and identified as severe or critically ill, were enrolled in this study. Clinical data and outcomes information was collected and nutritional risk was assessed by using Nutritional Risk Screening 2002 (NRS).

RESULTS: Totally, 413 patients were enrolled in this study, including 346 severe patients and 67 critically ill patients. Most patients, especially critically ill patients, had significant changes in nutrition-related parameters and inflammatory markers. As for nutritional risk, the critically ill patients had significantly higher proportion of high NRS scores (P<0.001), which were correlated with inflammatory and nutrition-related markers. Among 342 patients with NRS score ≥3, only 84 (25%) received nutritional support. The critically ill patients and the patients with higher NRS score had a higher risk of mortality and longer stay in hospital. In logistic regression models, one unit increased in NRS score was associated with the risk of mortality increased by 1.23 times (adjusted OR = 2.23, 95% CI: 1.10, 4.51, P = 0.026).

CONCLUSIONS: Most severe and critically ill patients infected with SARS-CoV-2 are at nutritional risk. The patients with higher nutrition risk have worse outcome, and require nutritional therapy. This article is protected by copyright. All rights reserved.

PMID:32613660 | DOI:10.1002/jpen.1953

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