A high neutrophil to lymphocyte ratio at ICU admission is associated with nutritional risk in COVID-19 patients

Link to article at PubMed

JPEN J Parenter Enteral Nutr. 2021 Dec 27. doi: 10.1002/jpen.2318. Online ahead of print.


BACKGROUND: Inflammation plays a crucial role in nutritional status and can be useful in early nutritional risk screening of patients during the COVID-19 pandemic. Thus, this study aimed to assess the association between systemic inflammatory markers and nutritional risk tools in ICU patients with COVID-19.

METHODS: Patients with confirmed COVID-19 and admitted to the ICU were enrolled in a retrospective, observational, cross-sectional study. The median of C-reactive protein (CRP ≥13.8 mg/dL) and the neutrophil-to-lymphocyte ratio (NLR ≥12.6) upon admission were used to dichotomize patients.

RESULTS: Of the 73 patients, 63% were men; the average age was 56 years, and the median length of hospital stay was 10 (25th : 4 and 75th : 17) days. When nutrition risk screening tools were used, 85% were at risk according to Nutritional Risk Screening (i.e., NRS ≥3), whereas 42% had high risk according to Nutrition Risk in the Critically Ill (mNUTRIC ≥5), and 57% were moderately or severely malnourished according to the Subjective Global Assessment (SGA, B/C). Mortality was higher in the NLR ≥12.6 group than NLR<12.6, with no difference between CRP groups. A significant association was found only between NLR and mNUTRIC, even when adjusted by sex, age, and BMI (OR: 1.36, 95%CI:1.06-1.76, p=0.016), but not between CRP and nutritional risk.

CONCLUSION: Although the inflammatory marker CRP is the most used in hospital clinical practice, we found that only NLR was associated with the nutritional risk (NUTRIC score). This article is protected by copyright. All rights reserved.

PMID:34961953 | DOI:10.1002/jpen.2318

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