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Souza JS, Giglio BM, Lobo PCB, Araújo VA, Pimentel GD. Weak association between urea-creatinine ratio and c-reactive protein with nutritional risk in hospitalized patients with COVID-19: A cross-sectional study. Clin Nutr ESPEN 2024; 63:676-680. [PMID: 39089653 DOI: 10.1016/j.clnesp.2024.07.1053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Revised: 07/12/2024] [Accepted: 07/26/2024] [Indexed: 08/04/2024]
Abstract
BACKGROUND COVID-19 is a systemic infection with a significant impact on nutrition risk and the hematopoietic system. The neutrophil-lymphocyte ratio (NLR) may have prognostic value in determining severe cases of COVID-19 and the urea-creatinine ratio (UCR) is currently being studied as a potential biomarker of catabolism associated with critical illness. The aim was to assess the association between the NLR, UCR and C-reactive protein (CRP) with nutritional risk in hospitalized patients with COVID-19. METHODS This is a retrospective cross-sectional study that assessed 589 hospitalized patients with COVID-19, 18 years of age or older, of both sexes. Nutritional risk was assessed by Nutritional Risk Screening (NRS, 2002) and NLR by neutrophils divided by lymphocyte count. The UCR was calculated by the ratio between urea and creatinine and quantified by the calorimetric biochemical method and CRP by the immunoturbidimetric method. Differences between groups were applied by the Mann-Whitney U test and the automated binary regression test. RESULTS Of the 589 patients, 87.4% were at nutritional risk. When evaluating patients admitted to the ICU, 91.9% were at nutritional risk. Patients with NRS ≥3 are older, with lower body mass and BMI, higher NLR and UCR and lower CRP values. However, 73% of patients admitted to the ward were at nutritional risk, and only age differed between groups, being higher in patients with NRS ≥3. Logistic regression showed a weak association between nutritional risk in NRS and UCR (Model 1) (OR = 0.96, 95%CI: 0.94-0.99, p = 0.003) and NRS with CRP (Model 1) (OR = 1.01, 95%CI: 1.00-1.02, p < 0.001) in patients in the ICU. On the other hand, the logistic regression in ward patients found association only for CRP in both models (Model 1, OR = 1.01, 95%CI: 1.00-1.01, p = 0.041) and (Model 2, OR = 1.01, 95%CI: 1.00-1.01, p = 0.031). CONCLUSION We found a weak association between nutritional risk and UCR and CRP levels in patients admitted to the ICU, while in the ward patients the nutritional risk also had weak association with CRP.
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Affiliation(s)
| | - Bruna M Giglio
- Faculty of Nutrition, Federal University of Goiás, Goiânia, Brazil
| | | | - Vanessa A Araújo
- Faculty of Nutrition, Federal University of Goiás, Goiânia, Brazil
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Miyata H, Tsunou A, Hokotachi Y, Amagai T. A Novel Facet of In-Hospital Food Consumption Associated with Hospital Mortality in Patients with Scheduled Admission-Addition of a Study Protocol to Test the Existence of Effects of COVID-19 in the Same Study in the Post-COVID-19 Period. Nutrients 2024; 16:2327. [PMID: 39064770 PMCID: PMC11280368 DOI: 10.3390/nu16142327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2024] [Revised: 07/15/2024] [Accepted: 07/16/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND Humankind has faced unexperienced pandemic events since 2020. Since the COVID-19 pandemic has calmed down, we felt the need to verify whether in-hospital mortality had worsened compared to pre-pandemic conditions due to the COVID-19 pandemic. OBJECTIVE To test the hypothesis that daily food consumption is associated with in-hospital mortality during hospitalization and to provide baseline data to examine whether the effects of COVID-19 exist or not in post-pandemic period. METHODS All hospitalized patients staying in a single institution on the third Thursday of May, August, November, and the following February were included. Compared data: (1) among four seasons, (2) between age < 75 vs. ≥75 years, (3) between <75% vs. ≥75% of in-hospital food, and (4) logistic regression analysis to identify factors associated with in-hospital mortality. RESULTS In 365 inpatients, the following results were obtained: (1) no seasonality or age effect in in-hospital mortality, (2) the novel cutoff value of 75% of the hospital food requirement was used to identify poor in-hospital survivors, (3) logistic regression analysis showed low food consumption, with <75% of the hospital food requirement as the predictor of high in-hospital mortality. CONCLUSIONS A small eater of in-hospital food < 75% during hospitalization was associated with significantly higher in-hospital mortality in patients with scheduled hospitalization in the pre-pandemic period. Then, a study protocol is proposed to test the existence of the effects of COVID-19 in the same study in the post-COVID-19 period. This study protocol is, to our knowledge, the first proposal to test the effects of food consumption in the post-COVID-19 period on in-hospital mortality in the clinical nutritional areas.
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Affiliation(s)
- Hiroyo Miyata
- Administration Food Sciences and Nutrition Major (Doctoral Program), Graduate School of Human Environmental Sciences, Mukogawa Women’s University, Nishinomiya 663-8558, Japan; (H.M.); (A.T.); (Y.H.)
- Department of Clinical Nutrition, Kindai University Hospital, Osaka 589-8511, Japan
| | - Ayako Tsunou
- Administration Food Sciences and Nutrition Major (Doctoral Program), Graduate School of Human Environmental Sciences, Mukogawa Women’s University, Nishinomiya 663-8558, Japan; (H.M.); (A.T.); (Y.H.)
- Department of Clinical Nutrition, Kitauwa Hospital, Uwajima 798-1392, Japan
| | - Yoko Hokotachi
- Administration Food Sciences and Nutrition Major (Doctoral Program), Graduate School of Human Environmental Sciences, Mukogawa Women’s University, Nishinomiya 663-8558, Japan; (H.M.); (A.T.); (Y.H.)
- Department of Clinical Nutrition, Takarazuka Dai-Ichi Hospital, Takarazuka 665-0832, Japan
| | - Teruyoshi Amagai
- Department of Clinical Engineering, Faculty of Health Care Sciences, Jikei University of Health Care Sciences, Osaka 532-0003, Japan
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Flores-López A, Quiroz-Olguin G, González-Garay AG, Serralde-Zúñiga AE. It is not just about prescription. A cohort study of the impact of enteral nutrition on mortality of hospitalized patients with COVID-19. NUTR HOSP 2024; 41:11-18. [PMID: 37929849 DOI: 10.20960/nh.04828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023] Open
Abstract
Introduction Introduction: during COVID-19 pandemic, international societies released guidelines and recommendations for patients requiring nutritional support according to previous similar respiratory diseases. Objectives: the aim of the study was to evaluate the nutritional support provided by enteral nutrition (EN) in patients with COVID-19 infection, identify if the recommendations from international societies were met and their impact on mortality rate. Methods: a cohort study was conducted on adult patients with COVID-19 admitted to a tertiary hospital. Demographic, clinical, biochemical, and nutritional variables were obtained. A random-effect parametric survival-time model was performed to quantify the risk of death for each variable, and the Hausman test was used to confirm the model. Results: two hundred and twenty-nine patients were enrolled. The delivered energy was > 80 % of adequacy in the first two days, as suggested by international guidelines (11.7 ± 4.9 kcal/kg); however, an adequacy rate less than 60 % was achieved on day 14 (25.4 ± 7.4 kcal/kg). The protein adequacy was > 75 % on the first days of infusion (1.3 ± 0.3 g/kg); however, the infusion was < 50 % (1.5 ± 0.4 g/kg) after being extubated. Age, sex, and nutritional risk were related to higher mortality in patients with EN, whereas the infused energy and protein, the percentage of protein adequacy, arginine, and n-3 PUFA were associated with lower mortality. Conclusion: achieving at least 80 % of the energy and protein requirements, as well as n-3 PUFA and arginine supplementation could be associated with lower mortality in COVID-19 patients. More studies are needed to confirm the role of these nutrients on the mortality rate.
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Affiliation(s)
- Adriana Flores-López
- Servicio Nutriología Clínica. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán
| | | | | | - Aurora E Serralde-Zúñiga
- Servicio Nutriología Clínica. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán
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Zhou Y, Chen Y, Zhang X, Zhao B, Gao F, Yuan X, Zhu Y, Liu D. Nutritional risk and a high NRS2002 score are closely related to disease progression and poor prognosis in patients with COVID-19. Front Nutr 2023; 10:1089972. [PMID: 37125047 PMCID: PMC10130536 DOI: 10.3389/fnut.2023.1089972] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 03/20/2023] [Indexed: 05/02/2023] Open
Abstract
Background Organism can lead to excessive nutrient consumption in the infected state and increase nutritional risk, which is detrimental to the control of the infection and can further aggravate the disease. Objectives To investigate the impact of nutritional risk and the NRS2002 score on disease progression and prognosis in patients with COVID-19. Methods This was a retrospective cohort study including 1,228 COVID-19 patients, who were divided into a with-nutritional risk group (patients with NRS2002 score ≥ 3) and a without-nutritional risk group (patients with NRS2002 score < 3) according to the NRS2002 score at admission. The differences in clinical and outcome data between the two groups were compared, and the relationship between the NRS2002 score and the disease progression and prognosis of COVID-19 patients was assessed. Results Of 1,228 COVID-19 patients, including 44 critical illness patients and 1,184 non-critical illness patients, the rate of harboring nutritional risk was 7.90%. Compared with those in the without-nutritional risk group, patients in the with-nutritional risk group had a significantly longer coronavirus negative conversion time, significantly lower serum albumin (ALB), total serum protein (TP) and hemoglobin (HGB) at admission, discharge or 2 weeks, a significantly greater proportion with 3 or more comorbidities, and a significantly higher rate of critical illness and mortality (all p < 0.001). Multiple regression analysis showed that nutritional risk, NRS2002 score and ALB at admission were risk factors for disease severity. In addition, nutritional risk, NRS2002 score and TP at admission were risk factors for prognosis. The NRS2002 score showed the best utility for predicting critical illness and death in COVID-19 patients. Conclusion Nutritional risk and a high NRS2002 score are closely related to disease progression and poor prognosis in COVID-19 patients. For patients with NRS2002 score > 0.5, early intervention of malnutrition is needed to reduce the occurrence of critical disease. Additionally, for patients with NRS2002 score > 5.5, continuous nutritional support therapy is needs to reduce mortality and improve prognosis.Clinical Trial registration: [https://www.chictr.org.cn/historyversionpub.aspx?regno=ChiCTR2000034563], identifier [Chinese Clinical Trial Register ChiCTR2000034563].
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Affiliation(s)
- Yuanyuan Zhou
- Department of Internal Medicine, Public Health and Clinical Center of Chengdu, Chengdu, China
- School of Public Health, Chengdu Medical College, Chengdu, China
| | - Yi Chen
- Department of Internal Medicine, Public Health and Clinical Center of Chengdu, Chengdu, China
| | - Xinyi Zhang
- Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China
| | - Bennan Zhao
- Department of Internal Medicine, Public Health and Clinical Center of Chengdu, Chengdu, China
| | - Fengjiao Gao
- Department of Internal Medicine, Public Health and Clinical Center of Chengdu, Chengdu, China
| | - Xiaoyan Yuan
- Department of Internal Medicine, Public Health and Clinical Center of Chengdu, Chengdu, China
| | - Yanfeng Zhu
- School of Public Health, Chengdu Medical College, Chengdu, China
- *Correspondence: Yanfeng Zhu,
| | - Dafeng Liu
- Department of Internal Medicine, Public Health and Clinical Center of Chengdu, Chengdu, China
- Dafeng Liu,
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da Silva CL, Sousa TMM, de Sousa Junior JB, Nakano EY. Nutritional factors associated with mortality in hospitalized patients with COVID-19. CLINICAL NUTRITION OPEN SCIENCE 2022; 45:17-26. [PMID: 36035064 PMCID: PMC9391077 DOI: 10.1016/j.nutos.2022.08.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 08/12/2022] [Indexed: 12/04/2022] Open
Abstract
Background & aims Malnutrition is a risk factor that can lead to diminished physical and mental function and impaired clinical outcome from diseases. This study was performed to investigate the influence of nutritional characteristics, age and the presence of pre-comorbidities in hospital mortality or medical discharge in a sample of hospitalized patients with COVID-19. Methods This historical cohort study was conducted in adults and elderly patients with COVID-19 who were admitted to a nursing ward at the University Hospital of Brasilia (Brazil). Data regarding demographics, comorbidities, laboratory parameters, nutritional characteristics (NRS 2002, SARC-F, BMI) and discharge or death were retrospectively extracted from medical records. Differences in each group (in-hospital mortality or discharge) were assessed using unpaired Student's t test for continuous variables, or Pearson Chi-square tests for categorical data. Results A total of 222 patients with COVID-19 were enrolled in this study. Nutritional risk and sarcopenia risk were higher in patients who died compared to patients who were discharged (3.55 ± 1.30 vs 2.96 ± 1.30; p = 0.005, 6.81 ± 1.84 vs 4.96 ± 2.95; p < 0.001, respectively). BMI, albumin, and total protein were lower in mortality group than in the discharge group (25.10 ± 5.46 vs 27.82 ± 6.76; p = 0.009, 2.81 ± 0.62 vs 3.27 ± 0.53; p < 0.001, 6.08 ± 0.87 vs 6.48 ± 0.86; p = 0.007, respectively). The mean age between groups was also different with a higher age in the mortality group (70.24 ± 16.23) than in the discharge group (60.54 ± 16.57). Conclusions Uses of validated tools to identify risk for malnutrition and sarcopenia would be beneficial in hospitalized patients with COVID-19 in order to optimize the treatment between them.
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Affiliation(s)
- Clíslian Luzia da Silva
- University of Brasília, University Hospital of Brasília, Sector of Big Areas North 605 - Asa Norte, Brasília, DF, 70840-901, Brazil
| | - Thaís Muniz Montalvão Sousa
- University of Brasília, University Hospital of Brasília, Sector of Big Areas North 605 - Asa Norte, Brasília, DF, 70840-901, Brazil
| | - Josimar Barbosa de Sousa Junior
- University of Brasília, University Hospital of Brasília, Sector of Big Areas North 605 - Asa Norte, Brasília, DF, 70840-901, Brazil
| | - Eduardo Yoshio Nakano
- University of Brasília, Department of Statistics, University of Brasília - CIC Building Est Campus Darcy Ribeiro - Asa Norte, Brasília, DF, 70910-900, Brazil
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Hung KC, Ko CC, Wang LK, Liu PH, Chen IW, Huang YT, Sun CK. Association of Prognostic Nutritional Index with Severity and Mortality of Hospitalized Patients with COVID-19: A Systematic Review and Meta-Analysis. Diagnostics (Basel) 2022; 12:diagnostics12071515. [PMID: 35885421 PMCID: PMC9322949 DOI: 10.3390/diagnostics12071515] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 06/17/2022] [Accepted: 06/19/2022] [Indexed: 01/08/2023] Open
Abstract
The associations of prognostic nutritional index (PNI) with disease severity and mortality in patients with coronavirus disease 2019 (COVID-19) remain unclear. Electronic databases, including MEDLINE, EMBASE, Google scholar, and Cochrane Library, were searched from inception to 10 May 2022. The associations of PNI with risk of mortality (primary outcome) and disease severity (secondary outcome) were investigated. Merged results from meta-analysis of 13 retrospective studies (4204 patients) published between 2020 and 2022 revealed a lower PNI among patients in the mortality group [mean difference (MD): −8.65, p < 0.001] or severity group (MD: −5.19, p < 0.001) compared to those in the non-mortality or non-severity groups. A per-point increase in PNI was associated with a reduced risk of mortality [odds ratio (OR) = 0.84, 95% CI: 0.79 to 0.9, p < 0.001, I2 = 67.3%, seven studies] and disease severity (OR = 0.84, 95% CI: 0.77 to 0.92, p < 0.001, I2 = 83%, five studies). The pooled diagnostic analysis of mortality yielded a sensitivity of 0.76, specificity of 0.71, and area under curve (AUC) of 0.79. Regarding the prediction of disease severity, the sensitivity, specificity, and AUC were 0.8, 0.61, and 0.65, respectively. In conclusion, this study demonstrated a negative association between PNI and prognosis of COVID-19. Further large-scale trials are warranted to support our findings.
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Affiliation(s)
- Kuo-Chuan Hung
- Department of Anesthesiology, Chi Mei Medical Center, Tainan City 71004, Taiwan; (K.-C.H.); (L.-K.W.)
- Department of Hospital and Health Care Administration, College of Recreation and Health Management, Chia Nan University of Pharmacy and Science, Tainan City 71710, Taiwan
| | - Ching-Chung Ko
- Department of Medical Imaging, Chi Mei Medical Center, Tainan City 71004, Taiwan;
- Department of Health and Nutrition, Chia Nan University of Pharmacy and Science, Tainan City 71710, Taiwan
- Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung City 80424, Taiwan
| | - Li-Kai Wang
- Department of Anesthesiology, Chi Mei Medical Center, Tainan City 71004, Taiwan; (K.-C.H.); (L.-K.W.)
- Department of Hospital and Health Care Administration, College of Recreation and Health Management, Chia Nan University of Pharmacy and Science, Tainan City 71710, Taiwan
| | - Ping-Hsin Liu
- Department of Anesthesiology, E-Da Hospital, Kaohsiung City 82445, Taiwan;
| | - I-Wen Chen
- Department of Anesthesiology, Chi Mei Hospital, Liouying, Tainan City 710402, Taiwan
- Correspondence: (I.-W.C.); (Y.-T.H.); (C.-K.S.)
| | - Yen-Ta Huang
- Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan City 70101, Taiwan
- Correspondence: (I.-W.C.); (Y.-T.H.); (C.-K.S.)
| | - Cheuk-Kwan Sun
- Department of Emergency Medicine, E-Da Hospital, Kaohsiung City 82445, Taiwan
- College of Medicine, I-Shou University, Kaohsiung City 84001, Taiwan
- Correspondence: (I.-W.C.); (Y.-T.H.); (C.-K.S.)
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Ahmadi S, Firoozi D, Dehghani M, Zare M, Mehrabi Z, Ghaseminasab-Parizi M, Masoumi SJ. Evaluation of Nutritional Status of Intensive Care Unit COVID-19 Patients Based on the Nutritional Risk Screening 2002 Score. Int J Clin Pract 2022; 2022:2448161. [PMID: 36320896 PMCID: PMC9592191 DOI: 10.1155/2022/2448161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 09/21/2022] [Accepted: 10/12/2022] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Patients with COVID-19 are susceptible to malnutrition, which is particularly concerning among critically ill patients. We evaluated the Nutritional Risk Screening 2002 (NRS-2002) score in such patients and determined its relationship with the hospitalization outcome. METHODS This cross-sectional study involved COVID-19 patients admitted to the intensive care units (ICUs) of Shahid Faghihi Hospital, Shiraz, Iran, between February and March 2021. We assessed the nutritional status using NRS-2002 and determined disease severity with the APACHE II index. Demographic information, weight, height, clinical signs, previous illness, medications, biochemical test results, and history of anorexia and weight loss were recorded. Data were analyzed using SPSS version 18. RESULTS The mean age of 100 patients was 55.36 ± 18.86 years. According to NRS-2002, 30%, 29%, and 41% of patients were at low risk, moderate risk, and high risk of malnutrition, respectively. Age and BUN increased significantly with NRS-2002, while albumin and hematocrit followed the opposite trend (P < 0.001). Patients who died had lower albumin and hematocrit levels but higher age, NRS-2002 scores, and BUN/creatinine levels than those who recovered. Multivariable logistic regression revealed that for every unit increase in the NRS-2002 score, the odds of mortality increased by 354% (OR: 4.54, CI: 1.48, 13.95, P=0.008). CONCLUSION NRS-2002 is a valuable prognostic tool for critically ill COVID-19 patients, with each unit's rise in the score being associated with a 354% rise in the odds of mortality. Increased malnutrition risk was linked with higher age and BUN and lower albumin and hematocrit levels.
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Affiliation(s)
- Sedigheh Ahmadi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Donya Firoozi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Dehghani
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Morteza Zare
- Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zeinab Mehrabi
- Department of Internal Disaease, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Ghaseminasab-Parizi
- Department of Health Education and Health Promotion, School of Health, Occupational Environment Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Seyed Jalil Masoumi
- Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Center for Cohort Study of SUMS Employees' Health, Shiraz University of Medical Sciences, Shiraz, Iran
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Alikiaii B, Heidari Z, Fazeli A, Rahimi Varposhti M, Moradi Farsani D, Fattahpour S, Rafiee S, Bagherniya M. Evaluation of the effectiveness of the Nutritional Risk Screening System 2002 (NRS-2002) in COVID-19 patients admitted to the intensive care unit. Int J Clin Pract 2021; 75:e14934. [PMID: 34606153 PMCID: PMC8646661 DOI: 10.1111/ijcp.14934] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 09/21/2021] [Accepted: 10/01/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Nutritional status of patients with COVID-19 can affect the recovery process of patients; however, no nutritional scale was introduced to evaluate the nutritional status of the patients. Thus, the main objective of this study was to examine the usefulness of Nutritional status-2002 (NRS-2002) among COVID-19 patients admitted to the intensive care unit (ICU). MATERIAL AND METHODS In this cross-sectional study, 73 patients with definitive corona diagnosis admitted to the ICUs of Al-Zahra hospital, Isfahan, Iran in October 2020 to January 2021 were recruited. Dietary intake, NRS-2002, demographic, anthropometric and biochemical indices of patients were recorded. RESULTS The majority of patients were at risk for moderate (69.9%) to severe (12.3%) malnutrition. Daily calorie intake (P = .001) and albumin (P = .001) levels in deceased patients were significantly lower than the recovered group. A direct correlation between NRS-2002 and age (P < .001) and an inverse correlation with daily calorie intake (P = .002), albumin (P = .05) and PaO2 (P = .034) was found. Moreover, there is a strong correlation between NRS-2002 score and chance of death among COVID-19 patients (OR=34.5, 95%CI:(5.2 - 228.93), P-value<0.001). Likewise, the levels of bilirubin direct (OR=8, 95%CI:(1.30 - 49.38), P-value=0.025) and creatine-phosphokinase (OR=0.9, 95%CI:(0.99 - 1.00), P-value=0.035) have a significant direct association with chance of death. CONCLUSION Results showed patients with COVID-19 admitted to the ICU did not have appropriate nutritional status and mortality was higher among patients with lower amounts of the serum albumin and daily calorie intakes. Furthermore, there is a strong association between the NRS-2002 index and the chance of mortality in these patients.
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Affiliation(s)
- Babak Alikiaii
- Anesthesia and Critical Care Research CenterIsfahan University of Medical SciencesIsfahanIran
| | - Zahra Heidari
- Department of Biostatistics and EpidemiologySchool of HealthIsfahan University of Medical SciencesIsfahanIran
- Isfahan Cardiac Rehabilitation Research CenterCardiovascular Research InstituteIsfahan University of Medical SciencesIsfahanIran
| | - Afshar Fazeli
- Anesthesia and Critical Care Research CenterIsfahan University of Medical SciencesIsfahanIran
| | | | - Darioush Moradi Farsani
- Anesthesia and Critical Care Research CenterIsfahan University of Medical SciencesIsfahanIran
| | - Shirin Fattahpour
- Craniofacial and Cleft Research CenterIsfahan University of Medical SciencesIsfahanIran
| | - Sahar Rafiee
- Food Security Research CenterIsfahan University of Medical SciencesIsfahanIran
- Department of Community NutritionSchool of Nutrition and Food ScienceIsfahan University of Medical SciencesIsfahanIran
| | - Mohammad Bagherniya
- Anesthesia and Critical Care Research CenterIsfahan University of Medical SciencesIsfahanIran
- Food Security Research CenterIsfahan University of Medical SciencesIsfahanIran
- Department of Community NutritionSchool of Nutrition and Food ScienceIsfahan University of Medical SciencesIsfahanIran
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