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Salehi Z, Askari M, Jafari A, Ghosn B, Surkan PJ, Hosseinzadeh-Attar MJ, Pouraram H, Azadbakht L. Dietary patterns and micronutrients in respiratory infections including COVID-19: a narrative review. BMC Public Health 2024; 24:1661. [PMID: 38907196 PMCID: PMC11193220 DOI: 10.1186/s12889-024-18760-y] [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: 02/12/2023] [Accepted: 05/02/2024] [Indexed: 06/23/2024] Open
Abstract
BACKGROUND COVID-19 is a pandemic caused by nCoV-2019, a new beta-coronavirus from Wuhan, China, that mainly affects the respiratory system and can be modulated by nutrition. METHODS This review aims to summarize the current literature on the association between dietary intake and serum levels of micronutrients, malnutrition, and dietary patterns and respiratory infections, including flu, pneumonia, and acute respiratory syndrome, with a focus on COVID-19. We searched for relevant articles in various databases and selected those that met our inclusion criteria. RESULTS Some studies suggest that dietary patterns, malnutrition, and certain nutrients such as vitamins D, E, A, iron, zinc, selenium, magnesium, omega-3 fatty acids, and fiber may have a significant role in preventing respiratory diseases, alleviating symptoms, and lowering mortality rates. However, the evidence is not consistent and conclusive, and more research is needed to clarify the mechanisms and the optimal doses of these dietary components. The impact of omega-3 and fiber on respiratory diseases has been mainly studied in children and adults, respectively, and few studies have examined the effect of dietary components on COVID-19 prevention, with a greater focus on vitamin D. CONCLUSION This review highlights the potential of nutrition as a modifiable factor in the prevention and management of respiratory infections and suggests some directions for future research. However, it also acknowledges the limitations of the existing literature, such as the heterogeneity of the study designs, populations, interventions, and outcomes, and the difficulty of isolating the effects of single nutrients from the complex interactions of the whole diet.
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Affiliation(s)
- Zahra Salehi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, IR, Iran
| | - Mohammadreza Askari
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, IR, Iran
| | - Alireza Jafari
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, IR, Iran
| | - Batoul Ghosn
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, IR, Iran
| | - Pamela J Surkan
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Mohammad Javad Hosseinzadeh-Attar
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetic, Tehran University of Medical Sciences, Tehran, Iran
- Department of Nutrition and Biochemistry, School of Public Health, Tehran University of Medical Sciences, Tehran, IR, Iran
| | - Hamed Pouraram
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, IR, Iran
| | - Leila Azadbakht
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, IR, Iran.
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, IR, Iran.
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, IR, Iran.
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Guðnadóttir SD, Gunnarsdóttir I, Hernandez UB, Ingadóttir ÁR. High risk of malnutrition among hospitalised coronavirus disease 2019 (COVID-19) patients is associated with mortality and other clinical outcomes. Clin Nutr ESPEN 2024; 61:1-7. [PMID: 38777420 DOI: 10.1016/j.clnesp.2024.02.023] [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: 07/09/2023] [Revised: 01/28/2024] [Accepted: 02/21/2024] [Indexed: 05/25/2024]
Abstract
INTRODUCTION Increasing evidence indicates an association between nutritional status and Coronavirus disease 2019 (COVID-19) disease severity. The aim of the study was to describe the risk of malnutrition, body mass index (BMI) and vitamin D status of hospitalised COVID-19 patients and assess whether they are associated with duration of hospital stay, intensive care unit (ICU) admission, mechanical ventilation, and mortality. METHODS The study is a descriptive retrospective study of 273 patients with COVID-19 admitted to Hospital from February 2020 to March 2021. Patients were screened for risk of malnutrition using a validated screening tool. BMI was calculated from height and weight. Insufficient Vitamin D status was defined as 25(OH)vitD <50 nmol/L. Logistic regression analysis was used to assess the association between indicators of nutritional status of patients with COVID-19, and outcomes such as duration of stay >7 days, ICU admission, mechanical ventilation, and mortality. Interaction between risk of malnutrition and BMI of ≥30 kg/m2 was assessed using the likelihood ratio test with hospital stay, ICU admission, mechanical ventilation, and mortality as outcomes. RESULTS Screening for risk of malnutrition identified 201 (74%) patients at a medium to high risk of malnutrition. Patients defined as being at a medium or high risk of malnutrition were more likely to be hospitalised for >7 days compared to those defined as low risk (OR: 10.72; 95% CI: 3.9-29.46; p < 0.001 and OR: 61.57; 95% CI: 19.48-194.62; p < 0.001, respectively). All patients who were admitted to ICU (n = 41) and required mechanical ventilation (n = 27) were defined as having medium or high risk of malnutrition. High risk of malnutrition was also associated with increased odds of mortality (OR: 8.87; 955 CI 1.08-72,96; p = 0.042). BMI of ≥30 kg/m2 (43%) and 25(OH)vitD <50 nmol/L (20%) were not associated with duration of stay >7 days or mortality, although BMI ≥30 kg/m2 was associated with increased risk of ICU admission (OR: 7.12; 95% CI: 1.59-31.94; p = 0.010) and mechanical ventilation (OR: 8.86; 95% CI: 1.12-69.87; p = 0.038). Interactions between risk of malnutrition and BMI ≥30 kg/m2 were not significant to explain the outcomes of hospital stay >7 days, ICU admission, mechanical ventilation, or mortality. CONCLUSION High risk of malnutrition among hospitalised COVID-19 patients was associated with longer duration of hospital stay, ICU admission, mechanical ventilation and mortality, and BMI ≥30 kg/m2 was associated with ICU admission and mechanical ventilation. Insufficient Vitamin D status was not associated with duration of hospital stay, ICU admission, mechanical ventilation, or mortality.
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Affiliation(s)
| | - Ingibjörg Gunnarsdóttir
- Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland; Department of Clinical Nutrition, Landspitali University Hospital, Reykjavik, Iceland
| | | | - Áróra Rós Ingadóttir
- Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland; Department of Clinical Nutrition, Landspitali University Hospital, Reykjavik, Iceland
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Jima LM, Atomsa GE, Allard JP, Nigatu YD. The effect of malnutrition on adult Covid-19 patient's ICU admission and mortality in Covid-19 isolation and treatment centers in Ethiopia: A prospective cohort study. PLoS One 2024; 19:e0298215. [PMID: 38507372 PMCID: PMC10954135 DOI: 10.1371/journal.pone.0298215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 01/20/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND A new coronavirus was first identified in Wuhan, China in December 2019. Since the times of the 1918 influenza pandemic, malnutrition has been known as a risk factor for severity and mortality from viral pneumonia. Similarly, the recently identified SARS-Cov2 infection (COVID-19) and related pneumonia may be closely linked to malnutrition. Therefore, this study will contribute to new knowledge and awareness of the recording and evaluation of each COVID-19 patient's nutritional status by assessing the effect of malnutrition on ICU admission and death of COVID-19 patients in developing countries. METHOD We conducted a prospective cohort study in adult COVID-19 patients admitted to selected COVID-19 Isolation and Treatment Centers, Addis Ababa, Ethiopia. Baseline data of the patients were collected using interviewer-administered structured questionnaire and data on the adverse outcomes of follow up were extracted from follow up chart. The main clinical outcomes (ICU admission and death) were captured every week of follow up. We ran a multivariate Cox's regression analysis to determine the relationship between malnutrition at admission and its effect on ICU admission and death. RESULTS A total of 581 COVID-19 patients were enrolled. From the total of recruited patients, 346 (59.6%) were males and 235 (40.4%) were females. The mean age of the respondents was 55 years (16.45) years. The Cox proportional hazard model controlled for sex, age group, number of co-morbidities, and number of medications found that malnutrition at admission was associated with ICU admission and death. When compared to well-nourished patients, the rate of ICU admission was significantly associated and found to be higher among underweight [(adjusted hazard ratio (AHR) = 10.02, 95% CI: (8.64-12.10)] and overweight [(AHR = 7.7, 95% CI: (6.41-9.62)] patients. The rate of survival probability was significantly associated and was found to be better among well-nourished patients (AHR = 0.06, 95% CI : (0.01-0.44) when compared with malnourished COVID-19 patients. CONCLUSION Malnutrition at the time of admission was shown to increase the risk of ICU admission and mortality among COVID-19 patients. Therefore, it is vital to evaluate patients' nutritional condition early in their admission and provide timely intervention to minimize the effects on patients and the healthcare system.
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Affiliation(s)
- Lencho Mekonnen Jima
- Department of Nutrition and Dietetics, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Gudina Egeta Atomsa
- Department of Nutrition and Dietetics, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Johane P. Allard
- Department of Medicine, University Health Network, University of Toronto, Toronto, Canada
| | - Yakob Desalegn Nigatu
- Department of Nutrition and Dietetics, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
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Zhao ZW, Chen Q, Zhang XT, Luo YK. The CONUT score predicts the length of hospital stay and the risk of long COVID. NUTR HOSP 2024; 41:138-144. [PMID: 38095071 DOI: 10.20960/nh.04656] [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: 02/16/2024] Open
Abstract
Introduction Objective: the Controlling Nutritional Status (CONUT) score is an objective tool widely used to assess nutritional status of patients. We aimed to investigate the value of CONUT score on predicting length of hospital stay (LOS) and the risk of long COVID in patients with COVID-19. Methods: a total of 151 patients with COVID-19 were enrolled for analysis. Patients were followed up for two years from three months after the onset of SARS-CoV-2 infection. CONUT score was calculated on admission. The correlation between CONUT score and LOS were assessed by Spearman's rank correlation coefficient and multivariate linear analysis. The association between different CONUT grade and long COVID was evaluated by Kaplan-Meier survival curves with log-rank test and Cox proportional hazard models. Results: Spearman's rank correlation coefficient showed that CONUT scores were positively correlated with LOS (r = 0.469, p < 0.001). Multivariate linear analysis showed that CONUT score is the only independent determinant of LOS (B 2.055, 95 % CI: 1.067-3.043, p < 0.001). A total of 53 (35.10 %) patients with long COVID were identified. Kaplan-Meier cumulative survival curves and Cox proportional hazards analyses showed that the incidence of long COVID in patients with a higher CONUT score was significantly higher than in patients with lower CONUT score (p < 0.001). Conclusions: higher CONUT score predicts longer LOS and the risk of long COVID in patients with COVID-19. The CONUT score might be useful for risk stratification in COVID-19 patients and help to develop new nutritional treatment strategies for long COVID.
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Affiliation(s)
- Zi-Wen Zhao
- Department of Cardiology. Fujian Heart Medical Center. Fujian Institute of Coronary Heart Disease. Fujian Medical University Union Hospital. Fujian Medical University
| | - Qin Chen
- Department of Cardiology. Fujian Heart Medical Center. Fujian Institute of Coronary Heart Disease. Fujian Medical University Union Hospital. Fujian Medical University
| | - Xin-Tao Zhang
- Department of Cardiology. Fujian Heart Medical Center. Fujian Institute of Coronary Heart Disease. Fujian Medical University Union Hospital. Fujian Medical University
| | - Yu-Kun Luo
- Department of Cardiology. Fujian Heart Medical Center. Fujian Institute of Coronary Heart Disease. Fujian Medical University Union Hospital. Fujian Medical University
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Oliveira LCD, Rosa KSDC, Pedrosa AP, Silva NFD, Santos LAD, Maria EV. Cancer patients with COVID-19: does prior nutritional risk associated with cancer indicate a poor prognosis for COVID-19? EINSTEIN-SAO PAULO 2023; 21:eAO0172. [PMID: 36946825 PMCID: PMC10010257 DOI: 10.31744/einstein_journal/2023ao0172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 08/30/2022] [Indexed: 03/11/2023] Open
Abstract
OBJECTIVE To verify whether the presence of related nutritional risk indicators prior to COVID-19 diagnosis is associated with poor survival in patients with cancer. METHODS We retrospectively analyzed the data of hospitalized cancer patients who tested positive for COVID-19 between March 2020 and February 2021. Nutritional risk was defined as the presence of one of the following characteristics: body mass index <20kg/m 2 , scored Patient-generated Subjective Global Assessment ≥9 points or classification B, albumin level <3.5g/dL, and C-reactive protein level ≥10mg/L, evaluated between 7 and 60 days prior to the date of patient inclusion. The endpoint measure was all-cause mortality within 30 days of COVID-19 diagnosis. RESULTS A total of 253 patients were included, most of whom were elderly (62.4%) and female (63.6%). Overall, 45.4% of the patients were at nutritional risk. Survival was significantly lower in patients at nutritional risk (8 days; interquartile range [IQR]: 3-29) than in patients not at nutritional risk (16 days; IQR: 6-30) (p<0.001). The presence of prior nutritional risk was associated with increased 30-day mortality (HR: 1.42; 95%CI: 1.03-1.94), regardless of age, gender, tumor site or stage, and other risk factors, and the model had good discrimination accuracy (concordance statistic: 0.744). CONCLUSION The presence of prior nutritional risk indicators is related to poor prognosis in patients with cancer and COVID-19, emphasizing the importance of nutritional care, notably during this pandemic.
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Feng X, Liu Z, He X, Wang X, Yuan C, Huang L, Song R, Wu Y. Risk of Malnutrition in Hospitalized COVID-19 Patients: A Systematic Review and Meta-Analysis. Nutrients 2022; 14:nu14245267. [PMID: 36558436 PMCID: PMC9780808 DOI: 10.3390/nu14245267] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/26/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022] Open
Abstract
(1) Background: Studies have reported that COVID-19 may increase the risk of malnutrition among patients. However, the prevalence of such risk in hospitalized COVID-19 patients is uncertain due to the inconsistent use of assessment methods. (2) Methods: PubMed, Web of Science, and EMBASE were searched to identify studies on the nutritional status of hospitalized COVID-19 patients. A pooled prevalence of malnutrition risk evaluated by Nutrition Risk Score (NRS-2002) was obtained using a random effects model. Differences by study-level characteristics were examined by hospitalization setting, time of assessment, age, and country. Risk of bias was assessed using the Newcastle−Ottawa Scale. (3) Results: 53 studies from 17 countries were identified and summarized. A total of 17 studies using NRS-2002, including 3614 COVID-19 patients were included in the primary meta-analysis. The pooled prevalence of risk of malnutrition was significantly higher among ICU patients (92.2%, 95% CI: 85.9% to 96.8%) than among general ward patients (70.7%, 95% CI: 56.4% to 83.2%) (p = 0.002). No significant differences were found between age groups (≥65 vs. <65 years, p = 0.306) and countries (p = 0.893). (4) Conclusions: High risk of malnutrition is common and concerning in hospitalized patients with COVID-19, suggesting that malnutrition screening and nutritional support during hospitalization are needed.
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Affiliation(s)
- Xiaoru Feng
- Institute for Hospital Management, Tsinghua University, Beijing 100084, China
| | - Zeqi Liu
- Institute for Hospital Management, Tsinghua University, Beijing 100084, China
| | - Xiaotong He
- School of Labor and Human Resources, Renmin University of China, Beijing 100872, China
| | - Xibiao Wang
- Department of Occupational Hygiene Engineering, China University of Labor Relations, Beijing 100048, China
| | - Changzheng Yuan
- School of Public Health, Zhejiang University School of Medicine, Hangzhou 310058, China
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA
| | - Liyan Huang
- School of Public Health, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Rui Song
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA
| | - You Wu
- Institute for Hospital Management, Tsinghua University, Beijing 100084, China
- School of Medicine, Tsinghua University, Beijing 100084, China
- Correspondence: ; Tel.: +86-13641181601
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Baik I. Region-specific COVID-19 risk scores and nutritional status of a high-risk population based on individual vulnerability assessment in the national survey data. Clin Nutr 2022; 41:3100-3105. [PMID: 33933298 PMCID: PMC7901377 DOI: 10.1016/j.clnu.2021.02.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 02/04/2021] [Accepted: 02/12/2021] [Indexed: 01/27/2023]
Abstract
BACKGROUND & AIMS Coronavirus disease 2019 (COVID-19) is an ongoing pandemic outbreak leading to more than 1 million deaths worldwide as reported in 2020. Several risk assessment tools, including individual vulnerability to COVID-19, have been developed. The present study aimed to characterize a high-risk population using such a tool and examine risk factors and nutritional status in the national survey data and estimate the region-specific population size. METHODS The study included 17,540 Korean adults who participated in the Korea National Health and Nutrition Examination Survey (KNHANES). The risk scores for individual vulnerability to COVID-19 were calculated based on age, sex, smoking status, and comorbidities, and a high-risk population was defined as having risk scores ≥11. Nutritional status was compared between the high-risk population and the remaining participants in the KNHANES data. The region-specific population size was estimated using national statistics. RESULTS The proportion of the high-risk population was estimated to be 10.5%, which corresponds to approximately 4.6 million adults in South Korea. About 20% of them had inadequate intake of all of vitamins A, B1, B2, B3, and C below the estimated average requirement. The high-risk population showed 1.65 [95% confidence interval: 1.39, 1.96] higher odds of inadequate intake of multiple vitamins than the remaining participants. In the ecological analysis, the region-specific numbers of the high-risk population correlated significantly with the actual numbers of deaths due to COVID-19 (P value = 0.013). CONCLUSIONS These results suggest that individuals vulnerable to COVID-19, in particular those are living in densely populated regions, should pay particular attention to the protection against this pandemic and have adequate nutritional status, which may support optimal immune function.
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Affiliation(s)
- Inkyung Baik
- Department of Foods and Nutrition, College of Science and Technology, Kookmin University, 77, Jeongneung-ro, Seongbuk-gu, Seoul, 02707, Republic of Korea. Fax: +82 2 910 5249
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Alkhatib B, Al Hourani HM, Al-Shami I. Using inflammatory indices for assessing malnutrition among COVID-19 patients: A single-center retrospective study. J Infect Public Health 2022; 15:1472-1476. [PMID: 36403404 PMCID: PMC9650260 DOI: 10.1016/j.jiph.2022.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/14/2022] [Accepted: 11/08/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) causes malnutrition in infected patients. This study aimed to investigate the use of systemic immune-inflammatory index (SII), platelet-to-lymphocyte ratio (PLR), the Glasgow Prognostic Score (GPS), and neutrophil-to-lymphocyte ratio (NLR) for malnutrition assessment among COVID-19 inpatients. METHODS This is a single-center retrospective study on 108 hospitalized COVID-19 patients; 14 were admitted to the intensive care unit (ICU). Data were collected from patients' profiles while NLR, PLR, GPS, and SII were calculated. Inflammatory indices' predictive power was analyzed using the receiver operating characteristic curve (ROC). A P-value of < 0.05 was considered statistically significant. RESULTS Hospitalization days, neutrophils count, C-reactive protein (CRP), and serum urea levels were significantly higher in ICU patients. None of SII, PLR, and NLR were significantly different between ICU and non-ICU groups. Also, albumin and GPS showed a higher sensitivity level (100.0), followed by PLR and SII (78.57 and 71.34, respectively). Regarding ROC curves, even though NLR, PLR, and SII provided the largest area under the curve (AUC) (0.687, 0.682, 0.645; respectively), they have shown a poor discrimination ability, while GPS and albumin were ineffective in predicting malnutrition in COVID-19 patients. CONCLUSION NLR, SII, and PLR showed poor predicting ability for malnutrition among COVID-19 inpatients. Additional consideration should be taken for using inflammatory parameters (SII, PLR, GPS, and NLR) to predict malnutrition in COVID-19 inpatients.
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Sharif N, Opu RR, Khan A, Alzahrani KJ, Banjer HJ, Alzahrani FM, Haque N, Khan S, Soumik ST, Zhang M, Huang H, Song X, Parvez AK, Dey SK. Impact of Zinc, Vitamins C and D on Disease Prognosis among Patients with COVID-19 in Bangladesh: A Cross-Sectional Study. Nutrients 2022; 14:nu14235029. [PMID: 36501059 PMCID: PMC9737649 DOI: 10.3390/nu14235029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 11/17/2022] [Accepted: 11/24/2022] [Indexed: 11/29/2022] Open
Abstract
Vitamin C, (ascorbic acid), vitamin D (cholecalciferol) and zinc (zinc sulfate monohydrate) supplements are important in immunity against coronavirus disease-2019 (COVID-19). However, a limited number of studies have been conducted on the association of vitamins and supplements with the reduced risks of COVID-19 infection. This study aims to evaluate the association of vitamins and supplements as treatment options to reduce the severity of COVID-19. Data were collected from 962 participants from 13 December 2020 to 4 February 2021. The presence of COVID-19 was confirmed by qRT-PCR. The Chi-square test and multivariate regression analyses were conducted. The ratio of uptake of vitamin C:vitamin D:zinc was 1:1:0.95. Uptake of vitamin C, vitamin D and zinc were significantly associated with the reduced risk of infection and severity of COVID-19 (OR: 0.006 (95% CI: 0.03-0.11) (p = 0.004)) and (OR: 0.03 (95% CI: 0.01-0.22) (p = 0.005)). The tendency of taking supplements was associated with the presence of infection of COVID-19 (p = 0.001), age (p = 0.02), sex (p = 0.05) and residence (p = 0.04). The duration of supplementation and medication was significantly associated with reduced hospitalization (p = 0.0001). Vitamins C, D and zinc were not significantly (p = 0.9) associated with a reduced risk of severity when taken through the diet. Hospitalization (p = 0.000001) and access to health facilities (p = 0.0097) were significantly associated with the survival period of the participants. Participants with better access to health facilities recovered early (OR: 6.21, 95% CI 1.56-24.7). This study will add knowledge in the field of treatment of COVID-19 by using vitamins and zinc supplements.
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Affiliation(s)
- Nadim Sharif
- Department of Microbiology, Jahangirnagar University, Dhaka 1342, Bangladesh
| | - Rubayet Rayhan Opu
- Department of Microbiology, Jahangirnagar University, Dhaka 1342, Bangladesh
| | - Afsana Khan
- Department of Statistics, Jahangirnagar University, Dhaka 1342, Bangladesh
| | - Khalid J. Alzahrani
- Department of Clinical Laboratories Sciences, College of Applied Medical Sciences, Taif University, Taif 21944, Saudi Arabia
| | - Hamsa Jameel Banjer
- Department of Clinical Laboratories Sciences, College of Applied Medical Sciences, Taif University, Taif 21944, Saudi Arabia
| | - Fuad M. Alzahrani
- Department of Clinical Laboratories Sciences, College of Applied Medical Sciences, Taif University, Taif 21944, Saudi Arabia
| | - Nusaira Haque
- Department of Microbiology, Jahangirnagar University, Dhaka 1342, Bangladesh
| | - Shahriar Khan
- Department of Microbiology, Jahangirnagar University, Dhaka 1342, Bangladesh
| | | | - Ming Zhang
- Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, GA 30602, USA
| | - Hanwen Huang
- Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, GA 30602, USA
| | - Xiao Song
- Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, GA 30602, USA
| | | | - Shuvra Kanti Dey
- Department of Microbiology, Jahangirnagar University, Dhaka 1342, Bangladesh
- Correspondence: ; Tel./Fax: +880-1759588088
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Palermo Dos Santos AC, Japur CC, Passos CR, Lunardi TCP, Lovato WJ, Pena GDG. Nutritional risk, not obesity, is associated with mortality in critically ill COVID-19 patients. Obes Res Clin Pract 2022; 16:379-385. [PMID: 36041995 PMCID: PMC9395293 DOI: 10.1016/j.orcp.2022.08.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 08/04/2022] [Accepted: 08/18/2022] [Indexed: 11/29/2022]
Abstract
Background Despite the identification of obesity as a risk factor for higher rates of hospital and Intensive Care Unit (ICU) admissions and complications due to COVID-19, the association between obesity and mortality in critically ill COVID-19 patients remains controversial, and the nutritional risk is little considered. Hence, our study sought to evaluate the association between obesity, nutritional risk, and mortality in critically ill patients diagnosed with COVID-19. Methods Retrospective study were condutcted including adult critically ill COVID-19 patients admitted to an ICU between April 2020 and March 2021. Clinical and laboratory data were collected from electronic medical records. Obesity was classified by body mass index ≥ 30 kg/m2. A mNUTRIC score of ≥ 5 indicated high nutritional risk. Multiple Cox Regression was used to estimate the association between mNUTRIC, obesity, and mortality. Results From 71 patients aged 59 (± 15) years, 71.8 % were male. The frequencies of obesity (58.7 %) and death (49.3 %) were high, but obesity was not associated with mortality. Based on mNUTRIC, 85.9 % of patients were at high nutritional risk, presenting a higher frequency of mortality than patients at low nutritional risk (50.8 % vs 40.0 %; p = 0.014). Multiple Cox Regression showed that for each unit increase in mNUTRIC score the probability of death almost doubled, regardless of the presence of obesity (HR = 1.74; p < 0.001). Conclusions A higher nutritional risk was positively associated with mortality in critically ill COVID-19 patients, regardless of obesity, showing the importance of early identification of nutritional risk for appropriate nutritional interventions in this population.
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Affiliation(s)
- Ana Carolina Palermo Dos Santos
- Multiprofessional Residency Program in Urgency and Emergency of the Hospital das Clínicas of Ribeirão Preto Medical School, University of São Paulo, 1000 Bernardino de Campos Street, Ribeirão Preto, SP 14015130, Brazil.
| | - Camila Cremonezi Japur
- Division of Nutrition and Metabolism, Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, 3900 Bandeirantes Avenue, Ribeirão Preto, SP 14049900, Brazil.
| | - Clara Romanholi Passos
- Nutrition Department of the Hospital das Clínicas of Ribeirão Preto Medical School, University of São Paulo, 1000 Bernardino de Campos Street, Ribeirão Preto, SP 14015130, Brazil.
| | - Thereza Cristina Pereira Lunardi
- Nutrition Department of the Hospital das Clínicas of Ribeirão Preto Medical School, University of São Paulo, 1000 Bernardino de Campos Street, Ribeirão Preto, SP 14015130, Brazil.
| | - Wilson José Lovato
- Intensive Care Unit of the Emergency Unit of the Hospital das Clínicas of Ribeirão Preto Medical School, University of São Paulo, 1000 Bernardino de Campos Street, Ribeirão Preto, SP 14015130, Brazil.
| | - Geórgia das Graças Pena
- Graduate Program in Health Sciences, Federal University of Uberlandia, 1720 Pará Avenue, Uberlândia, MG 38405320, Brazil.
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Ting THY, Lo THM, Lo WWT, Ding Q, Yuk DKL, Hui E, Tang MWS. Inadequate energy and protein intake, underweight and malnutrition are associated with in‐hospital mortality among
COVID
‐19 rehabilitation patients during the omicron outbreak in Hong Kong. Aging Med (Milton) 2022; 5:204-210. [PMID: 36247341 PMCID: PMC9539165 DOI: 10.1002/agm2.12220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 07/28/2022] [Accepted: 08/01/2022] [Indexed: 11/15/2022] Open
Abstract
Objective Malnourished COVID‐19 patients were prone to higher mortality and longer length of stay (LOS). This study aims to investigate the malnutrition risk prevalence in the COVID‐19 patients and how other nutritional indicators are related to the clinical outcomes in a rehabilitation hospital. Methods A retrospective cross‐sectional study involved 174 COVID‐19 patients during the rehabilitation phase. Malnutrition risk, nutritional indicators, mortality, and LOS were compared among different risk groups. Albumin, nutrition intake, and body mass index (BMI) were investigated for their effects on the clinical outcomes. Results The prevalence of malnutrition risk was 94.9%; those older were higher in malnutrition risk. BMI, energy and protein intakes decreased as the malnutrition risk increased. Albumin, energy and protein intakes were lower in the death group. The high malnutrition risk group and severely underweight patients had 2.7 times and 2.2 times higher in‐hospital death, respectively. For subjects ≥75 years old, the odds ratio to death was 6.2 compared to those <75 years old. Conclusion We observed a high malnutrition risk of 94.9% in COVID‐19 patients. Patients with malnutrition risk had a lower BMI, lower nutritional intake, and a higher chance of in‐hospital death. These results reinforced the importance of nutrition management in COVID‐19 patients.
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Affiliation(s)
| | | | | | - Qi Ding
- Department of Medicine and Geriatrics Shatin Hospital Hong Kong China
| | - Daniel Ka Lok Yuk
- Department of Medicine and Geriatrics Shatin Hospital Hong Kong China
| | - Elsie Hui
- Department of Medicine and Geriatrics Shatin Hospital Hong Kong China
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12
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Tetamo R, Fittipaldi C, Buono S, Umbrello M. Nutrition support for critically ill patients during the COVID-19 pandemic: the Italian SIAARTI survey. JOURNAL OF ANESTHESIA, ANALGESIA AND CRITICAL CARE 2022. [PMCID: PMC9361260 DOI: 10.1186/s44158-022-00063-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Background
Critically ill, COVID-19 patients are characterized by a hypermetabolic state and a reduced food intake and are at high risk of malnutrition and lean body mass loss. An appropriate metabolic-nutritional intervention aims to reduce complications and improve the clinical outcomes. We conducted a cross-sectional, multicenter, observational, nationwide online survey involving Italian Intensivists to assess the nutritional practices in critically ill patients with COVID-19. Results A group of experts in nutrition of the Italian Society of Anaesthesia Analgesia Resuscitation and Intensive Care (SIAARTI) developed a 24-item questionnaire; the 9000 members of the Society were invited to participate through emails and social networks. Data was collected from June 1 to August 1, 2021. A total of 545 responses were collected: 56% in northern, 25% in central, and 20% in southern Italy. Artificial nutrition support is directly handled by intensivists in > 90 of the cases; the nutritional status is assessed as suggested by the guidelines in more than 70% of the cases, and a form of nutrition support is started within the first 48 h from ICU admission by > 90% of the respondents. Nutritional targets are reached in 4–7 days in > 75% of the cases, mainly by the enteral route. Indirect calorimetry, muscle ultrasound, and bioimpedance analysis are used by a limited part of the interviewees. Only about a half of the respondents reported the nutritional issues in the ICU discharge summary. Conclusions This survey among Italian Intensivists during the COVID-19 epidemic showed how the beginning, progression, and route of nutritional support adhere to international recommendations, while recommendations on the tools to set the target and monitor the efficacy of the metabolic support are less followed. Supplementary Information The online version contains supplementary material available at 10.1186/s44158-022-00063-6.
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13
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A Crisis within a Crisis: COVID-19 and Hidden Hunger. JOURNAL OF BASIC AND CLINICAL HEALTH SCIENCES 2022. [DOI: 10.30621/jbachs.1101717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The coronavirus (Covid-19), which was recognized in December 2019 and quickly became a worldwide pandemic, has become a significant public health problem. When it comes to the immune and infectious diseases, effects of nutrition on the inflammatory system cannot be ignored. Micronutrients, including vitamins and minerals, are critical to a well-functioning immune system and vital in supporting nutritional and health well-being. However, there are serious vitamin and mineral deficiencies worldwide known as "Hidden Hunger". It is thought that need for micronutrients in nutrition may increase especially during Covid-19 pandemic process. Therefore, it is essential to take precautions regarding the formation of hidden hunger. While the underlying determinants and complexity of malnutrition have been better understood through years of research, these researches have been limited in scaling, developing and implementing nutrition and food system approaches closely related to sustainable agriculture targeting food diversity and livelihoods.. In this review, the Covid-19 pandemic and its interactions with health, environment, food and their relationship to chronic micronutrient deficiencies, known as 'hidden hunger,' which affected more than two billion people worldwide, are evaluated.
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Aktan A, Güzel T, Demir M, Özbek M. The effect of nutritional scores on mortality in COVID-19 patients. Rev Assoc Med Bras (1992) 2022; 68:1096-1102. [PMID: 36134839 PMCID: PMC9574980 DOI: 10.1590/1806-9282.20220577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 05/27/2022] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES: While studies on the treatment for the coronavirus disease 2019 (COVID-19) pandemic continue all over the world, factors that increase the risk of severe disease have also been the subject of research. Malnutrition has been considered an independent risk factor. Therefore, we aimed to investigate the clinical effect of dietary habits and evaluate the prognostic value of the Controlling Nutritional Status score in the COVID-19 patients we followed up. METHODS: A total of 2760 patients hospitalized for COVID-19 were examined. Patients were retrospectively screened from three different centers between September 1 and November 30, 2020. A total of 1488 (53.9%) patients who met the criteria were included in the study. Risk classifications were made according to the calculation methods of prognostic nutritional index and Controlling Nutritional Status scores and total scores. The primary outcome of the study was in-hospital mortality. RESULTS: The groups with severe Controlling Nutritional Status and prognostic nutritional index scores had a significantly higher mortality rate than those with mild scores. In the multivariable regression analysis performed to determine in-hospital mortality, the parameters, such as age (OR 1.04; 95%CI 1.02–1.06, p<0.001), admission oxygen saturation value (SaO2) (OR 0.85; 95%CI 0.83–0.87, p<0.001), and Controlling Nutritional Status score (OR 1.34; 95%CI 1.23–1.45, p<0.001), were independent predictors. The patient groups with a low Controlling Nutritional Status score had a higher rate of discharge with recovery (p<0.001). CONCLUSIONS: Higher Controlling Nutritional Status scores may be effective in determining in-hospital mortality in patients with COVID-19. Nutrition scores can be used as a useful and effective parameter to determine prognosis in patients with COVID-19.
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Affiliation(s)
- Adem Aktan
- Mardin Training and Research Hospital, Department of Cardiology - Mardin, Turkey
| | - Tuncay Güzel
- Health Science University, Gazi Yaşargil Training and Research Hospital, Department of Cardiology - Diyarbakır, Turkey
| | - Muhammed Demir
- Dicle University Faculty of Medicine, Department of Cardiology - Diyarbakır, Turkey
| | - Mehmet Özbek
- Dicle University Faculty of Medicine, Department of Cardiology - Diyarbakır, Turkey
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15
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de Blasio F, Scalfi L, Castellucci B, Sacco AM, Berlingieri GM, Capitelli L, Alicante P, Sanduzzi A, Bocchino M. Poor Nutritional Status and Dynapenia Are Highly Prevalent in Post-Acute COVID-19. Front Nutr 2022; 9:888485. [PMID: 35719154 PMCID: PMC9205211 DOI: 10.3389/fnut.2022.888485] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 04/12/2022] [Indexed: 11/28/2022] Open
Abstract
Poor nutritional status is common (estimated prevalence 5–69%) in acute coronavirus disease-2019 (COVID-19), and has been associated with hospitalization, the need for intensive care, and mortality. Body composition (BC) and muscle function have also been related in such patients to poor disease outcomes. As the evidence in the literature is limited, a cross-sectional study was carried out to determine the frequency of malnutrition in a cohort of post-acute COVID-19 patients referred to a rehabilitation center after hospital discharge. BC and muscle strength were assessed and the differences between bedridden and not bedridden patients were specifically evaluated. The study sample was composed of 144 post-acute COVID-19 patients (mean age 64.8 years; males = 95), 37% of whom were bedridden (males = 60%). Nutritional status was evaluated with Mini-Nutritional Assessment (MNA) and Controlling Nutritional status (CONUT). Fat-free mass (FFM) and skeletal muscle mass (SM) were estimated using bioelectrical impedance analysis (BIA). Raw BIA variables (phase angle = PhA and impedance ratios = IRs) were also determined and handgrip strength (HGS) was measured. Dynapenia was identified according to the 2019 EWGSOP criteria. According to MNA, 18% (n. 26) of patients were malnourished and 62% (n. 89) were at risk of malnutrition. As for CONUT, 21% (n. 31) of cases had moderate–severe malnutrition and 58% (n. 83) had light malnutrition. Abnormalities of raw BIA variables (low PhA and high IRs) and low HGS were more common in bedridden patients, in those who were malnourished, or had low FFM or SM. Dynapenic patients were 65% men and 47% women. In conclusion, malnutrition, BC alterations, and low HGS occur in post-acute COVID-19 patients and are more common in bedridden patients. Further studies are needed to identify reliable algorithms for assessing nutritional status in post-acute COVID-19 patients undergoing rehabilitation.
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Affiliation(s)
- Francesco de Blasio
- Respiratory Medicine and Pulmonary Rehabilitation, Clinic Center, Private Hospital, Naples, Italy
| | - Luca Scalfi
- Department of Public Health, Federico II University, Naples, Italy
| | - Bianca Castellucci
- Respiratory Medicine and Pulmonary Rehabilitation, Clinic Center, Private Hospital, Naples, Italy
| | - Anna Maria Sacco
- Department of Public Health, Federico II University, Naples, Italy
| | | | - Ludovica Capitelli
- Respiratory Medicine Unit, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Paola Alicante
- Department of Public Health, Federico II University, Naples, Italy
| | - Alessandro Sanduzzi
- Respiratory Medicine Unit, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Marialuisa Bocchino
- Respiratory Medicine Unit, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
- *Correspondence: Marialuisa Bocchino
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16
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Gómez-Uranga A, Guzmán-Martínez J, Esteve-Atiénzar PJ, Wikman-Jorgensen P, Núñez-Cruz JM, Espinosa-del-Barrio L, Hernández-Isasi I, Pomares-Gómez FJ, Perelló-Camacho E, Fernández-García N, Sánchez-Miralles Á, Giner-Galvañ V. Nutritional and Functional Impact of Acute SARS-CoV-2 Infection in Hospitalized Patients. J Clin Med 2022; 11:jcm11092424. [PMID: 35566549 PMCID: PMC9103467 DOI: 10.3390/jcm11092424] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 04/24/2022] [Accepted: 04/25/2022] [Indexed: 02/06/2023] Open
Abstract
Aim: To assess the prevalence of malnutrition, frailty, and sarcopenia and the relationships between them in patients hospitalized for COVID-19. Methods: This was a cross-sectional study of the prevalence, determinants, and associations between malnutrition (GLIM 2019 criteria), sarcopenia (SARC-F scale, dynamometry, and calf circumference), and frailty (FRAIL scale) upon discharge following hospitalization for COVID 19. Results: A total of 101 patients (67.3% men, mean age 66.3 years) were recruited. Malnutrition was diagnosed in 49.5%, sarcopenia in 32.7%, and frailty in 28.7% of patients. Of the patients with malnutrition, 48% were also sarcopenic, and 42% were frail. There was a significant association between malnutrition and the severity of pneumonia according to the CURB-65 scale (odds ratio [OR] 2.61, p = 0.036), between sarcopenia and a Barthel score lower than 60 points (OR 29.52, p < 0.001), and between frailty and both a Barthel score lower than 60 points (OR 32.27, p < 0.001) and a length of hospital stay of over 30 days (OR 9.11, p = 0.008). Conclusions: Malnutrition, sarcopenia, and frailty are prevalent and interrelated entities in patients hospitalized for acute SARS CoV-2 infection, especially in patients with greater baseline functional impairment prior to admission and a higher infection severity.
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Affiliation(s)
- Angie Gómez-Uranga
- Internal Medicine Service, University Hospital San Juan de Alicante, 03550 Alicante, Spain; (J.G.-M.); (P.W.-J.); (J.M.N.-C.); (L.E.-d.-B.); (I.H.-I.); (V.G.-G.)
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), 46020 Valencia, Spain; (F.J.P.-G.); (E.P.-C.); (N.F.-G.); (Á.S.-M.)
- Correspondence: (A.G.-U.); (P.J.E.-A.)
| | - Javier Guzmán-Martínez
- Internal Medicine Service, University Hospital San Juan de Alicante, 03550 Alicante, Spain; (J.G.-M.); (P.W.-J.); (J.M.N.-C.); (L.E.-d.-B.); (I.H.-I.); (V.G.-G.)
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), 46020 Valencia, Spain; (F.J.P.-G.); (E.P.-C.); (N.F.-G.); (Á.S.-M.)
| | - Pedro Jesús Esteve-Atiénzar
- Internal Medicine Service, University Hospital San Juan de Alicante, 03550 Alicante, Spain; (J.G.-M.); (P.W.-J.); (J.M.N.-C.); (L.E.-d.-B.); (I.H.-I.); (V.G.-G.)
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), 46020 Valencia, Spain; (F.J.P.-G.); (E.P.-C.); (N.F.-G.); (Á.S.-M.)
- Correspondence: (A.G.-U.); (P.J.E.-A.)
| | - Philip Wikman-Jorgensen
- Internal Medicine Service, University Hospital San Juan de Alicante, 03550 Alicante, Spain; (J.G.-M.); (P.W.-J.); (J.M.N.-C.); (L.E.-d.-B.); (I.H.-I.); (V.G.-G.)
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), 46020 Valencia, Spain; (F.J.P.-G.); (E.P.-C.); (N.F.-G.); (Á.S.-M.)
| | - Juan Manuel Núñez-Cruz
- Internal Medicine Service, University Hospital San Juan de Alicante, 03550 Alicante, Spain; (J.G.-M.); (P.W.-J.); (J.M.N.-C.); (L.E.-d.-B.); (I.H.-I.); (V.G.-G.)
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), 46020 Valencia, Spain; (F.J.P.-G.); (E.P.-C.); (N.F.-G.); (Á.S.-M.)
| | - Leticia Espinosa-del-Barrio
- Internal Medicine Service, University Hospital San Juan de Alicante, 03550 Alicante, Spain; (J.G.-M.); (P.W.-J.); (J.M.N.-C.); (L.E.-d.-B.); (I.H.-I.); (V.G.-G.)
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), 46020 Valencia, Spain; (F.J.P.-G.); (E.P.-C.); (N.F.-G.); (Á.S.-M.)
| | - Isidro Hernández-Isasi
- Internal Medicine Service, University Hospital San Juan de Alicante, 03550 Alicante, Spain; (J.G.-M.); (P.W.-J.); (J.M.N.-C.); (L.E.-d.-B.); (I.H.-I.); (V.G.-G.)
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), 46020 Valencia, Spain; (F.J.P.-G.); (E.P.-C.); (N.F.-G.); (Á.S.-M.)
| | - Francisco J. Pomares-Gómez
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), 46020 Valencia, Spain; (F.J.P.-G.); (E.P.-C.); (N.F.-G.); (Á.S.-M.)
- Endocrinology and Nutrition Section, University Hospital San Juan de Alicante, 03550 Alicante, Spain
| | - Eva Perelló-Camacho
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), 46020 Valencia, Spain; (F.J.P.-G.); (E.P.-C.); (N.F.-G.); (Á.S.-M.)
- Endocrinology and Nutrition Section, University Hospital San Juan de Alicante, 03550 Alicante, Spain
| | - Nuria Fernández-García
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), 46020 Valencia, Spain; (F.J.P.-G.); (E.P.-C.); (N.F.-G.); (Á.S.-M.)
- Rehabilitation Service, University Hospital San Juan de Alicante, 03550 Alicante, Spain
| | - Ángel Sánchez-Miralles
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), 46020 Valencia, Spain; (F.J.P.-G.); (E.P.-C.); (N.F.-G.); (Á.S.-M.)
- Intensive Care Unit, University Hospital San Juan de Alicante, 03550 Alicante, Spain
- Clinical Medicine Department, University Miguel Hernández de Elche, 03550 Alicante, Spain
| | - Vicente Giner-Galvañ
- Internal Medicine Service, University Hospital San Juan de Alicante, 03550 Alicante, Spain; (J.G.-M.); (P.W.-J.); (J.M.N.-C.); (L.E.-d.-B.); (I.H.-I.); (V.G.-G.)
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), 46020 Valencia, Spain; (F.J.P.-G.); (E.P.-C.); (N.F.-G.); (Á.S.-M.)
- Clinical Medicine Department, University Miguel Hernández de Elche, 03550 Alicante, Spain
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shabanpur M, Pourmahmoudi A, Nicolau J, Veronese N, Roustaei N, Jahromi AJ, Hosseinikia M. The importance of nutritional status on clinical outcomes among both ICU and Non-ICU patients with COVID-19. Clin Nutr ESPEN 2022; 49:225-231. [PMID: 35623817 PMCID: PMC9021035 DOI: 10.1016/j.clnesp.2022.04.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 03/22/2022] [Accepted: 04/15/2022] [Indexed: 12/19/2022]
Abstract
Background and aims Methods Results Conclusion
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18
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Hamaguchi M, Nojiri T, Okamura T, Hashimoto Y, Hanai A, Narisawa S, Ushigome E, Nakanishi N, Fukui M. Status of online diet management program users in Japan during the 2020 Coronavirus disease 2019 pandemic. J Clin Biochem Nutr 2021; 69:305-310. [PMID: 34857994 PMCID: PMC8611371 DOI: 10.3164/jcbn.21-31] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 03/30/2021] [Indexed: 12/15/2022] Open
Abstract
The spread of coronavirus disease 2019 (COVID-19) has led to drastic changes in people’s lifestyles, including teleworking and restrictions on socializing. In the context of observing social distancing for preventing infection, the need to maintain fitness and health has attracted particular attention. We aimed to determine the relationship between the increase in the number of active users of online diet management applications and COVID-19 infection rates in Japan. A total of 1.5 million rows of log data was analyzed. The active number of users of online diet management applications increased with increase in the number of COVID-19 infections. The active user number in Kanagawa Prefecture, where the first cases of COVID-19 were reported in Japan, was particularly high. Moreover, there was a significant increase in the user number in prefectures under a state of emergency when compared to that in prefectures not under a state of emergency. The social anxiety caused by COVID-19 is expected to increase the demand for online health management applications further. The use of such programs can aid in achieving social distancing while enabling users to maintain healthy lifestyles.
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Affiliation(s)
- Masahide Hamaguchi
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Tetsuya Nojiri
- Oishi Kenko Incorporated, &WORK NINGYOCHO, 6-4 Nihonbashi Tomizawa-cho, Chuo-ku, Tokyo 103-0006, Japan
| | - Takuro Okamura
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Yoshitaka Hashimoto
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Akiyoshi Hanai
- Oishi Kenko Incorporated, &WORK NINGYOCHO, 6-4 Nihonbashi Tomizawa-cho, Chuo-ku, Tokyo 103-0006, Japan
| | - Shota Narisawa
- Oishi Kenko Incorporated, &WORK NINGYOCHO, 6-4 Nihonbashi Tomizawa-cho, Chuo-ku, Tokyo 103-0006, Japan
| | - Emi Ushigome
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Naoko Nakanishi
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Michiaki Fukui
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
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19
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Prognostic Role of Malnutrition Diagnosed by Bioelectrical Impedance Vector Analysis in Older Adults Hospitalized with COVID-19 Pneumonia: A Prospective Study. Nutrients 2021; 13:nu13114085. [PMID: 34836338 PMCID: PMC8621574 DOI: 10.3390/nu13114085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 11/06/2021] [Accepted: 11/09/2021] [Indexed: 12/17/2022] Open
Abstract
Background: Little is known on the clinical relevance of the nutritional status and body composition of patients hospitalized with SARS-CoV-2 infection. The aim of our study was to assess the prevalence of malnutrition in patients with COVID-19 pneumonia using bioelectrical impedance vector analysis (BIVA), and to evaluate the relationship of their nutritional status with the severity and outcome of disease. Methods: Among 150 consecutive patients who were hospitalized with COVID-19 pneumonia, 37 (24.3%) were classified as malnourished by BIVA, and were followed-up for 60 days from admission. Outcome measures were differences in the need for invasive mechanical ventilation, in-hospital mortality, and the duration of hospital stay in survivors. Results: During 60 days of follow-up, 10 (27%) malnourished patients and 13 (12%) non-malnourished patients required invasive mechanical ventilation (p = 0.023), and 13 (35%) malnourished patients and 9 (8%) non-malnourished patients died (p < 0.001). The average duration of the hospital stay in survivors was longer in patients with malnutrition (18.2 ± 15.7 vs. 13.2 ± 14.8 days, p < 0.001). In survival analyses, mechanical ventilation free (log-rank 7.887, p = 0.050) and overall (log-rank 17.886, p < 0.001) survival were significantly longer in non-malnourished than malnourished patients. The Cox proportional ratio showed that malnutrition was associated with an increased risk of mechanical ventilation (HR 4.375, p = 0.004) and death (HR 4.478, p = 0.004) after adjusting for major confounders such as age, sex, and BMI. Conclusions: Malnutrition diagnosed with BIVA was associated with worse outcomes in hospitalized patients with COVID-19 pneumonia.
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van der Meij BS, Ligthart-Melis GC, de van der Schueren MAE. Malnutrition in patients with COVID-19: assessment and consequences. Curr Opin Clin Nutr Metab Care 2021; 24:543-554. [PMID: 34419971 DOI: 10.1097/mco.0000000000000783] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE OF REVIEW COVID-19 disease often presents with malnutrition and nutrition impact symptoms, such as reduced appetite, nausea and loss of taste. This review summarizes the most up-to-date research on nutritional assessment in relation to mortality and morbidity risk in patients with COVID-19. RECENT FINDINGS Numerous studies have been published on malnutrition, muscle wasting, obesity, and nutrition impact symptoms associated with COVID-19, mostly observational and in hospitalized patients. These studies have shown a high prevalence of symptoms (loss of appetite, nausea, vomiting, diarrhea, dysphagia, fatigue, and loss of smell and taste), malnutrition, micronutrient deficiencies and obesity in patients with COVID-19, all of which were associated with increased mortality and morbidity risks. SUMMARY Early screening and assessment of malnutrition, muscle wasting, obesity, nutrition impact symptoms and micronutrient status in patients with COVID-19, followed by pro-active nutrition support is warranted, and expected to contribute to improved recovery. There is limited research on nutritional status or nutrition impact symptoms in patients living at home or in residential care. RCTs studying the effects of nutrition intervention on clinical outcomes are lacking. Future research should focus on these evidence gaps.
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Affiliation(s)
- Barbara S van der Meij
- Department of Nutrition, Dietetics and Lifestyle, HAN University of Applied Sciences, Nijmegen, The Netherlands
- Division of Human Nutrition, Wageningen University and Research, Wageningen, The Netherlands
- Bond University Nutrition and Dietetics Research Group, Faculty of Health Sciences and Medicine, Gold Coast, Australia
| | - Gerdien C Ligthart-Melis
- Center for Translational Research in Aging & Longevity, Department Health & Kinesiology, Texas A&M University, College Station, Texas, USA
| | - Marian A E de van der Schueren
- Department of Nutrition, Dietetics and Lifestyle, HAN University of Applied Sciences, Nijmegen, The Netherlands
- Division of Human Nutrition, Wageningen University and Research, Wageningen, The Netherlands
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21
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Bengelloun AK, Ortega GJ, Ancochea J, Sanz-Garcia A, Rodríguez-Serrano DA, Fernández-Jiménez G, Girón R, Ávalos E, Soriano JB, de Ulíbarri JI. Usefulness of the CONUT index upon hospital admission as a potential prognostic indicator of COVID-19 health outcomes. Chin Med J (Engl) 2021; 135:187-193. [PMID: 34711718 PMCID: PMC8769140 DOI: 10.1097/cm9.0000000000001798] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND In-hospital mortality in patients with coronavirus disease 2019 (COVID-19) is high. Simple prognostic indices are needed to identify patients at high-risk of COVID-19 health outcomes. We aimed to determine the usefulness of the CONtrolling NUTritional status (CONUT) index as a potential prognostic indicator of mortality in COVID-19 patients upon hospital admission. METHODS Our study design is of a retrospective observational study in a large cohort of COVID-19 patients. In addition to descriptive statistics, a Kaplan-Meier mortality analysis and a Cox regression were performed, as well as receiver operating curve (ROC). RESULTS From February 5, 2020 to January 21, 2021, there was a total of 2969 admissions for COVID-19 at our hospital, corresponding to 2844 patients. Overall, baseline (within 4 days of admission) CONUT index could be scored for 1627 (57.2%) patients. Patients' age was 67.3 ± 16.5 years and 44.9% were women. The CONUT severity distribution was: 194 (11.9%) normal (0-1); 769 (47.2%) light (2-4); 585 (35.9%) moderate (5-8); and 79 (4.9%) severe (9-12). Mortality of 30 days after admission was 3.1% in patients with normal risk CONUT, 9.0% light, 22.7% moderate, and 40.5% in those with severe CONUT (P < 0.05). An increased risk of death associated with a greater baseline CONUT stage was sustained in a multivariable Cox regression model (P < 0.05). An increasing baseline CONUT stage was associated with a longer duration of admission, a greater requirement for the use of non-invasive and invasive mechanical ventilation, and other clinical outcomes (all P < 0.05). The ROC of CONUT for mortality had an area under the curve (AUC) and 95% confidence interval of 0.711 (0.676-0746). CONCLUSION The CONUT index upon admission is potentially a reliable and independent prognostic indicator of mortality and length of hospitalization in COVID-19 patients.
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Affiliation(s)
| | - Guillermo J. Ortega
- Unidad de Análisis de Datos, Instituto de Investigación Sanitaria del Hospital de la Princesa, Madrid, Spain
| | - Julio Ancochea
- Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain
- Servicios de Neumología, Admisión y Documentación Clínica, Cuidados Intensivos y Nutrición y Dietética; Hospital Universitario de La Princesa, Madrid, Spain
- Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, España, Spain
| | - Ancor Sanz-Garcia
- Unidad de Análisis de Datos, Instituto de Investigación Sanitaria del Hospital de la Princesa, Madrid, Spain
| | - Diego A. Rodríguez-Serrano
- Servicios de Neumología, Admisión y Documentación Clínica, Cuidados Intensivos y Nutrición y Dietética; Hospital Universitario de La Princesa, Madrid, Spain
| | - Guillermo Fernández-Jiménez
- Servicios de Neumología, Admisión y Documentación Clínica, Cuidados Intensivos y Nutrición y Dietética; Hospital Universitario de La Princesa, Madrid, Spain
| | - Rosa Girón
- Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain
- Servicios de Neumología, Admisión y Documentación Clínica, Cuidados Intensivos y Nutrición y Dietética; Hospital Universitario de La Princesa, Madrid, Spain
- Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, España, Spain
| | - Elena Ávalos
- Servicios de Neumología, Admisión y Documentación Clínica, Cuidados Intensivos y Nutrición y Dietética; Hospital Universitario de La Princesa, Madrid, Spain
| | - Joan B. Soriano
- Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain
- Servicios de Neumología, Admisión y Documentación Clínica, Cuidados Intensivos y Nutrición y Dietética; Hospital Universitario de La Princesa, Madrid, Spain
- Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, España, Spain
| | - J. Ignacio de Ulíbarri
- Servicios de Neumología, Admisión y Documentación Clínica, Cuidados Intensivos y Nutrición y Dietética; Hospital Universitario de La Princesa, Madrid, Spain
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22
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Czapla M, Juárez-Vela R, Gea-Caballero V, Zieliński S, Zielińska M. The Association between Nutritional Status and In-Hospital Mortality of COVID-19 in Critically-Ill Patients in the ICU. Nutrients 2021; 13:3302. [PMID: 34684305 PMCID: PMC8538443 DOI: 10.3390/nu13103302] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 09/18/2021] [Accepted: 09/19/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) has become one of the leading causes of death worldwide. The impact of poor nutritional status on increased mortality and prolonged ICU (intensive care unit) stay in critically ill patients is well-documented. This study aims to assess how nutritional status and BMI (body mass index) affected in-hospital mortality in critically ill COVID-19 patients Methods: We conducted a retrospective study and analysed medical records of 286 COVID-19 patients admitted to the intensive care unit of the University Clinical Hospital in Wroclaw (Poland). RESULTS A total of 286 patients were analysed. In the sample group, 8% of patients who died had a BMI within the normal range, 46% were overweight, and 46% were obese. There was a statistically significantly higher death rate in men (73%) and those with BMIs between 25.0-29.9 (p = 0.011). Nonsurvivors had a statistically significantly higher HF (Heart Failure) rate (p = 0.037) and HT (hypertension) rate (p < 0.001). Furthermore, nonsurvivors were statistically significantly older (p < 0.001). The risk of death was higher in overweight patients (HR = 2.13; p = 0.038). Mortality was influenced by higher scores in parameters such as age (HR = 1.03; p = 0.001), NRS2002 (nutritional risk score, HR = 1.18; p = 0.019), PCT (procalcitonin, HR = 1.10; p < 0.001) and potassium level (HR = 1.40; p = 0.023). CONCLUSIONS Being overweight in critically ill COVID-19 patients requiring invasive mechanical ventilation increases their risk of death significantly. Additional factors indicating a higher risk of death include the patient's age, high PCT, potassium levels, and NRS ≥ 3 measured at the time of admission to the ICU.
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Affiliation(s)
- Michał Czapla
- Department of Public Health, Faculty of Health Sciences, Wroclaw Medical University, 51-618 Wroclaw, Poland;
- Institute of Heart Diseases, University Hospital, 50-566 Wroclaw, Poland
| | - Raúl Juárez-Vela
- Biomedical Research Centre of La Rioja (CIBIR), Research Group GRUPAC, Research Unit on Health System Sustainability (GISSOS), University of La Rioja, 26004 Logroño, Spain
| | - Vicente Gea-Caballero
- Faculty of Health Sciences, International University of Valencia, 46002 Valencia, Spain;
| | - Stanisław Zieliński
- Department and Clinic of Anaesthesiology and Intensive Therapy, Faculty of Medicine, Wroclaw Medical University, 50-556 Wrocław, Poland; (S.Z.); (M.Z.)
- Department of Anaesthesiology and Intensive Care, University Hospital, 50-556 Wrocław, Poland
| | - Marzena Zielińska
- Department and Clinic of Anaesthesiology and Intensive Therapy, Faculty of Medicine, Wroclaw Medical University, 50-556 Wrocław, Poland; (S.Z.); (M.Z.)
- Department of Paediatric Anaesthesiology and Intensive Care, University Hospital, 50-556 Wrocław, Poland
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23
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Wang R, He M, Kang Y. Hypophosphatemia at Admission is Associated with Increased Mortality in COVID-19 Patients. Int J Gen Med 2021; 14:5313-5322. [PMID: 34526806 PMCID: PMC8435477 DOI: 10.2147/ijgm.s319717] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 08/18/2021] [Indexed: 02/05/2023] Open
Abstract
Background Electrolyte disturbances are commonly observed in patients with coronavirus disease 2019 (COVID-19) and associated with outcome in these patients. Our study was designed to examine whether hypophosphatemia is associated with mortality in COVID-19 patients. Methods Patients diagnosed with COVID-19 and hospitalized in Renmin Hospital of Wuhan University between January 30 and February 24, 2020 were included in this study. Patients were divided into two groups, a hypophosphatemia group and a non-hypophosphatemia group, based on a serum phosphate level of 0.8 mmol/L. Logistic regression was performed to analyze the relationship between hypophosphatemia and mortality. A locally weighted scatterplot smoothing (LOWESS) curve was plotted to show the detailed association between mortality rate and serum phosphate level. A Kaplan–Meier survival curve was drawn to compare the difference in cumulative survival between the two groups. Results Hypophosphatemia at admission occurred in 33 patients, with an incidence of 7.6%. The hypophosphatemia group had a significantly higher incidence of respiratory failure (54.5% vs 32.6%, p=0.013) and mortality (57.6% vs 15.2%, p<0.001). Multivariate logistic regression indicated that age (OR=1.059, p<0.001), oxygen saturation (OR=0.733, p<0.001), white blood cells (OR=1.428, p<0.001), lymphocytes (OR=0.075, p<0.001) and hypophosphatemia (OR=3.636, p=0.015) were independently associated with mortality in the included patients. The hypophosphatemia group had significantly shorter survival than the non-hypophosphatemia group (p<0.001). Conclusion Hypophosphatemia at admission is associated with increased mortality in COVID-19 patients. More attention and medical care should be given to COVID-19 patients with hypophosphatemia at admission.
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Affiliation(s)
- Ruoran Wang
- Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, People's Republic of China
| | - Min He
- Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, People's Republic of China.,COVID19 Medical Team (Hubei) of West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Yan Kang
- Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, People's Republic of China.,COVID19 Medical Team (Hubei) of West China Hospital, Sichuan University, Chengdu, People's Republic of China
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24
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Bedock D, Couffignal J, Bel Lassen P, Soares L, Mathian A, Fadlallah JP, Amoura Z, Oppert JM, Faucher P. Evolution of Nutritional Status after Early Nutritional Management in COVID-19 Hospitalized Patients. Nutrients 2021; 13:nu13072276. [PMID: 34209229 PMCID: PMC8308434 DOI: 10.3390/nu13072276] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 06/15/2021] [Accepted: 06/23/2021] [Indexed: 12/17/2022] Open
Abstract
Background & Aims: SARS-CoV2 infection is associated with an increased risk of malnutrition. Although there are numerous screening and nutritional management protocols for malnutrition, only few studies have reported nutritional evolution after COVID-19. The objectives of this study were to describe the evolution of nutritional parameters between admission and 30 days after hospital discharge, and to determine predictive factors of poor nutritional outcome after recovery in adult COVID-19 patients. Methods: In this observational longitudinal study, we report findings after discharge in 91 out of 114 patients initially admitted for COVID-19 who received early nutritional management. Nutritional status was defined using GLIM criteria and compared between admission and day 30 after discharge. Baseline predictors of nutritional status at day 30 were assessed using logistic regression. Results: Thirty days after discharge, 28.6% of patients hospitalized for COVID-19 were malnourished, compared to 42.3% at admission. Half of malnourished patients (53%) at admission recovered a normal nutritional status after discharge. Weight trajectories were heterogeneous and differed if patients had been transferred to an intensive care unit (ICU) during hospitalization (p = 0.025). High oxygen requirement during hospitalization (invasive ventilation p = 0.016 (OR 8.3 [1.6–61.2]) and/or oxygen therapy over 5 L/min p = 0.021 (OR 3.2 [1.2–8.9]) were strong predictors of malnutrition one month after discharge. Conclusions: With early nutritional management, most patients hospitalized for COVID-19 improved nutritional parameters after discharge. These findings emphasize the importance of nutritional care in COVID-19 patients hospitalized in medicine departments, especially in those transferred from ICU.
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Affiliation(s)
- Dorothée Bedock
- Center for Research on Human Nutrition Ile-de-France (CRNH IdF), Nutrition Department, Institute of Cardiometabolism and Nutrition (ICAN), Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière University Hospital, Sorbonne Université, 47-83 Boulevard de l’Hôpital, 75013 Paris, France; (D.B.); (J.C.); (P.B.L.); (L.S.); (P.F.)
| | - Julie Couffignal
- Center for Research on Human Nutrition Ile-de-France (CRNH IdF), Nutrition Department, Institute of Cardiometabolism and Nutrition (ICAN), Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière University Hospital, Sorbonne Université, 47-83 Boulevard de l’Hôpital, 75013 Paris, France; (D.B.); (J.C.); (P.B.L.); (L.S.); (P.F.)
| | - Pierre Bel Lassen
- Center for Research on Human Nutrition Ile-de-France (CRNH IdF), Nutrition Department, Institute of Cardiometabolism and Nutrition (ICAN), Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière University Hospital, Sorbonne Université, 47-83 Boulevard de l’Hôpital, 75013 Paris, France; (D.B.); (J.C.); (P.B.L.); (L.S.); (P.F.)
- NutriOmics Team, INSERM UMRS U1166, Sorbonne Université, 75006 Paris, France
| | - Leila Soares
- Center for Research on Human Nutrition Ile-de-France (CRNH IdF), Nutrition Department, Institute of Cardiometabolism and Nutrition (ICAN), Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière University Hospital, Sorbonne Université, 47-83 Boulevard de l’Hôpital, 75013 Paris, France; (D.B.); (J.C.); (P.B.L.); (L.S.); (P.F.)
| | - Alexis Mathian
- French National Referral Center for Systemic Lupus Erythematosus, Antiphospholipid Antibody Syndrome and Other Autoimmune Disorders, Centre d’Immunologie et des Maladies Infectieuses (CIMI-Paris), Medicine Department, Inserm UMRS, Assistance Publique–Hôpitaux de Paris, Pitié-Salpêtrière University Hospital, Sorbonne Université, 47-83 Boulevard de l’Hôpital, 75013 Paris, France; (A.M.); (J.P.F.); (Z.A.)
| | - Jehane P. Fadlallah
- French National Referral Center for Systemic Lupus Erythematosus, Antiphospholipid Antibody Syndrome and Other Autoimmune Disorders, Centre d’Immunologie et des Maladies Infectieuses (CIMI-Paris), Medicine Department, Inserm UMRS, Assistance Publique–Hôpitaux de Paris, Pitié-Salpêtrière University Hospital, Sorbonne Université, 47-83 Boulevard de l’Hôpital, 75013 Paris, France; (A.M.); (J.P.F.); (Z.A.)
| | - Zahir Amoura
- French National Referral Center for Systemic Lupus Erythematosus, Antiphospholipid Antibody Syndrome and Other Autoimmune Disorders, Centre d’Immunologie et des Maladies Infectieuses (CIMI-Paris), Medicine Department, Inserm UMRS, Assistance Publique–Hôpitaux de Paris, Pitié-Salpêtrière University Hospital, Sorbonne Université, 47-83 Boulevard de l’Hôpital, 75013 Paris, France; (A.M.); (J.P.F.); (Z.A.)
| | - Jean-Michel Oppert
- Center for Research on Human Nutrition Ile-de-France (CRNH IdF), Nutrition Department, Institute of Cardiometabolism and Nutrition (ICAN), Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière University Hospital, Sorbonne Université, 47-83 Boulevard de l’Hôpital, 75013 Paris, France; (D.B.); (J.C.); (P.B.L.); (L.S.); (P.F.)
- Correspondence: ; Tel.: +331-4217-5779; Fax: +331-4217-5790
| | - Pauline Faucher
- Center for Research on Human Nutrition Ile-de-France (CRNH IdF), Nutrition Department, Institute of Cardiometabolism and Nutrition (ICAN), Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière University Hospital, Sorbonne Université, 47-83 Boulevard de l’Hôpital, 75013 Paris, France; (D.B.); (J.C.); (P.B.L.); (L.S.); (P.F.)
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25
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Cao TT, Zhang GQ, Pellegrini E, Zhao Q, Li J, Luo LJ, Pan HQ. COVID-19 and its effects on the digestive system. World J Gastroenterol 2021; 27:3502-3515. [PMID: 34239265 PMCID: PMC8240057 DOI: 10.3748/wjg.v27.i24.3502] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 04/16/2021] [Accepted: 05/25/2021] [Indexed: 02/06/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) is caused by infection of the coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with typical respiratory symptoms. SARS-CoV-2 invades not only the respiratory system, but also other organs expressing the cell surface receptor angiotensin converting enzyme 2. In particular, the digestive system is a susceptible target of SARS-CoV-2. Gastrointestinal symptoms of COVID-19 include anorexia, nausea, vomiting, diarrhea, abdominal pain, and liver damage. Patients with digestive damage have a greater chance of progressing to severe or critical illness, a poorer prognosis, and a higher risk of death. This paper aims to summarize the digestive system symptoms of COVID-19 and discuss fecal-oral contagion of SARS-CoV-2. It also describes the characteristics of inflammatory bowel disease patients with SARS-CoV-2 infection and discusses precautions for preventing SARS-CoV-2 infection during gastrointestinal endoscopy procedures. Improved attention to digestive system abnormalities and gastrointestinal symptoms of COVID-19 patients may aid health care providers in the process of clinical diagnosis, treatment, and epidemic prevention and control.
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Affiliation(s)
- Ting-Ting Cao
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan 430071, Hubei Province, China
| | - Gu-Qin Zhang
- Department of Respiratory and Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan 430071, Hubei Province, China
| | | | - Qiu Zhao
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan 430071, Hubei Province, China
| | - Jin Li
- Department of Gastroenterology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, Guangdong Province, China
| | - Lin-jie Luo
- Department of Experimental Radiation Oncology and Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, United States
| | - Hua-Qin Pan
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan 430071, Hubei Province, China
- Clinical Research Center of Hubei Critical Care Medicine, Wuhan 430071, Hubei Province, China
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26
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Ali AM, Kunugi H. Hypoproteinemia predicts disease severity and mortality in COVID-19: a call for action. Diagn Pathol 2021; 16:31. [PMID: 33849598 PMCID: PMC8042835 DOI: 10.1186/s13000-021-01092-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 03/30/2021] [Indexed: 12/13/2022] Open
Abstract
Proteins represent the major building blocks of body tissues, and they regulate signaling involved in most cellular activities. Coronavirus disease 2019 (COVID-19) infection has been associated with high fatality, especially among older adults. The main cause of death is pulmonary tissue damage and multiple organ failure. The disease is associated with a hypercatabolic state that entails excessive protein loss. This review commentary sheds the light on hypoproteinemia in symptomatic/hospitalized COVID-19 with a special emphasis on its pathophysiology, screening, as well as its contribution to disease severity and adverse effects.
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Affiliation(s)
- Amira Mohammed Ali
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan. .,Department of Psychiatric Nursing and Mental Health, Faculty of Nursing, Alexandria University, Alexandria, Egypt.
| | - Hiroshi Kunugi
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan.,Department of Psychiatry, Teikyo University School of Medicine, Tokyo, Japan
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27
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Ali AM, Kunugi H. Approaches to Nutritional Screening in Patients with Coronavirus Disease 2019 (COVID-19). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2772. [PMID: 33803339 PMCID: PMC7967488 DOI: 10.3390/ijerph18052772] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 02/25/2021] [Accepted: 03/02/2021] [Indexed: 02/07/2023]
Abstract
Malnutrition is common among severe patients with coronavirus disease 2019 (COVID-19), mainly elderly adults and patients with comorbidities. It is also associated with atypical presentation of the disease. Despite the possible contribution of malnutrition to the acquisition and severity of COVID-19, it is not clear which nutritional screening measures may best diagnose malnutrition in these patients at early stages. This is of crucial importance given the urgency and rapid progression of the disease in vulnerable groups. Accordingly, this review examines the available literature for different nutritional screening approaches implemented among COVID-19 patients, with a special focus on elderly adults. After a literature search, we selected and scrutinized 14 studies assessing malnutrition among COVID-19 patients. The Nutrition Risk Screening 2002 (NRS-2002) has demonstrated superior sensitivity to other traditional screening measures. The controlling nutritional status (CONUT) score, which comprises serum albumin level, cholesterol level, and lymphocytes count, as well as a combined CONUT-lactate dehydrogenase-C-reactive protein score expressed a predictive capacity even superior to that of NRS-2002 (0.81% and 0.92% vs. 0.79%) in midlife and elder COVID-19 patients. Therefore, simple measures based on routinely conducted laboratory investigations such as the CONUT score may be timely, cheap, and valuable alternatives for identifying COVID-19 patients with high nutritional risk. Mini Nutritional Assessment (MNA) was the only measure used to detect residual malnutrition and high malnutrition risk in remitting patients-MNA scores correlated with hypoalbuminemia, hypercytokinemia, and weight loss. Older males with severe inflammation, gastrointestinal symptoms, and pre-existing comorbidities (diabetes, obesity, or hypertension) are more prone to malnutrition and subsequently poor COVID-19 prognosis both during the acute phase and during convalescence. Thus, they are in need of frequent nutritional monitoring and support while detecting and treating malnutrition in the general public might be necessary to increase resilience against COVID-19.
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Affiliation(s)
- Amira Mohammed Ali
- National Center of Neurology and Psychiatry, Department of Mental Disorder Research, National Institute of Neuroscience, Tokyo 187-0031, Japan;
- Department of Psychiatric Nursing and Mental Health, Faculty of Nursing, Alexandria University, Alexandria 21527, Egypt
| | - Hiroshi Kunugi
- National Center of Neurology and Psychiatry, Department of Mental Disorder Research, National Institute of Neuroscience, Tokyo 187-0031, Japan;
- Department of Psychiatry, Teikyo University School of Medicine, Tokyo 173-8605, Japan
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28
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Good nutrition critical to prevent Covid 19 mortality. Heart Lung 2021; 50:441. [PMID: 33631468 PMCID: PMC7846208 DOI: 10.1016/j.hrtlng.2021.01.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 01/27/2021] [Indexed: 11/23/2022]
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29
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Zinellu A, Mangoni AA. Serum Prealbumin Concentrations, COVID-19 Severity, and Mortality: A Systematic Review and Meta-Analysis. Front Med (Lausanne) 2021; 8:638529. [PMID: 33575267 PMCID: PMC7870685 DOI: 10.3389/fmed.2021.638529] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 01/04/2021] [Indexed: 01/08/2023] Open
Abstract
Excessive inflammation and malnutrition are associated with coronavirus disease 2019 (COVID-19) severity and mortality. Combined biomarkers of malnutrition and inflammation, such as serum prealbumin, might be particularly attractive for early risk stratification. We conducted a systematic review and meta-analysis of studies reporting serum prealbumin in patients with COVID-19. We searched PubMed, Web of Science and Scopus, between January and November 2020, for studies reporting data on serum prealbumin, COVID-19 severity, defined as severe illness, prolonged viral load, receiving mechanical ventilation or admitted to intensive care unit (ICU), and mortality. Nineteen studies in 4,616 COVID-19 patients were included in the meta-analysis. Pooled results showed that serum prealbumin concentrations were significantly lower in patients with severe disease and non-survivors (standard mean difference, SMD, −0.92, 95% CI, −1.10 to −0.74, P < 0.001). Extreme heterogeneity was observed (I2 = 77.9%; P < 0.001). In sensitivity analysis, the effect size was not significantly affected when each study was in turn removed (range between −0.86 and −0.95). The Begg's (P = 0.06) and Egger's t-tests (P = 0.26) did not show publication bias. Pooled SMD values were significantly and negatively associated with age (t = −2.18, P = 0.045) and C-reactive protein (t = −3.85, P = 0.002). In our meta-analysis, lower serum prealbumin concentrations were significantly associated with COVID-19 severity and mortality. This combined marker of malnutrition and inflammation might assist with early risk stratification and management in this group.
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Affiliation(s)
- Angelo Zinellu
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Arduino A Mangoni
- Discipline of Clinical Pharmacology, College of Medicine and Public Health, Flinders University and Flinders Medical Centre, Adelaide, SA, Australia
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30
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Asai A, Yasuoka H, Matsui M, Okamoto N, Fukunishi S, Higuchi K. Exacerbation of liver dysfunction in non-alcoholic steatohepatitis patients during the coronavirus disease 2019 (COVID-19) pandemic. J Clin Biochem Nutr 2020; 68:243-245. [PMID: 34025027 PMCID: PMC8129973 DOI: 10.3164/jcbn.20-136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 09/17/2020] [Indexed: 11/22/2022] Open
Abstract
Many people were forced to stay at home, including non-alcoholic steatohepatitis (NASH) patients, however it is unclear how this home-life has affected the prognosis of NASH. In this study, we examined the influences of living at home during the coronavirus disease 2019 (COVID-19) pandemic NASH patients. In this study, we compared the clinical parameters of NASH patients without COVID-19 infection 3 months before with those 3 months after the declaration of a state of emergency. In the results, the changes of aspartate transaminase and alanine aminotransferase in the 3 months before (aspartate transaminase, -3.6 ± 13.8 U/L; alanine aminotransferase, -6.8 ± 19.5 U/L) was significantly exacerbated in the 3 months after (aspartate transaminase, 2.3 ± 7.5 U/L; alanine aminotransferase, 1.7 ± 10.4 U/L). Furthermore, the changes of the fibrosis-4 index in the 3 months before (-0.27 ± 0.84) was also significantly exacerbated in the 3 months after (0.38 ± 0.96). In conclusion, liver dysfunctions in NASH patients were exacerbated due to the emergency declaration and outing restriction which accompanied COVID-19.
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Affiliation(s)
- Akira Asai
- 2nd Department of Internal Medicine, Osaka Medical College, 2-7 Daigakumachi, Takatsuki, Osaka 569-8686, Japan
| | - Hidetaka Yasuoka
- 2nd Department of Internal Medicine, Osaka Medical College, 2-7 Daigakumachi, Takatsuki, Osaka 569-8686, Japan
| | - Masahiro Matsui
- 2nd Department of Internal Medicine, Osaka Medical College, 2-7 Daigakumachi, Takatsuki, Osaka 569-8686, Japan
| | - Norio Okamoto
- 2nd Department of Internal Medicine, Osaka Medical College, 2-7 Daigakumachi, Takatsuki, Osaka 569-8686, Japan
| | - Shinya Fukunishi
- 2nd Department of Internal Medicine, Osaka Medical College, 2-7 Daigakumachi, Takatsuki, Osaka 569-8686, Japan
| | - Kazuhide Higuchi
- 2nd Department of Internal Medicine, Osaka Medical College, 2-7 Daigakumachi, Takatsuki, Osaka 569-8686, Japan
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Naito Y. Editorial. J Clin Biochem Nutr 2020; 67:113. [PMID: 33041504 PMCID: PMC7533854 DOI: 10.3164/jcbn.67-2_editorial] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 07/08/2020] [Indexed: 11/22/2022] Open
Affiliation(s)
- Yuji Naito
- Executive Editor of JCBN
- Kyoto Prefectural University of Medicine
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