Evaluation of the Relationship between Nutritional Status of COVID-19 Patients Admitted to the ICU and Patients' Prognosis: A Cohort Study.

IF 2.3 Q3 NUTRITION & DIETETICS

Journal of Nutrition and Metabolism Pub Date : 2022-07-18 eCollection Date: 2022-01-01 DOI:10.1155/2022/5016649

Parsa Mohammadi, Hesam Aldin Varpaei, Alireza Khafaee Pour Khamseh, Mostafa Mohammadi, Mojgan Rahimi, Amirhossein Orandi

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引用次数: 5

Abstract

Background: Malnutrition in COVID-19 critically ill patients can lead to poor prognosis. This study aimed to evaluate the association between nutritional status (or risk) and the prognosis of critically ill COVID-19 patients. In this study, prognosis is the primary outcome of "hospital mortality" patients. The second outcome is defined as "need for mechanical ventilation."

Methods and materials: In this single-center prospective cohort study, 110 patients admitted to the Intensive Care Unit of Imam Khomeini Hospital Complex (Tehran, Iran) between April and September 2021 were enrolled. Participants formed a consecutive sample. MNA-SF, NRS-2002, mNUTRIC, and PNI scores were used to evaluate nutritional assessment. Patients' lab results and pulse oximetric saturation SpO₂/FiO₂ (SF) ratio at the time of intensive care unit (ICU) admission were collected. Patients were screened for nutritional status and categorized into two groups, patients at nutritional risk and nonrisk.

Results: Sixty-five (59.1%) of all patients were men. The overall range of age was 52 ± 15. Thirty-six (32.7%) of patients were obese (BMI ≥ 30). The hospital mortality rate was 59.1% (n = 65). According to the different criteria, malnutrition rate was 67.3% (n = 74) (NRS), 28.2% (n = 31) (MNA), 34.5% (n = 38) (mNUTRIC), and 58.2% (n = 64) (PNI). There was a statistically significant association between chronic kidney disease (CKD) and mNUTRIC risk (OR = 13.5, 95% CI (1.89-16.05), P=0.002), diabetes mellitus (DM) and MNA risk (OR = 2.82, 95% CI (1.01-7.83), P=0.041), hypertension (HTN) and MNA risk (OR = 5.63, 95% CI (2.26-14.05), P < 0.001), and malignancy and mNUTRIC risk (P=0.048). The nutritional risk (all tools) significantly increased the odds of in-hospital death and need for mechanical ventilation. The length of stay was not significantly different in malnourished patients.

Conclusion: In the critical care setting of COVID-19 patients, malnutrition is prevalent. Malnutrition (nutritional risk) is associated with an increased risk of need for mechanical ventilation and in-hospital mortality. Patients with a history of HTN, CKD, DM, and cancer are more likely to be at nutritional risk at the time of ICU admission.

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新冠肺炎ICU住院患者营养状况与预后关系的队列研究

背景:COVID-19危重症患者营养不良可导致预后不良。本研究旨在评估COVID-19危重患者营养状况(或风险)与预后的关系。在本研究中，预后是“住院死亡率”患者的主要预后指标。第二个结果被定义为“需要机械通气”。方法和材料:在这项单中心前瞻性队列研究中，纳入了2021年4月至9月期间在伊朗德黑兰伊玛目霍梅尼医院综合医院重症监护室住院的110例患者。参与者组成了一个连续的样本。MNA-SF、NRS-2002、mNUTRIC和PNI评分用于营养评估。收集患者入住重症监护病房(ICU)时的实验室结果和脉搏血氧饱和度SpO2/FiO2 (SF)比。对患者进行营养状况筛查，并将其分为两组，有营养风险的患者和无营养风险的患者。结果:男性65例(59.1%)。年龄总范围为52±15岁。36例(32.7%)为肥胖(BMI≥30)。住院死亡率为59.1% (n = 65)。根据不同标准，营养不良率分别为67.3% (n = 74) (NRS)、28.2% (n = 31) (MNA)、34.5% (n = 38) (mNUTRIC)和58.2% (n = 64) (PNI)。慢性肾脏疾病(CKD)和mNUTRIC风险(OR = 13.5, 95% CI (1.89-16.05)， P=0.002)、糖尿病(DM)和MNA风险(OR = 2.82, 95% CI (1.01-7.83)， P=0.041)、高血压(HTN)和MNA风险(OR = 5.63, 95% CI (2.26-14.05)， P < 0.001)、恶性肿瘤和mNUTRIC风险(P=0.048)有统计学意义。营养风险(所有工具)显著增加了住院死亡的几率和机械通气的需要。营养不良患者的住院时间无显著差异。结论:在COVID-19重症监护患者中，营养不良普遍存在。营养不良(营养风险)与需要机械通气的风险增加和住院死亡率相关。有HTN、CKD、DM和癌症病史的患者在ICU入院时更有可能存在营养风险。

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来源期刊

Journal of Nutrition and Metabolism NUTRITION & DIETETICS-

CiteScore

5.40

自引率

0.00%

发文量

审稿时长

17 weeks

期刊介绍： Journal of Nutrition and Metabolism is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies covering the broad and multidisciplinary field of human nutrition and metabolism. The journal welcomes submissions on studies related to obesity, diabetes, metabolic syndrome, molecular and cellular biology of nutrients, foods and dietary supplements, as well as macro- and micronutrients including vitamins and minerals.