Efficacy of the prognostic nutritional index (PNI) in critically ill COVID-19 patients: A multicenter study under a treatment regime in accordance with practice guidelines

Background & aims

The prognostic nutritional index (PNI), calculated from the serum level of albumin (Alb) and total lymphocyte count (TLC), has been considered to effectively predict the outcomes of critically ill COVID-19 patients. However, since the establishment of COVID-19 treatment regimens, its effectiveness has become unclear. Therefore, we conducted a multicenter study to establish whether PNI is still valid as a prognostic indicator for these patients.

Methods

We retrospectively examined the medical records of critically ill COVID-19 patients who required intubation and mechanical ventilatory management (MV) between July 2021 and March 2023.

Results

Seventy patients (50 males, mean age 62.9 years) were included and PNI at the start of intensive care was 31.7, which was in the “critical range”. The results obtained showed that PNI was not a predictor of death, whereas the presence of chronic obstructive pulmonary disease (COPD) and a high SOFA score were identified as predictors. The presence of COPD and obesity were also predictive factors for the number of days of MV.

Conclusions

Since the establishment of COVID-19 treatment regimens, PNI may not be an effective tool for predicting the risk of death or MV days in critically ill COVID-19 patients.