Prevalence and severity of malnutrition in hospitalized COVID-19 patients

Clin Nutr ESPEN. 2020 Dec;40:214-219. doi: 10.1016/j.clnesp.2020.09.018. Epub 2020 Sep 18.

Abstract

Background & aims: Nutritional knowledge in patients with SARS-Cov2 infection (COVID-19) is limited. Our objectives were: i) to assess malnutrition in hospitalized COVID-19 patients, ii) to investigate the links between malnutrition and disease severity at admission, iii) to study the impact of malnutrition on clinical outcomes such as transfer to an intensive care unit (ICU) or death.

Methods: Consecutive patients hospitalized in a medicine ward at a university hospital were included from March 21st to April 24th 2020 (n = 114, 60.5% males, age: 59.9 ± 15.9 years). Nutritional status was defined using Global Leadership Initiative on Malnutrition (GLIM) criteria. Clinical, radiological and biological characteristics of COVID-19 patients were compared according to the presence of malnutrition. Logistic regression was used to assess associations between nutritional parameters and unfavourable outcomes such as transfer to intensive care unit (ICU) or death.

Results: The overall prevalence of malnutrition was 42.1% (moderate: 23.7%, severe: 18.4%). The prevalence of malnutrition reached 66.7% in patients admitted from ICU. No significant association was found between nutritional status and clinical signs of COVID-19. Lower albumin levels were associated with a higher risk of transfer to ICU (for 10 g/l of albumin, OR [95%CI]: 0.31 [0.1; 0.7]; p < 0.01) and this association was independent of age and CRP levels.

Conclusions: COVID-19 in medical units dedicated to non-intensive care is associated with a high prevalence of malnutrition, especially for patients transferred from ICU. These data emphasize the importance of early nutritional screening in these patients to adapt management accordingly.

Keywords: Albumin; COVID-19; Malnutrition; Pneumonia; SARS-Cov2.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Betacoronavirus*
  • COVID-19
  • Coronavirus Infections / complications*
  • Female
  • France / epidemiology
  • Hospital Mortality
  • Hospitalization*
  • Humans
  • Longitudinal Studies
  • Male
  • Malnutrition / complications
  • Malnutrition / epidemiology*
  • Middle Aged
  • Nutrition Assessment
  • Pandemics
  • Pneumonia, Viral / complications*
  • Prevalence
  • SARS-CoV-2
  • Severity of Illness Index