Effects of malnutrition on mortality in oldest-old inpatients with COVID-19 in the GERIA-COVID cohort

Sánchez-Rodríguez, Dolores; Sacco, Guillaume; Gautier, Jennifer; Brière, Olivier; Annweiler, Cédric

doi:10.1016/j.maturitas.2021.11.016

Cited by 5 publications

(4 citation statements)

References 6 publications

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“…We found no significant association between malnutrition and COVID-19 mortality. In line with our results, Sanchez-Rodriguez et al reported a lack of significant association between malnutrition (using the geriatric nutritional risk index) and COVID-19 mortality among older adult patients (16). However, in some studies, a significant positive association was reported in this regard (37).…”

Section: Discussionsupporting

confidence: 92%

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Malnutrition elevates delirium and ICU stay among critically ill older adult COVID-19 patients

Gholi,

Rezaei,

Vahdat Shariatpanahi

et al. 2024

Front. Med.

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Background and aimMalnutrition among intensive care unit (ICU) patients is associated with a higher risk of mortality and prolonged hospitalization. However, the influence of malnutrition on severe outcomes of ICU patients with coronavirus disease 2019 (COVID-19) is unclear. By evaluating the effect of malnutrition on the outcomes of COVID-19 in the ICU in older adult patients, this study will contribute to new knowledge of assessing the nutritional status and recovery of these patients.MethodsIn the current single center prospective study, 310 critically ill COVID-19 patients with an age range of ≥65 years were recruited. Data on demographic characteristics, laboratory parameters, comorbidities, medications, and types of mechanical ventilation were collected in the first 24 h of ICU admission. Malnutrition was defined based on the two-step approach of the Global Leadership Initiative on Malnutrition (GLIM) scale at baseline. During the 45 days after the baseline, we collected data on delirium incidence, mortality, invasive mechanical ventilation (IMV) requirement, length of ICU and hospital admission, and re-hospitalization.ResultsIn this study, the prevalence of malnutrition was 63.4% among critically ill COVID-19 patients. During the 45-day follow-up, 190 (61.3%) COVID-19 deaths were recorded among the baseline 310 patients. After controlling for potential confounders, malnutrition was associated with an increased risk of delirium so malnourished COVID-19 patients had a significantly 35% higher risk of delirium than those without malnutrition (HR: 1.35, 95% CI: 1.01–1.83). Such a significant association was not for COVID-19 mortality and IMV requirement. In addition, malnutrition was associated with a significantly 84% greater odds of prolonged ICU admission (OR: 1.84, 95% CI: 1.09–3.10). No significant association was seen between malnutrition and re-hospitalization and also prolonged hospital admission.ConclusionMalnutrition was associated with an increased risk of delirium and prolonged ICU admission among critically ill older adult COVID-19 patients. Prevention, diagnosis, and treatment of malnutrition could be a key component in improving outcomes in these patients.

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Section: Discussionsupporting

confidence: 92%

“…However, these associations among ICU patients with COVID-19 are not clear. Some studies indicated that malnourished COVID-19 patients had a higher risk of mortality and prolonged hospitalization compared with patients without malnutrition (14,15), while other studies revealed a non-significant association (16).…”

Section: Introductionmentioning

confidence: 99%

Malnutrition elevates delirium and ICU stay among critically ill older adult COVID-19 patients

Gholi,

Rezaei,

Vahdat Shariatpanahi

et al. 2024

Front. Med.

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“…Moreover, patients at risk of malnutrition might have died sooner and had therefore a shorter length of stay. This letter supports the findings in GERIA-COVID, where the GNRI did not seem to be the most appropriate assessment tool in older inpatients with COVID-19 [5] and endorses the ESPEN statements [4] , which did not recommend the GNRI for this population.…”

supporting

confidence: 78%

“…Malnutrition is associated with higher mortality [1] , [2] and longer length of stay [3] in patients with COVID-19 and the expert statements and practical guidance from the European Society of Clinical Nutrition and Metabolism (ESPEN) on the nutritional management of individuals with SARS-CoV-2 infection [4] recommend several malnutrition assessment tools. The association between score on the Geriatric Nutritional Risk Index (GNRI) and mortality was also evaluated in our paper reporting results from the GERIA-COVID cohort, where “no association between 14-day, 3-month and 12-month mortality was found…” [5] . This letter reports the association of GNRI score with length of stay in older inpatients with COVID-19 in the Age ing in Bru ssels (AgeBru) cohort.…”

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confidence: 99%

Effects of malnutrition on mortality in oldest-old inpatients with COVID-19 in the GERIA-COVID cohort: Additional findings from the AgeBru cohort

et al. 2022

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Association between malnutrition and post–acute COVID‐19 sequelae: A retrospective cohort study

Ponce,

Anzalone,

Schissel

et al. 2024

J Parenter Enteral Nutr

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BackgroundLong coronavirus disease consists of health problems people experience after being infected with severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2). These can be severe and include respiratory, neurological, and gastrointestinal symptoms, with resulting detrimental impacts on quality of life. Although malnutrition has been shown to increase risk of severe disease and death during acute infection, less is known about its influence on post–acute COVID‐19 outcomes. We addressed this critical gap in knowledge by evaluating malnutrition's impact on post–COVID‐19 sequelae.MethodsThis study leveraged the National COVID Cohort Collaborative to identify a cohort of patients who were at least 28 days post–acute COVID‐19 infection. Multivariable Cox proportional hazard models evaluated the impact of malnutrition on the following postacute sequelae of SARS‐CoV‐2: (1) death, (2) long COVID diagnosis, (3) COVID‐19 reinfection, and (4) other phenotypic abnormalities. A subgroup analysis evaluated these outcomes in a cohort of hospitalized patients with COVID‐19 with hospital‐acquired (HAC) malnutrition.ResultsThe final cohort included 4,372,722 individuals, 78,782 (1.8%) with a history of malnutrition. Individuals with malnutrition had a higher risk of death (adjusted hazard ratio [aHR]: 2.10; 95% CI: 2.04–2.17) and SARS‐CoV‐2 reinfection (aHR: 1.52; 95% CI: 1.43–1.61) in the postacute period than those without malnutrition. In the subgroup, those with HAC malnutrition had a higher risk of death and long COVID diagnosis.ConclusionNutrition screening for individuals with acute SARS‐CoV‐2 infection may be a crucial step in mitigating life‐altering, negative postacute outcomes through early identification and intervention of patients with malnutrition.

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Effects of malnutrition on mortality in oldest-old inpatients with COVID-19 in the GERIA-COVID cohort

Cited by 5 publications

References 6 publications

Malnutrition elevates delirium and ICU stay among critically ill older adult COVID-19 patients

Malnutrition elevates delirium and ICU stay among critically ill older adult COVID-19 patients

Effects of malnutrition on mortality in oldest-old inpatients with COVID-19 in the GERIA-COVID cohort: Additional findings from the AgeBru cohort

Association between malnutrition and post–acute COVID‐19 sequelae: A retrospective cohort study

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