Evaluation of Nutritional Status of Intensive Care Unit COVID-19 Patients Based on the Nutritional Risk Screening 2002 Score

Abstract

Background. Patients with COVID-19 are susceptible to malnutrition, which is particularly concerning among critically ill patients. We evaluated the Nutritional Risk Screening 2002 (NRS-2002) score in such patients and determined its relationship with the hospitalization outcome. Methods. This cross-sectional study involved COVID-19 patients admitted to the intensive care units (ICUs) of Shahid Faghihi Hospital, Shiraz, Iran, between February and March 2021. We assessed the nutritional status using NRS-2002 and determined disease severity with the APACHE II index. Demographic information, weight, height, clinical signs, previous illness, medications, biochemical test results, and history of anorexia and weight loss were recorded. Data were analyzed using SPSS version 18. Results. The mean age of 100 patients was 55.36 ± 18.86 years. According to NRS-2002, 30%, 29%, and 41% of patients were at low risk, moderate risk, and high risk of malnutrition, respectively. Age and BUN increased significantly with NRS-2002, while albumin and hematocrit followed the opposite trend ( P < 0.001 ). Patients who died had lower albumin and hematocrit levels but higher age, NRS-2002 scores, and BUN/creatinine levels than those who recovered. Multivariable logistic regression revealed that for every unit increase in the NRS-2002 score, the odds of mortality increased by 354% (OR: 4.54, CI: 1.48, 13.95, P = 0.008 ). Conclusion. NRS-2002 is a valuable prognostic tool for critically ill COVID-19 patients, with each unit's rise in the score being associated with a 354% rise in the odds of mortality. Increased malnutrition risk was linked with higher age and BUN and lower albumin and hematocrit levels.

Exploring micronutrient supplements in disease conditions: are they effective?

“…Several reviews have indicated the important roles of micronutrients in immune response [18,20,32,80,87,125], with these roles also applying to the treatment of COVID-19 [20,87,126,127]. Deficiencies of these micronutrients have been reported in increased infection and severity of COVID-19 [128][129][130][131][132].…”

“…Vitamins C and D, zinc and selenium, which are essential micronutrients, have been reported to improve the treatment of COVID-19 and reduce mortality [128,133]. The effect of these micronutrients against COVID-19 is generally to strengthen the immune system by being available for every metabolic process.…”

Gut Microbiota and Critically Ill Patients: Immunity and Its Modulation via Probiotics and Immunonutrition

“…There is already solid evidence supporting the use of specific protein-rich food nutrient supplements on COVID-19 patients’ morbidity and mortality [ 97 ]. In detail, in the literature, some reports evaluated the impact of nutrition in ICU COVID-19 patients with early manifestations of malnutrition and, sarcopenia [ 98 ]. It is important to recognize that both malnutrition/sarcopenia and hyper-inflammatory state are significantly associated with morbidity and mortality of COVID-19 patients [ 99 ] ( Figure 1 ).…”

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“…Moreover, Figure 2 shows all the curcumin RCTs in COVID-19, studying several other outcomes in addition to mortality (hospitalization, ventilation, numbers of recovery or recovery time, progression of the disease, oxigen saturation, viral positivity, in both early and late treatments): [17,[22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40]. This plot shows pooled effects, see the specific outcome analyses for individual outcomes, and the heterogeneity section [21] for discussion.…”

“…Figure 2. Random effects meta-analysis for all RCTs about curcumin in COVID-19[17,[22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40]. This plot shows pooled effects, see the specific outcome analyses for individual outcomes, and the heterogeneity section[21] for discussion.…”