Malnutrition management of hospitalized patients with diabetes/hyperglycemia and COVID-19 infection

Burgos, R.; García-Almeida, José Manuel; Matía‐Martín, Pilar; Palma, S; Sanz-París, A.; Zugasti, Ana; Alfaro, Juan Manuel Esquivel; Fullana, Ana Artero; Continente, Alfonso Calañas; Chicetru, María Jesús; Malpartida, Katherine García; Faes, Ángela González; Sánchez, Víctor González; López, María Laínez; Martínez-Ortega, Antonio Jesús; Roldán, Juana Oliva; Moreno, Clara Serrano; Llanos, Pablo Suárez

doi:10.1007/s11154-022-09714-z

Cited by 6 publications

(6 citation statements)

References 48 publications

(52 reference statements)

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“…Both lymphocyte function and innate host defense mechanisms (macrophages and granulocytes) are affected [ 50 ]. Second, malnutrition not only promotes acute and chronic infections, but also leads to increased food intake, nutrient absorption, direct or catabolic nutrient losses, and metabolic demands [ 13 , 51 ]. Under inflammatory conditions, mediators increase the catabolic disease state, characterized by enhanced arginine use.…”

Section: Discussionmentioning

confidence: 99%

“…Both diabetes and malnutrition affect the subjective quality of life and the incidence of complications as well as life expectancy in hospitalized patients [ 11 , 12 ]. Patients with diabetes usually are at high risk of malnutrition due to increased nutritional requirements and severe acute inflammatory response [ 13 ]. It has been shown that malnutrition is associated with significant modulation of glycemic, hormonal, and cytokine parameters in type 2 diabetes [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

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Geriatric Nutrition Risk Index as a predictor of cardiovascular and all-cause mortality in older Americans with diabetes

Shen

Yang

et al. 2023

Diabetol Metab Syndr

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Background and aims Few studies have examined the relationship between malnutrition, as defined by the Geriatric Nutrition Risk Index (GNRI), and all-cause mortality and cardiovascular mortality events, particularly in persons with diabetes. The study aimed at the association between GNRI and all-cause mortality and cardiovascular mortality in older Americans with diabetes. Methods Data from this retrospective study were obtained from the National Health and Nutrition Examination (NHANES) 1999–2016. Using data from The NHANES Public-Use Linked Mortality Files to assess all-cause mortality (ACM) and cardiovascular mortality (CVM). After excluding participants younger than 60 years and without diabetes, and with missing follow-up data, 4400 cases were left in this study. Persons with diabetes were divided by GNRI into 3 groups: GNRI ≥ 98; 92 ≤ GNRI < 98; and GNRI < 92; (No; Low; Moderate/Severe (M/S) group). We used Cox proportional hazard regression model to explore the predictive role of GNRI on ACM and CVM in elderly persons with diabetes. Restricted cubic splines to investigate the existence of a dose–response linear relationship between them. Result During a median follow-up period of 89 months, a total of 538 (12.23%) cardiovascular deaths occurred and 1890 (42.95%) all-cause deaths occurred. Multifactorial COX regression analysis showed all-cause mortality (hazard ratio [HR]: 2.58, 95% CI: 1.672–3.994, p < 0.001) and cardiovascular mortality (HR: 2.29, 95% CI: 1.063–4.936, p = 0.034) associated with M/S group risk of malnutrition in GNRI compared to no group. A negative association between GNRI and all-cause mortality was observed across gender and ethnicity. However, the same negative association between GNRI and cardiovascular mortality was observed only for males (HR:0.94, 95% CI:0.905–0.974, p < 0.001) and other races (HR:0.92, 95% CI:0.861–0.976, p = 0.007). And there was no significant correlation between low malnutrition and cardiovascular mortality (p = 0.076). Restricted cubic splines showed a nonlinear relationship between GNRI and all-cause mortality and cardiovascular mortality (non-linear p < 0.001, non-linear p = 0.019). Conclusions Lower GNRI levels are associated with mortality in older patients with diabetes. GNRI may be a predictor of all-cause mortality and cardiovascular mortality risk in older patients with diabetes.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Geriatric Nutrition Risk Index as a predictor of cardiovascular and all-cause mortality in older Americans with diabetes

Shen

Yang

et al. 2023

Diabetol Metab Syndr

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“…Undernourished patients are more susceptible to infection with SARS-CoV-2. Also, COVID-19 itself can lead to malnutrition, which affects outcome and prognosis; therefore, COVID-19 outcome could be improved with improved nutritional status[ 58 ].…”

Section: Observations and Discussionmentioning

confidence: 99%

Non-pulmonary involvement in COVID-19: A systemic disease rather than a pure respiratory infection

El-Kassas¹,

Alboraie²,

Elbadry³

et al. 2023

World J Clin Cases

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During the early phase of the coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), diagnosis was difficult due to the diversity in symptoms and imaging findings and the variability of disease presentation. Pulmonary manifestations are reportedly the main clinical presentations of COVID-19 patients. Scientists are working hard on a myriad of clinical, epidemiological, and biological aspects to better understand SARS-CoV-2 infection, aiming to mitigate the ongoing disaster. Many reports have documented the involvement of various body systems and organs apart from the respiratory tract including the gastrointestinal, liver, immune system, renal, and neurological systems. Such involvement will result in diverse presentations related to effects on these systems. Other presentations such as coagulation defects and cutaneous manifestation may also occur. Patients with specific comorbidities including obesity, diabetes, and hypertension have increased morbidity and mortality risks with COVID-19.

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“…Population-level malnutrition is associated with increased rates of fatal COVID-19 in areas where undernutrition is commonplace (58). Moreover, nutritional status is adversely affected by acute and chronic infections, which serve as negative prognosticators, especially in institutional settings (59)(60)(61). Patients with COVID-19 are especially vulnerable to the metabolic derangements associated with malnutrition, particularly in light of the significant inflammatory response that accompanies both conditions (62)(63)(64).…”

Section: Edge 2: Covid-19 and Malnutrition Epidemiologymentioning

confidence: 99%

The syndromic triad of COVID-19, type 2 diabetes, and malnutrition

Mechanick

Christofides²,

Marchetti³

et al. 2023

Front. Nutr.

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The coronavirus disease 2019 (COVID-19) pandemic challenges our collective understanding of transmission, prevention, complications, and clinical management of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Risk factors for severe infection, morbidity, and mortality are associated with age, environment, socioeconomic status, comorbidities, and interventional timing. Clinical investigations report an intriguing association of COVID-19 with diabetes mellitus and malnutrition but incompletely describe the triphasic relationship, its mechanistic pathways, and potential therapeutic approaches to address each malady and their underlying metabolic disorders. This narrative review highlights common chronic disease states that interact epidemiologically and mechanistically with the COVID-19 to create a syndromic phenotype—the COVID-Related Cardiometabolic Syndrome—linking cardiometabolic-based chronic disease drivers with pre-, acute, and chronic/post-COVID-19 disease stages. Since the association of nutritional disorders with COVID-19 and cardiometabolic risk factors is well established, a syndromic triad of COVID-19, type 2 diabetes, and malnutrition is hypothesized that can direct, inform, and optimize care. In this review, each of the three edges of this network is uniquely summarized, nutritional therapies discussed, and a structure for early preventive care proposed. Concerted efforts to identify malnutrition in patients with COVID-19 and elevated metabolic risks are needed and can be followed by improved dietary management while simultaneously addressing dysglycemia-based chronic disease and malnutrition-based chronic disease.

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Malnutrition management of hospitalized patients with diabetes/hyperglycemia and COVID-19 infection

Cited by 6 publications

References 48 publications

Geriatric Nutrition Risk Index as a predictor of cardiovascular and all-cause mortality in older Americans with diabetes

Geriatric Nutrition Risk Index as a predictor of cardiovascular and all-cause mortality in older Americans with diabetes

Non-pulmonary involvement in COVID-19: A systemic disease rather than a pure respiratory infection

The syndromic triad of COVID-19, type 2 diabetes, and malnutrition

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