Nutrition risk assessed by Nutritional Risk Screening 2002 is associated with in‐hospital mortality in older patients with COVID‐19

Abstract

Background Although numerous studies have been performed to determine predictors of coronavirus disease 2019 (COVID‐19) mortality, studies that address the geriatric age group are limited. The aim of this study was to investigate the utility of the Nutritional Risk Screening 2002 (NRS‐2002) and the Geriatric 8 (G8) screening tools in predicting clinical outcomes in older adults hospitalized with COVID‐19. Methods Patients aged ≥60 years who were hospitalized with COVID‐19 in the second wave of the pandemic were included in the study. COVID‐19 infection was demonstrated by a positive real‐time reverse transcriptase–polymerase chain reaction on nasopharyngeal swab or positive radiological findings. Disease severity was determined as defined by the National Institutes of Health. Patient demographics, laboratory values on admission, comorbidities, and medications were recorded. The NRS‐2002 and the G8 screening tools were performed for all patients by the same geriatrician. Primary outcome was in‐hospital mortality. Results A total of 121 patients were included. Mean age was 75 ± 9 years, and 51% were female. Mean body mass index was 27 ± 4.5 kg/m2. Sixty‐nine percent of the patients had nutrition risk according to the NRS‐2002. Eighty‐nine percent of the patients had a G8 score ≤14. In‐hospital mortality occurred in 26 (22%) patients. Older age and having nutrition risk as determined by the NRS‐2002 were independently associated with a higher risk of in‐hospital mortality in older patients with COVID‐19. Conclusion The NRS‐2002 tool provides rapid assessment for risk stratification in hospitalized older patients with COVID‐19.

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

“…One study reviewed 4,187 hospitalized COVID-19 patients and revealed ten-fold higher odds of mortality among those who were malnourished relative to well-nourished individuals [ 19 ]. Another study on older, hospitalized COVID-19 patients also independently linked older age and higher NRS‐2002 scores with in‐hospital mortality [ 23 ].…”

Potentially inappropriate medications based on TIME criteria and risk of in-hospital mortality in COVID-19 patients

“…A study, which compared four different nutritional risk screening tools, found that the NRS-2002 was more successful than others in recognizing malnutrition in COVID-19 21 . Although the number of studies evaluating the relationship between COVID-19 and malnutrition is small, most of these studies found that malnutrition was an important risk factor for COVID-19-related mortality 2 . Early implementation of nutritional support may have reduced the mortality rate of our patients.…”

“…Many studies reported that older age was the main risk factor for COVID-19 mortality 2,3 . With aging, the immune system is more prone to infections, impaired cell-mediated and humoral immunity, and pro-inflammation.…”

“…Coronavirus disease-2019 (COVID- 19) started in China in December 2019 and it has caused mortality in approximately 6 million people and infected about 448 million people worldwide, as accessed at the time of writing this manuscript 1 . The predictors of poor outcomes in COVID-19 have been reported as male sex, older age, immunodeficiency, and having comorbidities (coronary artery disease, congestive heart failure [CHF], chronic kidney disease, chronic obstructive pulmonary disease, diabetes mellitus, hypertension, and/or obesity) [2][3][4] .…”

COVID, the Gut, and Nutritional Implications

“…Guidelines suggest implementation of a nutrition risk screening tool to identify high risk patients requiring nutrition interventions [ 1 ••]. Early evaluation (within 48 h of admission) is required to identify pre-existing malnutrition and those at high risk of developing malnutrition [ 12 ]. There are multiple validated tools that can be utilized to determine the level of nutritional risk, such as Nutrition Risk Screening 2002 (NRS-2002), Malnutrition Screening Tool (MST) or Malnutrition Universal Screening Tool (MUST), and The Nutrition Risk in Critically ill (NUTRIC) [ 3 ••, 13 ].…”