Prevalence of malnutrition and analysis of related factors in elderly patients with COVID-19 in Wuhan, China

Li, Tao; Yalan, ZhANG; Cheng, Gong; Wang, Jing; Bao, Lei; Shi, Li; Duan, Jun

doi:10.1038/s41430-020-0642-3

Cited by 299 publications

(371 citation statements)

References 28 publications

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“…22 Malnutrition has been deemed a risk factor in adult COVID-19. 23 In children, malnutrition is known to foster infections; however in this study, majority of the children were well nourished with respect to weight for age criteria. Also, only one (2%) child had underlying Type I Diabetes Mellitus and rest were free of co-morbidities thus maybe reducing the burden of severe disease.…”

Section: Discussionmentioning

confidence: 65%

Epidemiological and clinical characteristics of COVID-19 in Indian children in the initial phase of the pandemic: A cross-sectional study

Sarangi

Reddy

Oswal

et al. 2020

Preprint

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Background: India saw the largest and the most stringent lockdown in the world when the number of COVID-19 cases reached around 550. With some early benefits in containing the surge and restricting the R0 of the virus, the current relaxation of lockdown norms has witnessed an exponential rise in positive cases. With scarcity of Pediatric data from the Indian subcontinent, early observations in the pandemic are pivotal in improving the understanding of physiologic behaviors, identifying risks, and guiding clinicians in assessing time-tested interventions and augmenting the awareness in the masses about the manifold clinical profiles of an evolving disease.Objective: To assess the epidemiological and clinical characteristics of children admitted with COVID-19 infection early in the pandemic.Study Design: A cross-sectional studyParticipants: Fifty children between one month and 18 years of age whose nasopharyngeal swab tested positive for SARS-CoV-2 by RT- PCR. Results: 28 (56%) children were male. 41 (82%) came from government declared containment zones with only one child having history of travel to affected area. Home overcrowding was observed in 33 (66%). Of the 50 children, 29 (58%) were asymptomatic while 20 (40%) and one (2%) had mild and moderate symptoms respectively. Fever, cough, and sore throat were the most common symptoms. 49 (98%) children had BCG scar. Leucopenia was seen in three (6%) only. Mean (SD) Neutrophil-Lymphocyte-Ratio (NLR) was 0.78 (0.48) while mean (SD) CRP was 10.98 (23.90). All 50 (100%) were cured. Conclusion: Our study reasserts the increasing pediatric burden of COVID-19 with all age groups affected and overcrowding as a risk factor for continued community transmission, thus beckoning that public health policies be directed to ensuring further preventive measures. It also re-iterates the milder disease pattern in children with COVID-19 in the initial phase of the pandemic with a high proportion of asymptomatic and mild illness. Though abnormal CRP values are synonymous with the illness in children; leucopenia may not be a consistent finding.

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Section: Discussionmentioning

confidence: 65%

Epidemiological and clinical characteristics of COVID-19 in Indian children in the initial phase of the pandemic: A cross-sectional study

Sarangi

Reddy

Oswal

et al. 2020

Preprint

View full text Add to dashboard Cite

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“…Among patients with symptoms, those with severe or critical conditions had much higher BMIs and individuals with obesity prevalence than the normal population or patients who were COVID‐19 negative 32,61–70 . Two studies showed that the odds of having COVID‐19 increased by 30% (OR = 1.30; 95% CI, 1.09–1.54; p = 0.0030) 61 and by 38% (OR = 1.38; p < 0.0001), 32 respectively, among the individuals with obesity (Table 1).…”

Section: Epidemiological Relationships: Individuals With Overweight Amentioning

confidence: 99%

Individuals with obesity and COVID‐19: A global perspective on the epidemiology and biological relationships

et al. 2020

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Summary The linkage of individuals with obesity and COVID‐19 is controversial and lacks systematic reviews. After a systematic search of the Chinese and English language literature on COVID‐19, 75 studies were used to conduct a series of meta‐analyses on the relationship of individuals with obesity–COVID‐19 over the full spectrum from risk to mortality. A systematic review of the mechanistic pathways for COVID‐19 and individuals with obesity is presented. Pooled analysis show individuals with obesity were more at risk for COVID‐19 positive, >46.0% higher (OR = 1.46; 95% CI, 1.30–1.65; p < 0.0001); for hospitalization, 113% higher (OR = 2.13; 95% CI, 1.74–2.60; p < 0.0001); for ICU admission, 74% higher (OR = 1.74; 95% CI, 1.46–2.08); and for mortality, 48% increase in deaths (OR = 1.48; 95% CI, 1.22–1.80; p < 0.001). Mechanistic pathways for individuals with obesity are presented in depth for factors linked with COVID‐19 risk, severity and their potential for diminished therapeutic and prophylactic treatments among these individuals. Individuals with obesity are linked with large significant increases in morbidity and mortality from COVID‐19. There are many mechanisms that jointly explain this impact. A major concern is that vaccines will be less effective for the individuals with obesity.

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“…As suggested by the European Society of Enteral and Parenteral Nutrition (ESPEN), prevention, diagnosis and treatment of malnutrition should be considered in the management of COVID-19 patients to improve both short- and long-term prognosis [ 8 ]. However, the few studies available so far have focused on hospitalised patients and selected populations, such as elderly or critically ill patients [ 15 , 16 ]. Our study expands the knowledge of the impact of COVID-19 on nutritional status to a broader population, with a wide range of ages and disease severity, spanning from patients with mild disease managed at home to inpatients with severe disease admitted to the ICU.…”

Section: Discussionmentioning

confidence: 99%

COVID-19 is associated with clinically significant weight loss and risk of malnutrition, independent of hospitalisation: A post-hoc analysis of a prospective cohort study

et al. 2021

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Background & aims Coronavirus disease 2019 (COVID-19) may associate with clinical manifestations, ranging from alterations in smell and taste to severe respiratory distress requiring intensive care, that might associate with weight loss and malnutrition. We aimed to assess the incidence of unintentional weight loss and malnutrition in COVID-19 survivors. Methods In this post-hoc analysis of a prospective observational cohort study, we enrolled all adult (age ≥18 years) patients with a confirmed diagnosis of COVID-19 who had been discharged home from either a medical ward or the Emergency Department of San Raffaele University Hospital, and were re-evaluated after remission at the Outpatient COVID-19 Follow-Up Clinic of the same Institution from April 7, 2020, to May 11, 2020. Demographic, anthropometric, clinical and biochemical parameters upon admission were prospectively collected. At follow-up, anthropometrics, the mini nutritional assessment screening and a visual analogue scale for appetite were assessed. Results A total of 213 patients were included in the analysis (33% females, median age 59.0 [49.5–67.9] years, 70% overweight/obese upon initial assessment, 73% hospitalised). Sixty-one patients (29% of the total, and 31% of hospitalised patients vs . 21% of patients managed at home, p = 0.14) had lost >5% of initial body weight (median weight loss 6.5 [5.0–9.0] kg, or 8.1 [6.1–10.9]%). Patients who lost weight had greater systemic inflammation (C-reactive protein 62.9 [29.0–129.5] vs .48.7 [16.1–96.3] mg/dL; p = 0.02), impaired renal function (23.7% vs . 8.7% of patients; p = 0.003) and longer disease duration (32 [27–41] vs . 24 [21–30] days; p = 0.047) as compared with those who did not lose weight. At multivariate logistic regression analysis, only disease duration independently predicted weight loss (OR 1.05 [1.01–1.10] p = 0.022). Conclusions COVID-19 might negatively impact body weight and nutritional status. In COVID-19 patients, nutritional evaluation, counselling and treatment should be implemented at initial assessment, throughout the course of disease, and after clinical remission. Clinicaltrials.gov registration NCT04318366 .

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Prevalence of malnutrition and analysis of related factors in elderly patients with COVID-19 in Wuhan, China

Cited by 299 publications

References 28 publications

Epidemiological and clinical characteristics of COVID-19 in Indian children in the initial phase of the pandemic: A cross-sectional study

Epidemiological and clinical characteristics of COVID-19 in Indian children in the initial phase of the pandemic: A cross-sectional study

Individuals with obesity and COVID‐19: A global perspective on the epidemiology and biological relationships

COVID-19 is associated with clinically significant weight loss and risk of malnutrition, independent of hospitalisation: A post-hoc analysis of a prospective cohort study

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