Prognostic nutritional index as indicator of immune nutritional status of patients with COVID-19

Abstract

Abstract. Purpose: This study aimed to investigate the effect of the nutritional status, as assessed by the prognostic nutritional index (PNI) on the disease prognosis of patients with COVID-19. Methods: This retrospective study included 282 patients with COVID-19. The PNI score of all patients, 147 of whom were male, with a mean age of 56.4±15.3 years, was calculated. According to the PNI score, the patients with normal and mild malnutrition constituted group-1 (n=159) and the patients with moderate-to-severe and serious malnutrition constituted group-2 (n=123). Results: The PNI score was correlated with age (r=−0.146, p=0.014); oxygen saturation (r=0.190, p=0.001); heart rate (r=−0.117, p=0.05); hospitalization duration (r=−0.266, p<0.001); white blood cells (r=0.156, p=0.009); hemoglobin (r=0.307, p<0.001); C-reactive protein (CRP) (r=−0.346, p<0.001); creatinine (r=−0.184, p=0.002); D-dimer (r=−0.304, p<0.001); ferritin (r=−0.283, p<0.001); procalcitonin (r=−0.287, p<0.001); the confusion, urea, respiratory rate, blood pressure, and age ≥65 years score (r=−0.217, p<0.001); and the quick sequential organ failure assessment score (r=−0.261, p<0.001) in patients with COVID-19. Mortality was significantly higher in Group 2 (p<0.001). Survival was significantly higher if PNI score was >41.2 (p<0.001, sensitivity: 78.7% and specificity: 84.2%). In multivariate regression analysis, among various other parameters, only PNI score and oxygen saturation had a significant effect on the disease course (p=0.02 and p=0.045, respectively). Conclusion: PNI, calculated from the serum albumin concentration and total lymphocyte count, is a simple and objective indicator that assesses the immune nutritional status of patients with COVID-19. The presence of malnutrition has a high predictive value in predicting the severity of COVID-19. Our data suggest that the PNI might be useful for risk stratification of patients with COVID-19 in clinical practice.

The Relationship Between OR-PNI Score and Disease Course in Coronavirus-19 Infection

“…[20] In our previous study, we categorized our patients as having normal or mild malnutrition and moderate-to-severe or serious malnutrition using the PNI score and concluded that mortality was higher in patients with severe malnutrition. [14] The results obtained in the present study are in accordance with the data we presented in our previous study.…”

“…[12] The prognostic nutritional index (PNI) is an objective index calculated using albumin level and lymphocyte count, indicating the prognosis of various diseases. [13,14] In a previous study, we reported that the PNI score was correlated with many disease-related laboratory parameters in COVID-19 patients. The PNI values were worse in patients older than 65 years, and a higher mortality rate was seen in patients with low PNI scores.…”

“…The PNI values were worse in patients older than 65 years, and a higher mortality rate was seen in patients with low PNI scores. [14] OR-PNI is a newly developed score by our hospital, and it can be calculated by combining the PNI score with oxygen saturation percentage and radiological findings in PCR-positive COVID-19-infected patients. Details on OR-PNI scoring are described in the methods section.…”

Assessment of Spanish Food Consumption Patterns during COVID-19 Home Confinement

“…Recent studies have shown that diet and individual nutrients can influence systemic markers of immune function and inflammation. Moreover, the nutritional status could be used as indicator to assess the immune status of patients with COVID-19 [40,41]. It is also important to take into account the energy balance in any diet, since the prevalence of obesity is increasing worldwide, and there is a need to act to curb it [39].…”

Association between prognostic nutritional index (PNI) and depression: the NHANES 2005–2018

“…Secondly, the relationship between PNI and depression might be mutual. While a lower PNI signi es nutritional insu ciency, it also serves as a marker for adverse health conditions, including chronic diseases, immune dysfunction, and in ammation [22][23][24][25] . These health complications associated with a lower PNI could contribute to the onset or exacerbation of depressive symptoms [26][27][28][29] .…”