Prognostic Role of Malnutrition Diagnosed by Bioelectrical Impedance Vector Analysis in Older Adults Hospitalized with COVID-19 Pneumonia: A Prospective Study

Porto, Andrea Da; Tascini, Carlo; Peghin, Maddalena; Sozio, Emanuela; Colussi, GianLuca; Casarsa, Viviana; Bulfone, Luca; Graziano, Elena; Carlo, Chiara De; Catena, Cristiana; Sechi, Leonardo Antonio

doi:10.3390/nu13114085

Cited by 13 publications

(32 citation statements)

References 32 publications

(29 reference statements)

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“…They did not associate malnutrition with COVID-19 disease severity or outcomes. Da Porto et al reported a malnutrition prevalence of 24.3% in 150 consecutive adult patients admitted for COVID-19 pneumonia in Spain using bioelectrical impedance velocity analysis [ 29 ]. They noted during the 60 days of follow-up, 10/37 (27%) were malnourished patients, and 13/108 (12%) non-malnourished patients required invasive mechanical ventilation ( p = 0.023).…”

Section: Discussionmentioning

confidence: 99%

“…However, lower BMI appears to be an important variate of mortality in COVID-19. Da Porto et al conducted a mortality analysis based on malnutrition status in a smaller cohort of 150 adult inpatients with COVID-19 pneumonia [ 29 ]. Similar to the findings that we report in this paper, they observed a higher mortality rate (13/37; 35%) in COVID-19 inpatients with malnutrition when compared to non-malnourished patients (9/113; 8%) ( p < 0.001) [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

“…Da Porto et al conducted a mortality analysis based on malnutrition status in a smaller cohort of 150 adult inpatients with COVID-19 pneumonia [ 29 ]. Similar to the findings that we report in this paper, they observed a higher mortality rate (13/37; 35%) in COVID-19 inpatients with malnutrition when compared to non-malnourished patients (9/113; 8%) ( p < 0.001) [ 29 ]. Bedock et al reported a trend for a higher risk of mortality in 114 COVID-19 patients with weight loss above 5% of initial weight (OR: 3.7, 95% CI 1.0; 26.5, p = 0.09) [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

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Malnutrition Increases Hospital Length of Stay and Mortality among Adult Inpatients with COVID-19

et al. 2022

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Background: Malnutrition has been linked to adverse health economic outcomes. There is a paucity of data on malnutrition in patients admitted with COVID-19. Methods: This is a retrospective cohort study consisting of 4311 COVID-19 adult (18 years and older) inpatients at 5 Johns Hopkins-affiliated hospitals between 1 March and 3 December 2020. Malnourishment was identified using the malnutrition universal screening tool (MUST), then confirmed by registered dietitians. Statistics were conducted with SAS v9.4 (Cary, NC, USA) software to examine the effect of malnutrition on mortality and hospital length of stay among COVID-19 inpatient encounters, while accounting for possible covariates in regression analysis predicting mortality or the log-transformed length of stay. Results: COVID-19 patients who were older, male, or had lower BMIs had a higher likelihood of mortality. Patients with malnutrition were 76% more likely to have mortality (p < 0.001) and to have a 105% longer hospital length of stay (p < 0.001). Overall, 12.9% (555/4311) of adult COVID-19 patients were diagnosed with malnutrition and were associated with an 87.9% increase in hospital length of stay (p < 0.001). Conclusions: In a cohort of COVID-19 adult inpatients, malnutrition was associated with a higher likelihood of mortality and increased hospital length of stay.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Malnutrition Increases Hospital Length of Stay and Mortality among Adult Inpatients with COVID-19

et al. 2022

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“…Regarding the PhA values, the lowest median was observed in the study carried out in Spain, 4.4° (3.2°–5.4°), 27 whose median age was the highest among the studies. On the other hand, the highest PhA means were observed in studies with patients hospitalized exclusively in wards (5.6° ± 1.14° 25 and 5.5° ± 1.5° 28 ). There were variations in the reference values of PhA adopted by the authors of the studies included in this review, with three studies showing average PhA below the reference values 22–24 (Table 3).…”

Section: Resultsmentioning

confidence: 86%

“…After reading titles and abstracts, 218 articles were excluded. This resulted in 11 articles to be read in full and, of these, only 7 met the eligibility criteria 22–28 …”

Section: Resultsmentioning

confidence: 99%

Association between phase angle and adverse clinical outcomes in hospitalized patients with COVID‐19: A systematic review

et al. 2022

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Phase angle, obtained by bioelectrical impedance, is an indicator of cellular integrity and has been proposed as a prognostic parameter in patients who are critically ill. This systematic review aimed to evaluate the association between phase angle and adverse clinical outcomes in hospitalized patients with coronavirus disease–2019 (COVID‐19). An extensive literature search was performed in the MEDLINE/PubMed, Embase, and Web of Science databases, with interest in observational studies evaluating the association between phase angle and adverse clinical outcomes in individuals aged ≥18 years hospitalized with COVID‐19. Studies were independently selected by two reviewers, according to eligibility criteria. Subsequently, data were extracted and presented in a qualitative synthesis. The evaluation of the quality of the studies was performed according to the Newcastle‐Ottawa scale. The full methodology was published in PROSPERO (ID CRD42022306177). A total of 392 articles were identified, resulting in seven selected studies, of which six were prospective cohorts and one was retrospective. In the quality assessment, six studies obtained scores equal to or greater than seven, indicating a low risk of bias. A total of 750 participants composed the samples of the selected studies. Five studies reported an independent association between phase angle and adverse clinical outcomes during hospitalization for COVID‐19, with emphasis on prolonged hospitalization and mechanical ventilation and higher mortality in patients with a lower phase angle. Thus, phase angle measurement can be useful in the early identification of risks in patients hospitalized with COVID‐19, for the purpose of adequacy of clinical management.

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Phase angle and COVID-19: A systematic review with meta-analysis

Cornejo‐Pareja

Vegas-Aguilar

Fernández-Jiménez

et al. 2023

Rev Endocr Metab Disord

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Phase angle (PhA) has been identified as a poor prognostic factor in patients with COVID-19. This study aimed to achieve a systematic review, where we discussed the potential role of PhA value as a prognostic marker of adverse clinical outcomes such as mortality and complication in hospitalized with SARS-CoV2 infection and established the strength of recommendations for use. A systematic literature review with meta-analysis was done in the main electronic databases from 2020 to January 2023. The selected articles had to investigate adverse consequences of the COVID-19 population and raw bioimpedance parameters such as PhA and published in peer-reviewed journals. GRADE tools regarded the quality of the methodology. The review protocol was registered in PROSPERO. Only eight studies, 483 studies, were eligible for the analysis. In general, differences in PhA were seen between the comparative study groups. Patients with a low PhA experienced poor outcomes. A low PhA was associated with a significantly increased mortality risk [RR: 2.44; 95% CI (1.20–4.99), p = 0.01; I2 = 79% (p = 0.0008)] and higher complications risk [OR: 3.47, 95% CI (1.16 – 10.37), p = 0.03; I2 = 82% (p = 0.004)] in COVID-19 patients. Our analysis showed four evidence-based recommendations on the prognostic value of PhA with two strong recommendations, one of moderate and another of low-moderate quality, for predicting mortality and complications, respectively. We recommend using PhA as a prognostic marker for mortality and complications in this population. Although the results are promising, future studies must identify the PhA cut-off to guide therapeutic decisions more precisely.Registration code in PROSPERO: CRD42023391044

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Prognostic Role of Malnutrition Diagnosed by Bioelectrical Impedance Vector Analysis in Older Adults Hospitalized with COVID-19 Pneumonia: A Prospective Study

Cited by 13 publications

References 32 publications

Malnutrition Increases Hospital Length of Stay and Mortality among Adult Inpatients with COVID-19

Malnutrition Increases Hospital Length of Stay and Mortality among Adult Inpatients with COVID-19

Association between phase angle and adverse clinical outcomes in hospitalized patients with COVID‐19: A systematic review

Phase angle and COVID-19: A systematic review with meta-analysis

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