The prevalence of malnutrition and analysis of related factors among adult patients with the Coronavirus Disease 2019 (COVID 19) in a tertiary government hospital: The MalnutriCoV study

Abstract

Background and Aims As of November 2020, the Coronavirus Disease 2019 (COVID 19) has infected more than 396,000 people in the Philippines. Although no study has been done on malnutrition among a general cohort of patients with COVID 19, it has long been associated with increased mortality and poor long-term outcomes. We aimed to determine the prevalence of malnutrition among patients with COVID 19 admitted in a tertiary government hospital. Methods Cross-sectional study on COVID 19-confirmed patients admitted to the COVID 19 wards from July 15 to September 15, 2020. Nutritional status was assessed using the Philippine Society for Parenteral and Enteral Nutrition (PhilSPEN) modified Subjective Global Assessment Grade (SGA) tool. Malnutrition was defined as those with SGA grades B and C. Chi-square test or Fisher exact test of association, as appropriate, was used to identify factors that have a significant association with malnutrition. Furthermore, logistic regression was done on factors with significant association. Results Among the 355 adult patients in the study, 71.83% (255/355) were malnourished [SGA B: 48.73% (173/255); SGA C: 23.10% (82/255)]. The following were shown to have significant association with malnutrition: community-acquired pneumonia (CAP) [p-value < 0.001], hospital-acquired pneumonia (HAP) [p-value 0.002], and chronic kidney disease (p-value 0.033). Multivariable logistic regression revealed that age [OR 1.02, CI 95% 1.00, 1.04, p-value 0.027] and CAP-Moderate Risk (MR) [OR 3.02, CI 95% 1.73, 5.27, p-value < 0.001] are significant predictors of malnutrition. All patients with CAP- High Risk and HAP were malnourished. Conclusion The prevalence of malnutrition was high (71.83%) in a general cohort of COVID 19 patients as measured by the modified SGA tool. The following are risk factors of malnutrition among patients with COVID 19: age, CAP, and HAP. Nutritional support and management of comorbidities are of paramount importance in the care of patients with COVID 19.

Nutrition improves COVID-19 clinical progress

“…In viral infections such as COVID-19, the effect of nutrition on catching the disease and/or the prognosis of the disease should not be ignored. In line with our findings, in a study conducted with 355 adults, the prevalence of malnutrition was high (71.83%) in a general cohort of COVID-19 patients [ 14 ]. In addition, Allard et al reported that about 40% of patients admitted for COVID-19 pneumonia had malnutrition and about 35% of them had severe nutritional risk [ 2 ].…”

“…Similarly, in the recently defined COVID-19, malnutrition accelerates the inflammatory process and is associated with a long hospitalization period [ 2 , 12 , 13 ]. Therefore, it is very important to evaluate hospitalized patients in terms of malnutrition risk and take necessary precautions as well as monitor nutrition status during the clinical course of the disease [ 13 , 14 ]. The nutrition status of patients with COVID-19 should be taken into consideration, and most of all, it should be remembered that malnutrition can be a prognostic factor for morbidity and mortality related to COVID-19.…”

Gastrointestinal Sequelae 3 and 6 Months After Hospitalization for Coronavirus Disease 2019

“…Therefore, it may be imperative to establish malnutrition screening practices in post-COVID 19 patients who have recovered from acute infection. 6,7 The strengths of our study include the largest cohort of patients with follow-up data of COVID-19-associated GI symptoms to date; a diverse patient population across multiple hospitals in Long Island, Manhattan, Queens, and Staten Island making results more generalizable; and manual chart review to confirm GI findings on admission and follow-up visits. Moreover, patients were diagnosed with malnutrition by a dedicated nutrition service.…”

Outcomes of nutritionally at-risk Coronavirus Disease 2019 (COVID 19) patients admitted in a tertiary government hospital: A follow-up study of the MalnutriCoV study

“…Factors associated with malnutrition include older age, severity of pneumonia, and chronic kidney disease. However, there was no data on the clinical outcomes of the patients [6].…”