Are the Obese Patients and Patients with Severe Malnutrition at Increased Risk of Severe Coronavirus Disease 2019 during Hospital Admission?
DOI:
https://doi.org/10.3889/oamjms.2020.5619Keywords:
nutritional assessment, obesity, malnutrition, risk, COVID-19Abstract
BACKGROUND: Recently, authorities highlighted the need for nutritional management of individuals with severe acute respiratory syndrome coronavirus 2 infection.
AIM: The aim of the study was to evaluate the use of body mass index (BMI) and nutrition risk index (NRI) on hospital admission for detecting patients at risk for malnutrition and obesity and their association with patients’ outcomes (disease type, length of hospital and home stay, and inflammatory markers).
METHODS: The study of 100 patients with confirmed diagnosis Coronavirus Disease-19 (COVID-19). Assessment of patients took place at City General Hospital 8th September, Skopje, transformed into main COVID-19 Center during pandemic. Primary outcomes were NRI and BMI scores, while secondary ones: length of home and hospital stay, number of symptoms, presence of co-morbidities, type of disease, serum albumin, and C-reactive protein (CRP).
RESULTS: Patients were classified according to BMI and NRI scores. Increased BMI and NRI were associated with a severe type of disease. Most of the patients with severe disease were: obese (83.3%) and patients with risk for malnutrition (53.3%). Obese patients had a longer length of home stay and higher CRP levels, but the level of albumin was lower in a group with a risk for malnutrition.
CONCLUSION: Future studies are needed to identify and quantify specific screening tool for nutrition deficiency in patients with COVID-19 infection.
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Kakhki RK, Kakhki MK, Neshani A. COVID-19 target: A specific target for novel coronavirus detection. Gene Rep. 2020;20:100740. https://doi.org/10.1016/j.genrep.2020.100740 PMid:32510005 DOI: https://doi.org/10.1016/j.genrep.2020.100740
Barazzoni R, Bischoff SC, Breda J, Wickramasinghe K, Krznaric Z, Nitzan D, et al. ESPEN expert statements and practical guidance for nutritional management of individuals with SARS-CoV-2 infection. Clin Nutr. 2020;39(6):1631-8. https://doi.org/10.1016/j.clnu.2020.03.022 PMid:32305181 DOI: https://doi.org/10.1016/j.clnu.2020.03.022
D’Onofrio К. Malnutrition is Common at Hospital Admission and Pre-Discharge. Available from: https://www.docwirenews.com/ health-and-wellness/diet/malnutrition-hospital-admission. [Last accessed on 2020 Sep 20].
Schafer MH, Ferraro KF. Obesity and hospitalization over the adult life course: Does duration of exposure increase use? J Health Soc Behav. 2007;48(4):434-49. https://doi.org/10.1177/002214650704800407 PMid:18198689 DOI: https://doi.org/10.1177/002214650704800407
Volkert D, Beck AM, Cederholm T, Cruz-Jentoft A, Goisser S, Hooper L, et al. ESPEN guideline on clinical nutrition and hydration in geriatrics. Clin Nutr. 2019;38(1):10-47. https://doi.org/10.1016/j.clnu.2018.05.024 PMid:30005900 DOI: https://doi.org/10.1016/j.clnu.2018.05.024
Sobotka L. Nutritional support in geriatric patients: The ESPEN new recommended guidelines. Vnitr Lek. 2018;64(11):1053-8. PMid:30606021 DOI: https://doi.org/10.36290/vnl.2018.150
Naveed S, McInnes IB, McMurray JJ. Obesity a risk factor for sever COVID-19 infection; multiple potential mechanisms. Circulation. 2020;142:4-6. https://doi.org/10.1161/circulationaha.120.047659 DOI: https://doi.org/10.1161/CIRCULATIONAHA.120.047659
Donini LM, Savina C, Rosano A, Cannella C. Systematic review of nutritional status evaluation and screening tools in the elderly. J Nutr Health Aging. 2007;11(5):421-32. PMid:17657364
Van Bokhorst-de van der Schueren MA, Guaitoli PR, Jansma EP, De Vet HC. Nutrition screening tools: Does one size fit all? A systematic review of screening tools for the hospital setting. Clin Nutr. 2014;33(1):39-58. https://doi.org/10.1016/j.clnu.2013.04.008 PMid:23688831 DOI: https://doi.org/10.1016/j.clnu.2013.04.008
Farhadi S, Ovchinnikov RS. The relationship between nutrition and infectious diseases: A review. Biomed Biotechnol Res J. 2018;2(3):168-72. DOI: https://doi.org/10.4103/bbrj.bbrj_69_18
Romieu I, Dossus L, Barquera S, Blottière HM, Franks PW, Gunter M, et al. Energy balance and obesity: What are the main drivers? Cancer Causes Control. 2017;28(3):247-58. https://doi.org/10.1007/s10552-017-0869-z PMid:28210884 DOI: https://doi.org/10.1007/s10552-017-0869-z
Saunders J, Smith T. Malnutrition: Causes and consequences. Clin Med (Lond). 2010;10(6):624-7. DOI: https://doi.org/10.7861/clinmedicine.10-6-624
PMid:21413492
Kahokehr AA, Sammour T, Wang K, Sahakian V, Plank LD, Hill AG. Prevalence of malnutrition on admission to hospital-acute and elective general surgical patients. Eur J Clin Nutr Metab. 2010;5(1):e21-5. https://doi.org/10.1016/j.eclnm.2009.11.001 DOI: https://doi.org/10.1016/j.eclnm.2009.11.001
Petrili CM, Jones SA, Yang J, Rajagopalan H, O’Donnell L, Chernyak Y, et al. Factors Associated with Hospitalization and Critical Illness among 4 103 Patients with COVID-19 Disease in New York City. New York: medRixiv; 2020. https://doi.org/10.1101/2020.04.08.20057794 DOI: https://doi.org/10.1101/2020.04.08.20057794
Guan WJ, Zhong NS. Clinical characteristics of COVID-19 in China. N Engl J Med. 2020;382(19):1861-2. PMid:32220206 DOI: https://doi.org/10.1056/NEJMc2005203
Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult in patients with COVID-19 in Wuhan, China: A retrospective cohort study. Lancet. 2020;395(10229):1054-62. https://doi.org/10.1016/s0140-6736(20)30566-3 PMid:32171076 DOI: https://doi.org/10.1016/S0140-6736(20)30566-3
Manson JJ, Crooks C, Naja M, Ledlie A, Goulden B, Liddle T, et al. COVID-19-associated hyperinflammation and escalation of patient care: A retrospective longitudinal cohort study. Lancet Rheumatol. 2020;2(10):e594-602. PMid:32864628 DOI: https://doi.org/10.1016/S2665-9913(20)30275-7
Kwaifa IK, Bahari H,Yong YK, Noor SM. Endothelial dysfunction in obesity-induced inflammation: Molecular Mechanisms and clinical implications. Biomolecules. 2020:10(2):E291. https://doi.org/10.3390/biom10020291 PMid:32069832 DOI: https://doi.org/10.3390/biom10020291
Gastro MC, Carvalho LR, Chin T, Kahn R, Franca GV, Macario EM, et al. Demand for Hospitalization Services for COVID-19 Patients in Brazil. New York: medRxiv; 2020. https://doi.org/10.1101/2020.03.30.20047662 DOI: https://doi.org/10.1101/2020.03.30.20047662
Pichard C, Kyle UG, Morabia A, Perrier A, Vermeulen B, Unger P. Nutritional assessment: Lean body mass depletion at hospital admission is associated with an increased length of stay. Am J Clin Nutr. 2004;79(4):613-8. https://doi.org/10.1093/ajcn/79.4.613 PMid:15051605 DOI: https://doi.org/10.1093/ajcn/79.4.613
Pirlich M, Schütz T, Norman K, Gastell S, Lübke HJ, Bischoff SC, et al. The German hospital malnutrition study. Clin Nutr. 2006;25(4):563-72. https://doi.org/10.1016/j.clnu.2006.03.005 PMid:16698132 DOI: https://doi.org/10.1016/j.clnu.2006.03.005
Allard JP, Keller H, Jeejeebhoy KN, Laporte M, Duerksen DR, Gramlich L, et al. Malnutrition at hospital admission-contributors and effect on length of stay: A prospective cohort study from the Canadian malnutrition task force. JPEN J Parenter Enteral Nutr. 2016;40(4):487-97. https://doi.org/10.1177/0148607114567902 PMid:25623481. DOI: https://doi.org/10.1177/0148607114567902
Tartof SY, Qian L, Hong V, Wei R, Nadjafi RF, Fischer H, et al. Obesity and mortality among patients diagnosed with COVID- 19: Results from an integrated health care organization. Ann Intern Med. 2020;173(10):773-81. http://doi.org/10.7326/ M20-3742 DOI: https://doi.org/10.7326/M20-3742
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Copyright (c) 2020 Zorica Markovska, Dragan Mijakoski, Katerina Kuzmanova, Iskra Meshkova, Ivana Tusheva, Sasho Stoleski (Author)
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