Cochrane COVID-19 Study Register
Poulia 2020

Nutritional risk and outcomes in intensive care unit patients with severe acute respiratory syndrome corona virus 2. – preliminary data

  1. Study Type
  2. Observational
  1. Study Aim
  2. Diagnostic/Prognostic
  3. Epidemiology
  1. Study Design
  2. Case series/Case control/Cohort
  1. Intervention Assignment
  2. Not Applicable

Nutritional risk and outcomes in intensive care unit patients with severe acute respiratory syndrome corona virus 2. – preliminary data

Poulia KA, Karayiannis D, Almperti A, Pafili Z, Mastora Z
Rationale: As Severe Acute Respiratory Syndrome Coronavirus 2 disease (SARS-CoV-2/COVID-19) spread globally, intensive care units (ICUs) were called to face an extraordinary reality, where the need for treatment raised enormously. Patients with COVID-19 often experience significant nutritional obstacles, that could have a negative impact on their nutritional status. The aim of the present study was to investigate possible associations of nutritional risk with length of hospital stay (LoS) and clinical outcome in ICU patients with COVID-19. Methods: Data from patients with COVID-19 consequently admitted in the ICU of the biggest tertiary hospital in Greece were included in the study (Evaggelismos General Hospital, Athens). Geriatric nutrition risk index (GNRI) was calculated at baseline, at day 5-7 of the infection and before the exit of the hospital. Weight was measured in all patients on bed scales and height was measured or calculated by knee height. Albumin levels, c-reactive protein levels and data for their medical history were collected from the medical files. Nutritional support, intubation need and the LoS were reported, as well as weight loss and clinical outcome. Results: Data from forty-eight (48) patients (16 female) with median age 62 (IQR=52) years were included in the analysis. Fifty percent of the patients had less than 2 co morbidities, 60.4% of them (n=29) received enteral nutrition on admission and 34 (70.8%) were intubated during ICU stay. According to GNRI evaluation 38 (79%) patients were on low nutritional risk on admission, 9 (18.75%) on moderate risk and 1 (2%) on high risk. GNRI on admission was positively correlated with weight loss% (r=0.569,p=0.009) and negatively associated with the need of intubation an association that was enforced in the measurement of GNRI in the 5-7day (-0.424, p=0.003 and r=-0632,p=<0,001 respectively). Length of stay was negatively correlated with BMI at discharge (r=-0.551, p=0.015) and also showed a marginal non significant association with BMI on admission (r-0.335, p=0.065) Conclusion: Twenty per cent of patients were at moderate or high risk of malnutrition on admissionto the ICU. During hospitalization in the ICU for COVID-19, nutritional risk seems to increase and this increment is associated with the need of intubation. A low BMI seems to have a negative effect on LoS. References 1. Bouillanne O, Morineau G, Dupont C, et al. Geriatric Nutritional Risk Index: a new index for evaluating at-risk elderly medical patients. Am J Clin Nutr. 2005;82(4):777-783. doi:10.1093/ajcn/82.4.777 2. Laviano A, Koverech A, Zanetti M. Nutrition support in the time of SARS-CoV-2 (COVID-19) [published online ahead of print, 2020 Apr 2]. Nutrition. 2020;110834. doi:10.1016/j.nut.2020.110834 Disclosure of Interest: None declared