Cochrane COVID-19 Study Register
Pironi 2020a

Malnutrition in hospitalized patients with SARS-CoV-2 infection

  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

Malnutrition in hospitalized patients with SARS-CoV-2 infection

Pironi L, Sasdelli AS, Ravaioli F, Baracco B, Battaiola C, Bocedi G, Brodosi L, Leoni L, Mari GA, Musio A
Rationale: Patients with SARS-CoV-2 infection (COVID-19) are potentially at risk of malnutrition because of reduced food intake and catabolism-related inflammation, reduced mobility due to hospitalization, older age and comorbidities. The prevalence and the causes of malnutrition as well as the provided nutrition care were evaluated in all the COVID-19 adults hospitalized in a 3rd level hospital in Italy. Methods: A one-day audit was carried out recording: age, measured or estimated body weight (BW) and height, BMI (Kg/m2), 30-day weight loss (WL), comorbidities, serum albumin and C-reactive protein (CRP; nv<0.5 mg/dL), hospital diet intake, oral nutrition supplements (ONS), enteral (EN) or parenteral nutrition (PN). The NRS-2000 tool and the GLIM criteria were used for the malnutrition risk screening and the diagnosis of malnutrition, respectively. Statistics: %, median, non-parametric tests. Results: A total of 268 patients (74 yrs, M 55%) were hospitalized in 4 COVID-19 settings: internal medicine (IM) 61%, subintensive care unit (SICU) 8%, intensive care unit (ICU) 17%, rehabilitation unit (RU) 14%: BMI: <18.5, 9% (higher in RU, p=0.008) and ≥30, 13% (higher in ICU,p=0.011); WL≥5%, 52% (higher in ICU and RU,p<0.001); CRP >5: 36% (higher in ICU and lower in RU,p<0.001); NRS score ≥3, 76% (greater in ICU and RU,p<0.001); GLIM malnutrition, 29% (higher in ICU and smaller in MI,p<0.001); hospital diet intake ≤50%, 39% (higher in IM and ICU,p<0.001); ONS, EN and PN were prescribed to 6%, 12% and 13%, respectively. Energy and protein intake/kg BW (ideal BW in obese) were 25 (lower in ICU,p=0.037) and 1.2 g (p>0.05), respectively. Conclusion: Malnutrition risk was present in three-fourth of patients and malnutrition in about one-third. The frequency increased according to the severity of the COVID-19 clinical feature. A very low dietary intake and a very high inflammatory state were present in one-third. Most of the patients were on oral diet alone. Protein intake was appropriate, whereas energy intake was at the lower limit of the recommended amount. Disclosure of Interest: None declared