Assessment of Nutritional Risk at ICU Admission and Mortality in Patients with Suspected COVID-19.
Gustavo Duarte PimentelClaude PichardPaula M MartinsEmanoelly P FrancoPublished in: Clinics and practice (2022)
Background/Objectives: The association between the nutritional risk and mortality in Brazilians with COVID-19 is poorly documented. Therefore, this study, for the first time, aimed at investigating the length of stay in the ICU and the chance of dying in patients with suspected COVID-19, without and with nutritional risk. Subjects/Methods: This retrospective monocentric study enrolled adult, COVID-19-positive patients that were admitted to the ICU at a university hospital. Biochemical analysis and clinical data were collected from medical records and the nutritional risk was assessed according to the Modified-Nutrition Risk in the Critically Ill (mNUTRIC) score. The Cox model was used to assess the chance of mortality in the patients with and without nutritional risk. Results: Out of 71 patients, 63.3% were male and 52% were older (≥60 years). Although no differences were found between groups for the length of stay in ICU, C-reactive protein, alanine aminotransferase and aspartate aminotransferase concentrations, the mNUTRIC ≥ 5 group had higher D-dimer than the mNUTRIC < 5 group. Regarding ICU mortality, most patients (69.5%) in the mNUTRI ≥ 5 group died while in the mNUTRIC < 5 group 33.3% died (p = 0.0001). In addition, patients with mNUTRIC ≥ 5 had (HR: 2.04 [95% CI: 1.02−4.09], p = 0.04) a more likely chance of dying than patients in the mNUTRIC < 5 group, even that adjusted by BMI and D-dimer concentrations (HR: 2.18 [95% CI: 1.04−4.56], p = 0.03). Conclusion: In patients with COVID-19, an mNUTRIC ≥ 5 score at admission leads to a more likely chance of death even after controlling for confounding variables.
Keyphrases
- end stage renal disease
- ejection fraction
- coronavirus disease
- sars cov
- intensive care unit
- newly diagnosed
- chronic kidney disease
- emergency department
- peritoneal dialysis
- healthcare
- palliative care
- physical activity
- cardiovascular events
- risk factors
- body mass index
- patient reported outcomes
- type diabetes
- patient reported
- young adults
- coronary artery disease
- electronic health record
- acute respiratory distress syndrome