Nutritional risk and therapy for severe and critical COVID-19 patients: A multicenter retrospective observational study
Autor: | Xiao bin Cheng, Yuan ming Ba, Ye ming Wang, Sha sha You, Chen liang Zhou, Qiu fen Dong, Gang Li, Bin Song, Liu lin Wang |
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Rok vydání: | 2020 |
Předmět: |
0301 basic medicine
Adult Male medicine.medical_specialty China Coronavirus disease 2019 (COVID-19) Critical Illness Nutritional risk Nutritional Status 030209 endocrinology & metabolism Kaplan-Meier Estimate Critical Care and Intensive Care Medicine Risk Assessment Severity of Illness Index Time-to-Treatment 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans Medical nutrition therapy Hospital Mortality Adverse effect Aged Proportional Hazards Models Retrospective Studies 030109 nutrition & dietetics Nutrition and Dietetics business.industry Nutritional Support SARS-CoV-2 Medical record NUTRIC score Malnutrition COVID-19 Retrospective cohort study NRS score Middle Aged medicine.disease Hospitalization Intensive Care Units Parenteral nutrition Nutrition Assessment Original Article Female business |
Zdroj: | Clinical Nutrition Clinical Nutrition (Edinburgh, Scotland) |
ISSN: | 1532-1983 |
Popis: | Summary Objective To evaluate the nutritional risk and therapy in severe and critical patients with COVID-19. Methods A total of 523 patients enrolled from four hospitals in Wuhan, China. The inclusion time was from January 2, 2020 to February 15. Clinical characteristics and laboratory values were obtained from electronic medical records, nursing records, and related examinations. Results Of these patients, 211 (40.3%) were admitted to the ICU and 115 deaths (22.0%). Patients admitted to the ICU had lower BMI and plasma protein levels. The median Nutrition risk in critically ill (NUTRIC) score of 211 patients in the ICU was 5 (4, 6) and Nutritional Risk Screening (NRS) score was 5 (3, 6). The ratio of parenteral nutrition (PN) therapy in non-survivors was greater than that in survivors, and the time to start nutrition therapy was later than that in survivors. The NUTRIC score can independently predict the risk of death in the hospital (OR = 1.197, 95%CI: 1.091–1.445, p = 0.006) and high NRS score patients have a higher risk of poor outcome in the ICU (OR = 1.880, 95%CI: 1.151–3.070, p = 0.012). After adjusted age and sex, for each standard deviation increase in BMI, the risk of in-hospital death was reduced by 13% (HR = 0.871, 95%CI: 0.795–0.955, p = 0.003), and the risk of ICU transfer was reduced by 7% (HR = 0.932, 95%CI:0.885–0.981, p = 0.007). The in-hospital survival time of patients with albumin level ≤35 g/L was significantly decreased (15.9 d, 95% CI: 13.7–16.3, vs 24.2 d, 95% CI: 22.3–29.7, p Conclusion Severe and critical patients with COVID-19 have a high risk of malnutrition. Low BMI and protein levels were significantly associated with adverse events. Early nutritional risk screening and therapy for patients with COVID-19 are necessary. |
Databáze: | OpenAIRE |
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