Nutritional parameters associated with prognosis in non-critically ill hospitalized covid-19 patients: the nutri-covid19 study

Autor: Riccardo Caccialanza, Elena Formisano, Catherine Klersy, Virginia Ferretti, Alessandra Ferrari, Stefania Demontis, Annalisa Mascheroni, Sara Masi, Silvia Crotti, Federica Lobascio, Nadia Cerutti, Paolo Orlandoni, Cloè Dalla Costa, Elena Redaelli, Alessandra Fabbri, Alberto Malesci, Salvatore Corrao, Lorella Bordandini, Emanuele Cereda, Raffaele Bruno, Carlo Maurizio Montecucco, Angelo Guido Corsico, Mirko Belliato, Antonio Di Sabatino, Serena Ludovisi, Laura Bogliolo, Francesca Mariani, Chiara Muggia, Gabriele Croce, Chiara Barteselli, Jacopo Mambella, Francesco Di Terlizzi, Elena Lenta, Emanuela Nigro, Elisa Merelli, Alessandro Maria Misotti, Andrea de Monte, Laura Iorio Laura, Paola Rossi, Flavia Favareto, Elisa Pisocri, Manuela Cimorelli, Claudia Venturini, Salvatore Vaccaro, Simona Bodecchi, Elisa Monzali, Vincenzo Craviotto, Paolo Dario Omodei, Paoletta Preatoni, Manuela Pastore, Leonardo Da Rio, Cecilia Ivaldi, Elsa Sferrazzo, Lorenzina Arieta, Erika Natta, Raffaella Mollaci Bocchio, Francesco Palmese, Alessandro Graziani
Přispěvatelé: Riccardo Caccialanza, Elena Formisano, Catherine Klersy, Virginia Ferretti, Alessandra Ferrari, Stefania Demontis, Annalisa Mascheroni, Sara Masi, Silvia Crotti, Federica Lobascio, Nadia Cerutti, Paolo Orlandoni, Cloe Dalla Costa, Elena Redaelli, Alessandra Fabbri , Alberto Malesci , Salvatore Corrao, Lorella Bordandini , Emanuele Cereda
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: Clinical Nutrition Espen
Clinical Nutrition (Edinburgh, Scotland)
ISSN: 2405-4577
Popis: Background & aims: To investigate the association between the parameters used in nutritional screening assessment (body mass index [BMI], unintentional weight loss [WL] and reduced food intake) and clinical outcomes in non-critically ill, hospitalized coronavirus disease 2019 (COVID-19) patients. Methods: This was a prospective multicenter real-life study carried out during the first pandemic wave in 11 Italian Hospitals. In total, 1391 patients were included. The primary end-point was a composite of in-hospital mortality or admission to ICU, whichever came first. The key secondary end-point was in-hospital mortality. Results: Multivariable models were based on 1183 patients with complete data. Reduced self-reported food intake before hospitalization and/or expected by physicians in the next days since admission was found to have a negative prognostic impact for both the primary and secondary end-point (P < .001 for both). No association with BMI and WL was observed. Other predictors of outcomes were age and presence of multiple comorbidities. A significant interaction between obesity and multi-morbidity (≥2) was detected. Obesity was found to be a risk factor for composite end-point (HR = 1.36 [95%CI, 1.03–1.80]; P = .031) and a protective factor against in-hospital mortality (HR = 0.32 [95%CI, 0.20–0.51]; P < .001) in patients with and without multiple comorbidities, respectively. Secondary analysis (patients, N = 829), further adjusted for high C-reactive protein (>21 mg/dL) and LDH (>430 mU/mL) levels yielded consistent findings. Conclusions: Reduced self-reported food intake before hospitalization and/or expected by physicians in the next days since admission was associated with negative clinical outcomes in non-critically ill, hospitalized COVID-19 patients. This simple and easily obtainable parameter may be useful to identify patients at highest risk of poor prognosis, who may benefit from prompt nutritional support. The presence of comorbidities could be the key factor, which may determine the protective or harmful role of a high body mass index in COVID-19.
Databáze: OpenAIRE
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