Plain language summary
Literature shows that nutritional deficiency is common and serious in the elderly, with studies reporting malnourishment in 35–65% of elderly hospitalized patients and 25–60% of institutionalized older adults. The aim of this study to explore the relationship between nutritional risk and clinical outcome in patients older than 65 years with COVID-19. A secondary outcome was to investigate the ability of the (nutritional risk screening) NRS tools to predict worse-than-average clinical outcomes. The study is a retrospective cohort analysis which enrolled 141 patients (females n = 73). Patients were classified into either a normal group or a nutritional risk group according to the criterion of each NRS tool. Results indicate that patients with COVID-19 who classified as having a nutritional risk had significantly poorer clinical outcomes than those classified as normal following assessments by Nutrition Risk Screening 2002 (NRS 2002), Mini Nutrition Assessment Shortcut (MNA-sf), and Nutrition Risk Index (NRI). Authors conclude that the NRS 2002, MNAsf, and NRI are useful and practical tools for identifying older adult patients with COVID-19 who are at nutritional risk.
Abstract
OBJECTIVES The aim of this study was to assess the nutritional risks among older patients with COVID-19 and their associated clinical outcomes using four nutritional risk screening (NRS) tools: Nutrition Risk Screening 2002 (NRS 2002), Malnutrition Universal Screening Tool (MUST), Mini Nutrition Assessment Shortcut (MNA-sf), and Nutrition Risk Index (NRI). METHODS We retrospectively analyzed the data of patients with COVID-19 older than 65 years who were treated in our hospital from January 28, 2020 to March 5, 2020, and explored the relationship between nutritional risk and clinical outcomes. RESULTS A total of 141 patients with COVID-19 (46 common COVID-19, 73 severe COVID-19, and 22 extremely severe COVID-19) were enrolled in the study. NRS 2002 identified 85.8% of patients as having risk, with being identified 41.1% by MUST, 77.3% by MNA-sf, and 71.6% by NRI. The agreement strength was moderate between NRS 2002 and MNA-sf, NRI, fair between MUST and MNA-sf, NRI, fair between MNA-sf and NRI, poor between NRS 2002 and MUST (P < 0.01). After adjustment for confounding factors in multivariate regression analysis, patients in the risk group had significantly longer LOS, higher hospital expenses (except MNA-sf), poor appetite, heavier disease severity, and more weight change(kg) than normal patients by using NRS 2002, MNA-sf, and NRI(P < 0.05). CONCLUSIONS The NRS 2002, MNA-sf, and NRI are useful and practical tools with respect to screening for patients with COVID-19 who are at nutritional risk, as well as in need of additional nutritional intervention.
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