Evolution of Nutritional Status after Early Nutritional Management in COVID-19 Hospitalized Patients.

Center for Research on Human Nutrition Ile-de-France (CRNH IdF), Nutrition Department, Institute of Cardiometabolism and Nutrition (ICAN), Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière University Hospital, Sorbonne Université, 47-83 Boulevard de l'Hôpital, 75013 Paris, France. NutriOmics Team, INSERM UMRS U1166, Sorbonne Université, 75006 Paris, France. French National Referral Center for Systemic Lupus Erythematosus, Antiphospholipid Antibody Syndrome and Other Autoimmune Disorders, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), Medicine Department, Inserm UMRS, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital, Sorbonne Université, 47-83 Boulevard de l'Hôpital, 75013 Paris, France.

Nutrients. 2021;(7)
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Abstract

Background & Aims: SARS-CoV2 infection is associated with an increased risk of malnutrition. Although there are numerous screening and nutritional management protocols for malnutrition, only few studies have reported nutritional evolution after COVID-19. The objectives of this study were to describe the evolution of nutritional parameters between admission and 30 days after hospital discharge, and to determine predictive factors of poor nutritional outcome after recovery in adult COVID-19 patients. Methods: In this observational longitudinal study, we report findings after discharge in 91 out of 114 patients initially admitted for COVID-19 who received early nutritional management. Nutritional status was defined using GLIM criteria and compared between admission and day 30 after discharge. Baseline predictors of nutritional status at day 30 were assessed using logistic regression. Results: Thirty days after discharge, 28.6% of patients hospitalized for COVID-19 were malnourished, compared to 42.3% at admission. Half of malnourished patients (53%) at admission recovered a normal nutritional status after discharge. Weight trajectories were heterogeneous and differed if patients had been transferred to an intensive care unit (ICU) during hospitalization (p = 0.025). High oxygen requirement during hospitalization (invasive ventilation p = 0.016 (OR 8.3 [1.6-61.2]) and/or oxygen therapy over 5 L/min p = 0.021 (OR 3.2 [1.2-8.9]) were strong predictors of malnutrition one month after discharge. Conclusions: With early nutritional management, most patients hospitalized for COVID-19 improved nutritional parameters after discharge. These findings emphasize the importance of nutritional care in COVID-19 patients hospitalized in medicine departments, especially in those transferred from ICU.

Methodological quality

Publication Type : Observational Study

Metadata

MeSH terms : COVID-19 ; Malnutrition