Nutritional risk and clinical outcomes in patients diagnosed with COVID-19 in a high-complexity hospital network

Abstract

Introduction: The identification of nutritional risk at hospital admission is important to establish timely interventions in the COVID-19 patient care cycle, due to a high risk of it being associated with complications. Objective: To determine the association between the level of nutritional risk upon admission and in-hospital mortality at 28 days in patients diagnosed with COVID-19 treated between March and October 2020 in two hospital institutions in Colombia. Methods: A retrospective, observational study. Hospitalized patients with a diagnosis of COVID-19 were included and assessed by the Nutrition Service using the nutritional risk identification in emergencies scale, adapted from the NRS 2002 scale. In-hospital mortality at 28 days was analyzed as the primary endpoint, and hospital stay, admission to Intensive Care Unit (ICU), and requirement for mechanical ventilation as secondary endpoints. Results: A total of 1230 patients were included, with a mean age of 65.43±15.90 years, mainly men (57.1 %, n=702). A high nutritional risk (≥2 points) was identified in 74.3 % (n=914). Patients with a high nutritional risk had a greater probability of in-hospital death at 28 days (HRadj: 1.64; 95 % CI: 1.11-2.44), and a greater risk of requiring mechanical ventilation (OR=1.78; 95 % CI: 1.11-2.86) or ICU admission (OR=1.478; 95 % CI: 1.05-2.09), as well as hospital stay longer than 7 days (OR=1.91; 95 % CI: 1.47-2.48). Conclusions: Patients with a diagnosis of COVID-19 at high nutritional risk had a significantly higher in-hospital mortality at 28 days and a higher probability of requiring mechanical ventilation, ICU admission, and prolonged hospital stay.