Unit of Internal Medicine, Department of Medical and Surgical Sciences, S. Orsola- Malpighi University Hospital, University of Bologna, Via Pietro Albertoni 15, 40138, Bologna, Italy.
Department of Medical and Surgical Sciences, S. Orsola-Malpighi Hospital, University of Bologna, Via Pietro Albertoni 15, 40138, Bologna, Italy.
Aging Clin Exp Res. 2020 Dec;32(12):2695-2701. doi: 10.1007/s40520-020-01727-5. Epub 2020 Oct 8.
Symptomatic severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection incidence is higher in the elderly patients. Pre-existing geriatric conditions such as comorbidity and frailty seem related to worse hospital outcomes.
To assess the role of nutritional status as an independent prognostic factor for in-hospital death in elderly patients.
Consecutive elderly patients (age > 65 years) hospitalized for novel coronavirus disease (COVID-19) were enrolled. Demographics, laboratory and comorbidity data were collected. Nutritional status was evaluated using the Geriatric Nutritional Risk Index (GNRI). Uni- and multivariate Cox regression analyses to evaluate predictors for in-hospital death were performed.
One hundred and nine hospitalized elderly patients (54 male) were consecutively enrolled. At univariate analysis, age (HR 1.045 [CI 1.008-1.082]), cognitive impairment (HR 1.949 [CI 1.045-3.364]), C-reactive protein (HR 1.004 [CI 1.011-1.078]), lactate dehydrogenases (HR 1.003 [CI 1.001-1.004]) and GNRI moderate-severe risk category (HR 8.571 [CI 1.096-67.031]) were risk factors for in-hospital death, while albumin (HR 0.809 [CI 0.822-0.964]), PaO/FiO ratio (HR 0.996 [CI 0.993-0.999]) and body mass index (HR 0.875 [CI 0.782-0.979]) were protective factors. Kaplan-Meier survival curves showed a significative higher survival in patients without GNRI moderate or severe risk category (p = 0.0013). At multivariate analysis, PaO/FiO ratio (HR 0.993 [CI 0.987-0.999], p = 0.046) and GNRI moderate-severe risk category (HR 9.285 [1.183-72.879], p = 0.034) were independently associated with in-hospital death.
Nutritional status assessed by GNRI is a significative predictor of survival in elderly patients hospitalized for COVID-19. The association between GNRI and PaO/FiO ratio is a good prognostic model these patients.
有症状的严重急性呼吸综合征冠状病毒 2 型（SARS-CoV-2）感染在老年患者中的发病率较高。合并症和衰弱等预先存在的老年病似乎与更差的住院结局有关。
评估营养状况作为老年患者住院期间死亡的独立预后因素。
连续纳入因新型冠状病毒病（COVID-19）住院的老年患者（年龄>65 岁）。收集人口统计学、实验室和合并症数据。使用老年营养风险指数（GNRI）评估营养状况。进行单变量和多变量 Cox 回归分析，以评估住院死亡的预测因素。
连续纳入 109 名住院老年患者（54 名男性）。单因素分析显示，年龄（HR 1.045[CI 1.008-1.082]）、认知障碍（HR 1.949[CI 1.045-3.364]）、C 反应蛋白（HR 1.004[CI 1.011-1.078]）、乳酸脱氢酶（HR 1.003[CI 1.001-1.004]）和 GNRI 中重度风险类别（HR 8.571[CI 1.096-67.031]）是住院死亡的危险因素，而白蛋白（HR 0.809[CI 0.822-0.964]）、PaO/FiO 比值（HR 0.996[CI 0.993-0.999]）和体重指数（HR 0.875[CI 0.782-0.979]）是保护因素。Kaplan-Meier 生存曲线显示，无 GNRI 中重度风险类别的患者生存率显著更高（p=0.0013）。多变量分析显示，PaO/FiO 比值（HR 0.993[CI 0.987-0.999]，p=0.046）和 GNRI 中重度风险类别（HR 9.285[1.183-72.879]，p=0.034）与住院期间死亡独立相关。
GNRI 评估的营养状况是 COVID-19 住院老年患者生存的显著预测因素。GNRI 与 PaO/FiO 比值之间的关联是这些患者的良好预后模型。
