Department of Anesthesiology and Critical Care Unit, CHU Toulouse Rangueil, 1 av du Pr Jean Poulhès, 31400Toulouse, France.
INSERM UMR 1048, Institut des maladies métaboliques et cardiovasculaires, CHU Toulouse, 1 av du Pr Jean Poulhès, 31400Toulouse, France.
Br J Nutr. 2021 Nov 14;126(9):1296-1303. doi: 10.1017/S0007114520005127. Epub 2020 Dec 21.
Recent European Society of Parenteral and Enteral Nutrition guidelines highlighted the interest of prevention, diagnosis and treatment of malnutrition in the management of coronavirus disease 19 (COVID-19) patients. The aim of our study was to evaluate the prevalence of malnutrition in patients hospitalised for COVID-19. In a prospective observational cohort study malnutrition was diagnosed according to the Global Leadership Initiative on Malnutrition (GLIM) two-step approach. Patients were divided into two groups according to the diagnosis of malnutrition. Covariate selection for the multivariate analysis was based on P <0·2 in univariate analysis, with a logistic regression model and a backward elimination procedure. A partitioning of the population was realised. Eighty patients were prospectively enrolled. Thirty patients (37·5 %) had criteria for malnutrition. The need for intensive care unit admission (n 46, 57·5 %) was similar in the two groups. Three patients who died (3·75 %) were malnourished. Multivariate analysis exhibited that low BMI (OR 0·83, 95 % CI 0·73, 0·96, P = 0·0083), dyslipidaemia (OR 29·45, 95 % CI 3·12, 277·73, P = 0·0031), oral intake reduction <50 % (OR 3·169, 95 % CI 1·04, 9·64, P = 0·0422) and glomerular filtration rate (Chronic Kidney Disease Epidemiology Collaboration; CKD-EPI) at admission (OR 0·979, 95 % CI 0·96, 0·998, P = 0·0297) were associated with the occurrence of malnutrition. We demonstrate the existence of a high prevalence of malnutrition in a general cohort of COVID-19 inpatients according to GLIM criteria. Nutritional support in COVID-19 care seems an essential element.
最近，欧洲肠外和肠内营养学会指南强调了在冠状病毒病 19 (COVID-19) 患者管理中预防、诊断和治疗营养不良的重要性。我们的研究目的是评估因 COVID-19 住院的患者中营养不良的发生率。在一项前瞻性观察队列研究中，根据全球营养不良倡议 (GLIM) 两步法诊断营养不良。根据营养不良的诊断，将患者分为两组。多变量分析的协变量选择基于单变量分析中 P<0·2，使用逻辑回归模型和向后消除过程。对人群进行了分区。前瞻性纳入了 80 例患者。30 例患者（37·5%）符合营养不良标准。两组患者需要入住重症监护病房（n=46，57·5%）的比例相似。3 例死亡患者（3·75%）为营养不良。多变量分析显示，低 BMI（OR 0·83，95%CI 0·73，0·96，P=0·0083）、血脂异常（OR 29·45，95%CI 3·12，277·73，P=0·0031）、口服摄入量减少<50%（OR 3·169，95%CI 1·04，9·64，P=0·0422）和入院时肾小球滤过率（慢性肾脏病流行病学合作；CKD-EPI）（OR 0·979，95%CI 0·96，0·998，P=0·0297）与营养不良的发生相关。我们根据 GLIM 标准证明了在 COVID-19 住院患者的一般队列中存在高营养不良患病率。在 COVID-19 护理中提供营养支持似乎是一个重要的环节。
