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营养不良风险是 COVID-19 患者的一个负面预后因素。

Malnutrition risk as a negative prognostic factor in COVID-19 patients.

机构信息

IRCCS Humanitas Research Hospital Rozzano, Milan, Italy.

IRCCS Humanitas Research Hospital Rozzano, Milan, Italy.

出版信息

Clin Nutr ESPEN. 2021 Oct;45:369-373. doi: 10.1016/j.clnesp.2021.07.016. Epub 2021 Aug 2.

DOI:10.1016/j.clnesp.2021.07.016
PMID:34620342
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8327593/
Abstract

BACKGROUND/OBJECTIVE: SARS CoV-2 infection is a disease, whose prevalence has drastically risen in the past year. The aim of this study is to examine a possible association between the risk of malnutrition, clinical outcomes following hospitalisation and morbidity at discharge.

METHODS

This study has analysed the medical records of 652 patients hospitalised at Humanitas Research Hospital (Milan, Italy) between 01/03 and 30/04/2020. The risk of malnutrition was identified with the Malnutrition Universal Screening Tool (MUST).

RESULTS

The cohort was composed of 515 patients. The MUST scale is significantly associated to malnutrition evaluating the morbidity at discharge (discharged 0.27 ± 0.68, discharged with problems 0.40 ± 0.93, deceased 0.64 ± 0.93, p < 0.001), and the clinical outcome following hospitalisation (HR 1.25, 95% CI 1.04-1.51, p = 0.019) is maintained even after correction for age, treated hypertension, admission to an intensive care unit and oxygen therapy). A subgroup analysis addressing patients with a BMI ≥30 shows a significant association between comorbidities such as: arterial hypertension (HR 4.95, 95% CI 1.10-22.22, p = 0.037), diabetes (HR 3.37, 95% CI 1.04-10.89, p = 0.043) and renal failure (HR 3.94, 95% CI 1.36-11.36, p = 0.011).

CONCLUSIONS

The results of this study suggest that the risk of malnutrition is a noteworthy indicator that impacts both the clinical outcomes and morbidity at discharge.

摘要

背景/目的:SARS-CoV-2 感染是一种疾病,其发病率在过去一年中急剧上升。本研究旨在研究营养不良风险与住院后临床结局和出院时发病率之间的可能关联。

方法

本研究分析了 2020 年 3 月 1 日至 4 月 30 日期间在 Humanitas 研究医院(意大利米兰)住院的 652 名患者的病历。使用营养不良通用筛查工具(MUST)确定营养不良风险。

结果

该队列由 515 名患者组成。MUST 量表与营养不良显著相关,可评估出院时的发病率(出院 0.27±0.68,出院有问题 0.40±0.93,死亡 0.64±0.93,p<0.001),并且在调整年龄、治疗高血压、入住重症监护病房和氧疗后,住院后的临床结局(HR 1.25,95%CI 1.04-1.51,p=0.019)仍保持不变。对 BMI≥30 的患者进行亚组分析显示,动脉高血压(HR 4.95,95%CI 1.10-22.22,p=0.037)、糖尿病(HR 3.37,95%CI 1.04-10.89,p=0.043)和肾功能衰竭(HR 3.94,95%CI 1.36-11.36,p=0.011)等合并症之间存在显著关联。

结论

本研究结果表明,营养不良风险是一个重要指标,既影响临床结局,也影响出院时的发病率。

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