Chen Jiao, Zhao Can, Huang Yingzi, Wang Hao, Lu Xiang, Zhao Wei, Gao Wei
Department of Intensive Care Unit, the Affiliated Sir Run Run Hospital of Nanjing Medical University, Nanjing, Jiangsu 211100, China.
Department of Geriatrics, the Affiliated Sir Run Run Hospital of Nanjing Medical University, Nanjing, Jiangsu 211100, China.
J Biomed Res. 2021 Nov 23;36(1):32-38. doi: 10.7555/JBR.35.20210083.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has spread throughout the world, which becomes a global public health emergency. Undernourishment prolongs its convalescence and has an adverse effect on its prognosis, especially in diabetic patients. The purpose of this study was to evaluate the prevalence and characteristics of undernourishment and to determine how it is related to the prognostic outcomes in the diabetic patients with coronavirus disease 2019 (COVID-19). A retrospective, multicenter study was conducted in 85 diabetic COVID-19 patients from three hospitals in Hubei Province. All patients were assessed using the European Nutritional Risk Screening 2002 (NRS-2002) and other nutritional assessments when admitted. Of them, 35 (41.18%) were at risk of malnutrition (NRS score ≥3). Severe COVID-19 patients had a significantly lower level of serum albumin and prealbumin and higher NRS score than non-severe patients. Multivariate logistic regression analysis showed that serum prealbumin and NRS score increased the likelihood of progression into severe status ( <0.05). Meanwhile, single factor and multivariate analysis determined that grade of illness severity was an independent predictor for malnutrition. Furthermore, prealbumin and NRS score could well predict severe status for COVID-19 patients. The malnutrition group (NRS score ≥3) had more severe illness than the normal nutritional (NRS score <3) group ( <0.001), and had a longer length of in-hospital stay and higher mortality. Malnutrition is highly prevalent among COVID-19 patients with diabetes. It is associated with severely ill status and poor prognosis. Evaluation of nutritional status should be strengthened, especially the indicators of NRS-2002 and the level of serum prealbumin.
严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染已在全球蔓延,成为全球突发公共卫生事件。营养不良会延长其康复期,并对其预后产生不利影响,尤其是在糖尿病患者中。本研究的目的是评估营养不良的患病率和特征,并确定其与2019冠状病毒病(COVID-19)糖尿病患者预后结果的关系。对湖北省三家医院的85例糖尿病COVID-19患者进行了一项回顾性多中心研究。所有患者入院时均使用欧洲营养不良风险筛查2002(NRS-2002)及其他营养评估方法进行评估。其中35例(41.18%)存在营养不良风险(NRS评分≥3)。重型COVID-19患者血清白蛋白和前白蛋白水平显著低于非重型患者,NRS评分更高。多因素logistic回归分析显示,血清前白蛋白和NRS评分增加了进展为重型的可能性(<0.05)。同时,单因素和多因素分析确定疾病严重程度分级是营养不良的独立预测因素。此外,前白蛋白和NRS评分可以很好地预测COVID-19患者的重型状态。营养不良组(NRS评分≥3)病情比营养正常组(NRS评分<3)更严重(<0.001),住院时间更长,死亡率更高。营养不良在COVID-19糖尿病患者中非常普遍。它与重症状态和不良预后相关。应加强营养状况评估,尤其是NRS-2002指标和血清前白蛋白水平。