Department of Medicine, Division of Health Sciences, Universidad del Norte and Hospital Universidad del Norte, Barranquilla 081001, Colombia.
Department of Infectious Diseases, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), University of Barcelona, 08907 Barcelona, Spain.
Nutrients. 2022 Aug 7;14(15):3235. doi: 10.3390/nu14153235.
Malnutrition comprises two groups of conditions: undernutrition and overweight or obesity. It has been associated with a high risk of contracting infectious diseases and with elevated mortality rates. Community-acquired pneumonia (CAP) is one of the most common infectious diseases worldwide and its prognosis is affected by a large number of recognizable risk factors. This narrative review updates the information on the impact of malnutrition, including both undernutrition and obesity, on the risk and prognosis of adults with CAP. Studies of CAP that have evaluated undernutrition have applied a variety of definitions when assessing the nutritional status of patients. Undernutrition has been associated with unfavorable clinical outcomes, such as prolonged hospital stay, need for intensive care unit admission, and mortality; in contrast, most published studies have found that increased body mass index is significantly associated with higher survival in patients with CAP. However, some authors have presented divergent results, mainly in relation to the etiology of CAP (bacterial versus viral). Influenza infection, caused by influenza A (H1N1) pdm09, has been associated with worse prognosis in obese patients. The current data underscore the need for larger studies to examine the physiological mechanisms that explain the differential impact of malnutrition on outcomes. Achieving a better understanding may help to guide the design of new interventions to improve prognosis.
营养不足和超重或肥胖。它与感染传染病的高风险和更高的死亡率有关。社区获得性肺炎（CAP）是全球最常见的传染病之一，其预后受许多可识别的危险因素的影响。本叙述性综述更新了关于营养不良（包括营养不足和肥胖）对成人 CAP 风险和预后的影响的信息。评估 CAP 患者营养状况的研究在评估患者的营养状况时应用了多种定义。营养不足与不良的临床结局相关，如住院时间延长、需要重症监护病房入院和死亡率；相比之下，大多数已发表的研究发现，体重指数增加与 CAP 患者的生存率显著相关。然而，一些作者提出了不同的结果，主要与 CAP 的病因（细菌与病毒）有关。由甲型流感（H1N1）pdm09 引起的流感感染与肥胖患者的预后较差有关。目前的数据强调需要进行更大规模的研究，以检查解释营养不良对结果的不同影响的生理机制。更好地了解这些机制可能有助于指导设计新的干预措施以改善预后。
