AP-HP, Geriatric Department, Bichat University Hospital, Paris, France.
Fondation Roguet Nursing Home, Clichy, France.
Gerontology. 2023;69(7):818-825. doi: 10.1159/000529357. Epub 2023 Feb 17.
In nursing homes, where residents are at elevated risk for malnutrition, the specific additive effect of the coronavirus disease 2019 (COVID-19) on weight loss has not yet been adequately evaluated. This study aimed to determine the factors independently associated with weight loss in nursing home residents who survived the first wave of the COVID-19 pandemic, whether they have contracted COVID-19 or not.
This research was a retrospective study conducted in three nursing homes. Residents who survived the first French COVID-19 lockdown (March to May 2020) were included, provided their weight records were available. Baseline data included the body mass index (BMI), capacity to self-feed, need for texture-modified food, disability, and legal guardianship status. The diagnosis of COVID-19 was based on the results of a positive reverse transcriptase-polymerase chain reaction test. Univariate and multivariate logistic regression analyses were used to investigate associations between resident characteristics, COVID-19 status, and at least 5% weight loss.
Of the 316 included residents (72% female, mean age of 88 years, 48% severely disabled, and 38% under legal guardianship), 111 (35%) contracted COVID-19 and 102 (32%) lost at least 5% of their body weight. No difference was observed between the baseline characteristics of residents subsequently affected or unaffected by COVID-19. In the univariate analysis, old age, severe disability, texture-modified food, the need for close mealtime supervision, and COVID-19 were significantly associated with at least 5% weight loss. In the multivariate logistic regression analysis, COVID-19 (p = 0.02) and the need for close mealtime supervision (p = 0.02) were associated with weight loss in a model that also included age, BMI, texture-modified food, disability, and nursing home.
For nursing home residents, COVID-19 was an independent risk factor for weight loss. Weight loss was most common in residents needing close mealtime supervision, suggesting that organizational issues may have affected the quality of the nutritional care provided during the lockdown.
在养老院中，居民面临更高的营养不良风险，新冠病毒病 2019（COVID-19）对体重减轻的具体附加影响尚未得到充分评估。本研究旨在确定在经历了 COVID-19 大流行第一波的养老院居民中，与体重减轻相关的独立因素，无论他们是否感染了 COVID-19。
本研究为在三家养老院进行的回顾性研究。纳入在 2020 年 3 月至 5 月 COVID-19 第一次法国封锁期间存活下来的居民，只要他们的体重记录可用。基线数据包括体重指数（BMI）、自主进食能力、需要质地改良食物、残疾和法定监护状况。COVID-19 的诊断基于阳性逆转录酶-聚合酶链反应检测的结果。采用单变量和多变量逻辑回归分析来调查居民特征、COVID-19 状态与至少 5%体重减轻之间的关联。
在 316 名纳入的居民中（72%为女性，平均年龄为 88 岁，48%为严重残疾，38%为法定监护），111 名（35%）感染了 COVID-19，102 名（32%）体重减轻至少 5%。随后感染或未感染 COVID-19 的居民的基线特征无差异。在单变量分析中，年龄较大、严重残疾、质地改良食物、需要密切就餐监督以及 COVID-19 与至少 5%的体重减轻显著相关。在多变量逻辑回归分析中，COVID-19（p=0.02）和需要密切就餐监督（p=0.02）与体重减轻相关，该模型还包括年龄、BMI、质地改良食物、残疾和养老院。
对于养老院居民，COVID-19 是体重减轻的独立危险因素。需要密切就餐监督的居民体重减轻最常见，这表明组织问题可能影响了封锁期间提供的营养护理质量。
