Vita Salute University, 20100 Milan, Italy.
General Medicine and Continuity of Care Unit, IRCCS San Raffaele Hospital, 20132 Milan, Italy.
Nutrients. 2023 Nov 9;15(22):4727. doi: 10.3390/nu15224727.
Older individuals face an elevated risk of developing geriatric syndromes when confronted with acute stressors like COVID-19. We assessed the connection between in-hospital delirium, malnutrition, and frailty in a cohort of COVID-19 survivors. Patients aged ≥65, hospitalized in a tertiary hospital in Milan for SARS-CoV-2 pneumonia, were enrolled and screened for in-hospital delirium with the 4 'A's Test (4AT) performed twice daily (morning and evening) during hospital stay. Malnutrition was assessed with the malnutrition universal screening tool (MUST) at hospital admission and with the mini-nutritional assessment short-form (MNA-SF) one month after hospital discharge. Frailty was computed with the frailty index one month after hospital discharge. Fifty patients (median age 78.5, 56% male) were enrolled. At hospital admission, 10% were malnourished. The 13 patients (26%) who developed delirium were frailer (7 vs. 4), experienced a higher in-hospital mortality (5 vs. 3), and were more malnourished one month after discharge (3 of the 4 patients with delirium vs. 6 of the 28 patients without delirium who presented at follow up). The 4AT scores correlated with the MNA-SF scores (r = -0.55, = 0.006) and frailty (r = 0.35, = 0.001). Frailty also correlated with MUST (r = 0.3, = 0.04), MNA-SF (r = -0.42, = 0.02), and hospitalization length (r = 0.44, = 0.001). Delirium, malnutrition, and frailty are correlated in COVID-19 survivors. Screening for these geriatric syndromes should be incorporated in routine clinical practice.
老年人在面临 COVID-19 等急性应激源时，患老年综合征的风险增加。我们评估了 COVID-19 幸存者队列中住院期间谵妄、营养不良和衰弱之间的关系。在米兰的一家三级医院住院的年龄≥65 岁、因 SARS-CoV-2 肺炎住院的患者被纳入并通过每天两次（早晨和晚上）进行的 4 'A' 测试（4AT）筛查住院期间谵妄。在入院时使用营养不良通用筛查工具（MUST）和出院后一个月使用迷你营养评估简表（MNA-SF）评估营养不良。出院后一个月使用衰弱指数计算衰弱。共纳入 50 名患者（中位年龄 78.5 岁，56%为男性）。入院时，10%的患者存在营养不良。发生谵妄的 13 名患者（26%）更虚弱（7 比 4），住院期间死亡率更高（5 比 3），出院后一个月营养不良更严重（4 名发生谵妄的患者中有 3 名，而 28 名无谵妄但在随访中出现的患者中有 6 名）。4AT 评分与 MNA-SF 评分（r = -0.55， = 0.006）和衰弱（r = 0.35， = 0.001）相关。衰弱也与 MUST（r = 0.3， = 0.04）、MNA-SF（r = -0.42， = 0.02）和住院时间（r = 0.44， = 0.001）相关。COVID-19 幸存者中谵妄、营养不良和衰弱相关。应将这些老年综合征的筛查纳入常规临床实践。
