Faculty of Nutrition, Federal University of Goiás, Goiânia, Brazil.
Faculty of Nutrition, Federal University of Goiás, Goiânia, Brazil.
Clin Nutr ESPEN. 2024 Oct;63:676-680. doi: 10.1016/j.clnesp.2024.07.1053. Epub 2024 Jul 30.
COVID-19 is a systemic infection with a significant impact on nutrition risk and the hematopoietic system. The neutrophil-lymphocyte ratio (NLR) may have prognostic value in determining severe cases of COVID-19 and the urea-creatinine ratio (UCR) is currently being studied as a potential biomarker of catabolism associated with critical illness. The aim was to assess the association between the NLR, UCR and C-reactive protein (CRP) with nutritional risk in hospitalized patients with COVID-19.
This is a retrospective cross-sectional study that assessed 589 hospitalized patients with COVID-19, 18 years of age or older, of both sexes. Nutritional risk was assessed by Nutritional Risk Screening (NRS, 2002) and NLR by neutrophils divided by lymphocyte count. The UCR was calculated by the ratio between urea and creatinine and quantified by the calorimetric biochemical method and CRP by the immunoturbidimetric method. Differences between groups were applied by the Mann-Whitney U test and the automated binary regression test.
Of the 589 patients, 87.4% were at nutritional risk. When evaluating patients admitted to the ICU, 91.9% were at nutritional risk. Patients with NRS ≥3 are older, with lower body mass and BMI, higher NLR and UCR and lower CRP values. However, 73% of patients admitted to the ward were at nutritional risk, and only age differed between groups, being higher in patients with NRS ≥3. Logistic regression showed a weak association between nutritional risk in NRS and UCR (Model 1) (OR = 0.96, 95%CI: 0.94-0.99, p = 0.003) and NRS with CRP (Model 1) (OR = 1.01, 95%CI: 1.00-1.02, p < 0.001) in patients in the ICU. On the other hand, the logistic regression in ward patients found association only for CRP in both models (Model 1, OR = 1.01, 95%CI: 1.00-1.01, p = 0.041) and (Model 2, OR = 1.01, 95%CI: 1.00-1.01, p = 0.031).
We found a weak association between nutritional risk and UCR and CRP levels in patients admitted to the ICU, while in the ward patients the nutritional risk also had weak association with CRP.
COVID-19 是一种全身性感染，对营养风险和造血系统有重大影响。中性粒细胞与淋巴细胞比值（NLR）可能对确定 COVID-19 的重症病例具有预后价值，而尿素-肌酐比值（UCR）目前正被研究作为与危重病相关的分解代谢的潜在生物标志物。目的是评估 NLR、UCR 和 C 反应蛋白（CRP）与住院 COVID-19 患者营养风险之间的关系。
这是一项回顾性横断面研究，评估了 589 名年龄在 18 岁及以上的住院 COVID-19 患者。营养风险通过营养风险筛查（NRS，2002 年）和中性粒细胞与淋巴细胞计数之比进行评估。UCR 通过尿素与肌酐的比值计算，并通过比色生化法进行定量，CRP 通过免疫比浊法进行定量。通过 Mann-Whitney U 检验和自动二项回归检验对组间差异进行评估。
在 589 名患者中，87.4%存在营养风险。在评估入住 ICU 的患者时，91.9%存在营养风险。NRS≥3 的患者年龄较大，体重和 BMI 较低，NLR 和 UCR 较高，CRP 值较低。然而，73%的住院患者存在营养风险，且仅在 NRS≥3 的患者中存在组间差异，年龄较大。逻辑回归显示，在 ICU 患者中，NRS 与 UCR（模型 1）（OR=0.96，95%CI：0.94-0.99，p=0.003）和 NRS 与 CRP（模型 1）（OR=1.01，95%CI：1.00-1.02，p<0.001）之间存在弱关联。另一方面，在病房患者的逻辑回归中，仅在两个模型中发现 CRP 存在关联（模型 1，OR=1.01，95%CI：1.00-1.01，p=0.041）和（模型 2，OR=1.01，95%CI：1.00-1.01，p=0.031）。
我们发现 ICU 患者的营养风险与 UCR 和 CRP 水平之间存在弱关联，而在病房患者中，营养风险与 CRP 也存在弱关联。
