Body mass index and Mini Nutritional Assessment-Short Form as predictors of in-geriatric hospital mortality in older adults with COVID-19.
BMI
COVID-19
MNA-SF
Malnutrition
Mortality
Obesity
Journal
Clinical nutrition (Edinburgh, Scotland)
ISSN: 1532-1983
Titre abrégé: Clin Nutr
Pays: England
ID NLM: 8309603
Informations de publication
Date de publication:
12 2022
12 2022
Historique:
received:
10
05
2021
revised:
06
07
2021
accepted:
20
07
2021
pubmed:
15
8
2021
medline:
7
12
2022
entrez:
14
8
2021
Statut:
ppublish
Résumé
Overweight and obesity have been consistently reported to carry an increased risk for poorer outcomes in coronavirus disease 2019 (COVID-19) in adults. Existing reports mainly focus on in-hospital and intensive care unit mortality in patient cohorts usually not representative of the population with the highest mortality, i.e. the very old and frail patients. Accordingly, little is known about the risk patterns related to body mass and nutrition in very old patients. Our aim was to assess the relationship between body mass index (BMI), nutritional status and in-geriatric hospital mortality among geriatric patients treated for COVID-19. As a reference, the analyses were performed also in patients treated for other diagnoses than COVID-19. We analyzed up to 10,031 geriatric patients with a median age of 83 years of which 1409 (14%) were hospitalized for COVID-19 and 8622 (86%) for other diagnoses in seven geriatric hospitals in the Stockholm region, Sweden during March 2020-January 2021. Data were available in electronic hospital records. The associations between 1) BMI and 2) nutritional status, assessed using the Mini-Nutritional Assessment - Short Form (MNA-SF) scale, and short-term in-geriatric hospital mortality were analyzed using logistic regression. After adjusting for age, sex, comorbidity, polypharmacy, frailty and the wave of the pandemic (first vs. second), underweight defined as BMI<18.5 increased the risk of in-hospital mortality in COVID-19 patients (odds ratio [OR] = 2.30; confidence interval [CI] = 1.17-4.31). Overweight and obesity were not associated with in-hospital mortality. Malnutrition; i.e. MNA-SF 0-7 points, increased the risk of in-hospital mortality in patients treated for COVID-19 (OR = 2.03; CI = 1.16-3.68) and other causes (OR = 6.01; CI = 2.73-15.91). Our results indicate that obesity is not a risk factor for very old patients with COVID-19, but emphasize the role of underweight and malnutrition for in-hospital mortality in geriatric patients with COVID-19.
Sections du résumé
BACKGROUND & AIMS
Overweight and obesity have been consistently reported to carry an increased risk for poorer outcomes in coronavirus disease 2019 (COVID-19) in adults. Existing reports mainly focus on in-hospital and intensive care unit mortality in patient cohorts usually not representative of the population with the highest mortality, i.e. the very old and frail patients. Accordingly, little is known about the risk patterns related to body mass and nutrition in very old patients. Our aim was to assess the relationship between body mass index (BMI), nutritional status and in-geriatric hospital mortality among geriatric patients treated for COVID-19. As a reference, the analyses were performed also in patients treated for other diagnoses than COVID-19.
METHODS
We analyzed up to 10,031 geriatric patients with a median age of 83 years of which 1409 (14%) were hospitalized for COVID-19 and 8622 (86%) for other diagnoses in seven geriatric hospitals in the Stockholm region, Sweden during March 2020-January 2021. Data were available in electronic hospital records. The associations between 1) BMI and 2) nutritional status, assessed using the Mini-Nutritional Assessment - Short Form (MNA-SF) scale, and short-term in-geriatric hospital mortality were analyzed using logistic regression.
RESULTS
After adjusting for age, sex, comorbidity, polypharmacy, frailty and the wave of the pandemic (first vs. second), underweight defined as BMI<18.5 increased the risk of in-hospital mortality in COVID-19 patients (odds ratio [OR] = 2.30; confidence interval [CI] = 1.17-4.31). Overweight and obesity were not associated with in-hospital mortality. Malnutrition; i.e. MNA-SF 0-7 points, increased the risk of in-hospital mortality in patients treated for COVID-19 (OR = 2.03; CI = 1.16-3.68) and other causes (OR = 6.01; CI = 2.73-15.91).
CONCLUSIONS
Our results indicate that obesity is not a risk factor for very old patients with COVID-19, but emphasize the role of underweight and malnutrition for in-hospital mortality in geriatric patients with COVID-19.
Identifiants
pubmed: 34389208
pii: S0261-5614(21)00360-5
doi: 10.1016/j.clnu.2021.07.025
pmc: PMC8318666
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
2973-2979Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.
Déclaration de conflit d'intérêts
Conflict of interest The authors declare no conflicts of interest.
Références
Clin Nutr. 2015 Jun;34(3):335-40
pubmed: 25799486
BMJ Open. 2021 Feb 17;11(2):e044486
pubmed: 33597145
Ups J Med Sci. 2020 Nov;125(4):297-304
pubmed: 33100083
Nutrients. 2020 Nov 28;12(12):
pubmed: 33260603
J Nutr Health Aging. 2021;25(4):528-583
pubmed: 33786572
Gastroenterology. 2020 Dec;159(6):2221-2225.e6
pubmed: 32835663
Nutrition. 1999 Feb;15(2):116-22
pubmed: 9990575
Eur J Epidemiol. 2021 Mar;36(3):287-298
pubmed: 33704634
Am J Physiol. 1947 Jul 1;150(1):153-69
pubmed: 20252838
Trends Immunol. 2016 Jun;37(6):386-398
pubmed: 27237815
Clin Nutr. 2017 Jun;36(3):839-847
pubmed: 27236599
J Nutr Health Aging. 2021;25(3):369-373
pubmed: 33575730
Eur J Clin Nutr. 2012 Sep;66(9):1050-3
pubmed: 22947901
MMWR Morb Mortal Wkly Rep. 2021 Mar 12;70(10):355-361
pubmed: 33705371
Eur J Clin Nutr. 2020 Jun;74(6):876-883
pubmed: 32404899
J Nephrol. 2021 Apr;34(2):295-304
pubmed: 33751497
Clin Nutr. 2015 Apr;34(2):252-6
pubmed: 24755235
Eat Weight Disord. 2021 Feb;26(1):27-35
pubmed: 31865598
Am Heart J. 1978 May;95(5):584-94
pubmed: 416704
Nutrition. 2016 Jan;32(1):95-100
pubmed: 26515901
J Appl Physiol Respir Environ Exerc Physiol. 1982 Jan;52(1):64-70
pubmed: 7061279
Obes Rev. 2020 Aug;21(8):e13035
pubmed: 32319198
N Engl J Med. 2017 Jul 6;377(1):13-27
pubmed: 28604169
BMJ. 2016 May 04;353:i2156
pubmed: 27146380
Clin Nutr. 2021 Apr;40(4):2154-2161
pubmed: 33077274
J Intern Med. 1999 May;245(5):475-82
pubmed: 10363748
J Chronic Dis. 1987;40(5):373-83
pubmed: 3558716
Eur J Clin Nutr. 2020 Jun;74(6):871-875
pubmed: 32322046
Clin Nutr. 2019 Feb;38(1):1-9
pubmed: 30181091
Eur J Clin Invest. 2020 Oct;50(10):e13362
pubmed: 32726868
BMC Geriatr. 2021 Jan 15;21(1):63
pubmed: 33451296
Pathol Res Pract. 2020 Oct;216(10):153222
pubmed: 32979742
Curr Med Res Opin. 2021 Apr;37(4):549-554
pubmed: 33509001
Ann Intern Med. 2020 Nov 17;173(10):855-858
pubmed: 32628537
J Am Med Dir Assoc. 2020 Nov;21(11):1555-1559.e2
pubmed: 32978065
Endocr Rev. 2020 May 1;41(3):
pubmed: 32128581
J Am Geriatr Soc. 2021 May;69(5):1128-1139
pubmed: 33619733
Proc Nutr Soc. 2006 Aug;65(3):319-25
pubmed: 16923315
PLoS One. 2021 Mar 4;16(3):e0247461
pubmed: 33661992
Thorax. 1978 Aug;33(4):483-7
pubmed: 694801
J Gerontol A Biol Sci Med Sci. 2020 Sep 25;75(10):1943-1950
pubmed: 32348465
Nat Rev Endocrinol. 2018 Oct;14(10):576-590
pubmed: 30046148
J Gerontol A Biol Sci Med Sci. 2001 Jun;56(6):M366-72
pubmed: 11382797
Am Rev Respir Dis. 1982 Jul;126(1):5-8
pubmed: 7091909
Lancet. 2018 May 5;391(10132):1775-1782
pubmed: 29706364
Circulation. 2021 Jan 12;143(2):135-144
pubmed: 33200947