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Impact of malnutrition on clinical outcomes in patients diagnosed with COVID‐19
Background Coronavirus disease 2019 (COVID‐19) is now the third leading cause of death in the United States. Malnutrition in hospitalized patients increases risk of complications. However, the effect of malnutrition on outcomes in patients infected is unclear. This study aims to identify the impact...
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| Published in: | JPEN. Journal of parenteral and enteral nutrition 2022-11, Vol.46 (8), p.1797-1807 |
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| cites | cdi_FETCH-LOGICAL-c4158-b8579934dae32abbe7f4f7cff7ad7bee3bbaec055b636177ec971e26da19ce63 |
| container_end_page | 1807 |
| container_issue | 8 |
| container_start_page | 1797 |
| container_title | JPEN. Journal of parenteral and enteral nutrition |
| container_volume | 46 |
| creator | Ponce, Jana Anzalone, Alfred Jerrod Bailey, Kristina Sayles, Harlan Timmerman, Megan Jackson, Mariah McClay, James Hanson, Corrine |
| description | Background
Coronavirus disease 2019 (COVID‐19) is now the third leading cause of death in the United States. Malnutrition in hospitalized patients increases risk of complications. However, the effect of malnutrition on outcomes in patients infected is unclear. This study aims to identify the impact of malnutrition on mortality and adverse hospital events in patients hospitalized with COVID‐19.
Methods
This study used data from the National COVID Cohort Collaborative (N3C), a COVID‐19 repository containing harmonized, longitudinal electronic health record data from US health systems. Malnutrition was categorized into three groups based on condition diagnosis: (1) none documented, (2) history of malnutrition, and (3) hospital‐acquired malnutrition. Multivariable logistic regression was performed to determine whether malnutrition was associated with mortality and adverse events, including mechanical ventilation, acute respiratory distress syndrome, extracorporeal membrane oxygenation, and hospital‐acquired pressure injury, in hospitalized patients with COVID‐19.
Results
Of 343,188 patients hospitalized with COVID‐19, 11,206 had a history of malnutrition and 15,711 had hospital‐acquired malnutrition. After adjustment for potential confounders, odds of mortality were significantly higher in patients with a history of malnutrition (odds ratio [OR], 1.71; 95% confidence interval [CI], 1.63–1.79; P |
| doi_str_mv | 10.1002/jpen.2418 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_9347569</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2674349079</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4158-b8579934dae32abbe7f4f7cff7ad7bee3bbaec055b636177ec971e26da19ce63</originalsourceid><addsrcrecordid>eNp1kc1KxDAQx4Moun4cfAHJUQ_VpE2TzUWQ9Wtl8QMWryFNp2ukTWrTKt58BJ_RJ7HrrqIHYWAO8-M3w_wR2qXkkBISHz3W4A5jRocraEAlo1HMGFtFA0LZMOJE0A20GcIjISThhKyjjSTlIpY0HaC7cVVr02Jf4EqXrmsb21rvcF-mtM4aXWLftcZXELB1uNatBdcGnFs9cz5Ajl9s-4BHN_fj04-3dyq30VqhywA7y76Fpudn09FlNLm5GI9OJpFhNB1G2TAVUiYs15DEOstAFKwQpiiEzkUGkGSZBkPSNOMJp0KAkYJCzHNNpQGebKHjhbbusgpy0x_V6FLVja1086q8turvxNkHNfPPqt8pUi57wf5S0PinDkKrKhsMlKV24LugYi5YwiQRc_RggZrGh9BA8bOGEjVPQM0TUPMEenbv910_5PfLe-BoAbzYEl7_N6mr27PrL-UnKEGT0Q</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2674349079</pqid></control><display><type>article</type><title>Impact of malnutrition on clinical outcomes in patients diagnosed with COVID‐19</title><source>Wiley</source><creator>Ponce, Jana ; Anzalone, Alfred Jerrod ; Bailey, Kristina ; Sayles, Harlan ; Timmerman, Megan ; Jackson, Mariah ; McClay, James ; Hanson, Corrine</creator><creatorcontrib>Ponce, Jana ; Anzalone, Alfred Jerrod ; Bailey, Kristina ; Sayles, Harlan ; Timmerman, Megan ; Jackson, Mariah ; McClay, James ; Hanson, Corrine ; National COVID Cohort Collaborative (N3C) Consortium ; National COVID Cohort Collaborative (N3C) Consortium</creatorcontrib><description>Background
Coronavirus disease 2019 (COVID‐19) is now the third leading cause of death in the United States. Malnutrition in hospitalized patients increases risk of complications. However, the effect of malnutrition on outcomes in patients infected is unclear. This study aims to identify the impact of malnutrition on mortality and adverse hospital events in patients hospitalized with COVID‐19.
Methods
This study used data from the National COVID Cohort Collaborative (N3C), a COVID‐19 repository containing harmonized, longitudinal electronic health record data from US health systems. Malnutrition was categorized into three groups based on condition diagnosis: (1) none documented, (2) history of malnutrition, and (3) hospital‐acquired malnutrition. Multivariable logistic regression was performed to determine whether malnutrition was associated with mortality and adverse events, including mechanical ventilation, acute respiratory distress syndrome, extracorporeal membrane oxygenation, and hospital‐acquired pressure injury, in hospitalized patients with COVID‐19.
Results
Of 343,188 patients hospitalized with COVID‐19, 11,206 had a history of malnutrition and 15,711 had hospital‐acquired malnutrition. After adjustment for potential confounders, odds of mortality were significantly higher in patients with a history of malnutrition (odds ratio [OR], 1.71; 95% confidence interval [CI], 1.63–1.79; P < 0.001) and hospital‐acquired malnutrition (OR, 2.5; 95% CI, 2.4–2.6; P < 0.001). Adjusted odds of adverse hospital events were also significantly elevated in both malnutrition groups.
Conclusions
Results indicate the risk of mortality and adverse inpatient events in adults with COVID‐19 is significantly higher in patients with malnutrition. Prevention, diagnosis, and treatment of malnutrition could be a key component in improving outcomes in these patients.</description><identifier>ISSN: 0148-6071</identifier><identifier>ISSN: 1941-2444</identifier><identifier>EISSN: 1941-2444</identifier><identifier>DOI: 10.1002/jpen.2418</identifier><identifier>PMID: 35672915</identifier><language>eng</language><publisher>United States: John Wiley and Sons Inc</publisher><subject>Adult ; Cohort Studies ; COVID-19 - complications ; COVID-19 - therapy ; Hospitalization ; Humans ; malnutrition ; Malnutrition - complications ; nutrition assessment ; nutrition support practice ; Original Research ; outcomes research/quality ; pulmonary disease ; Respiration, Artificial ; United States - epidemiology</subject><ispartof>JPEN. Journal of parenteral and enteral nutrition, 2022-11, Vol.46 (8), p.1797-1807</ispartof><rights>2022 The Authors. published by Wiley Periodicals LLC on behalf of American Society for Parenteral and Enteral Nutrition.</rights><rights>2022 The Authors. Journal of Parenteral and Enteral Nutrition published by Wiley Periodicals LLC on behalf of American Society for Parenteral and Enteral Nutrition.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4158-b8579934dae32abbe7f4f7cff7ad7bee3bbaec055b636177ec971e26da19ce63</citedby><cites>FETCH-LOGICAL-c4158-b8579934dae32abbe7f4f7cff7ad7bee3bbaec055b636177ec971e26da19ce63</cites><orcidid>0000-0002-1040-8750</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35672915$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ponce, Jana</creatorcontrib><creatorcontrib>Anzalone, Alfred Jerrod</creatorcontrib><creatorcontrib>Bailey, Kristina</creatorcontrib><creatorcontrib>Sayles, Harlan</creatorcontrib><creatorcontrib>Timmerman, Megan</creatorcontrib><creatorcontrib>Jackson, Mariah</creatorcontrib><creatorcontrib>McClay, James</creatorcontrib><creatorcontrib>Hanson, Corrine</creatorcontrib><creatorcontrib>National COVID Cohort Collaborative (N3C) Consortium</creatorcontrib><creatorcontrib>National COVID Cohort Collaborative (N3C) Consortium</creatorcontrib><title>Impact of malnutrition on clinical outcomes in patients diagnosed with COVID‐19</title><title>JPEN. Journal of parenteral and enteral nutrition</title><addtitle>JPEN J Parenter Enteral Nutr</addtitle><description>Background
Coronavirus disease 2019 (COVID‐19) is now the third leading cause of death in the United States. Malnutrition in hospitalized patients increases risk of complications. However, the effect of malnutrition on outcomes in patients infected is unclear. This study aims to identify the impact of malnutrition on mortality and adverse hospital events in patients hospitalized with COVID‐19.
Methods
This study used data from the National COVID Cohort Collaborative (N3C), a COVID‐19 repository containing harmonized, longitudinal electronic health record data from US health systems. Malnutrition was categorized into three groups based on condition diagnosis: (1) none documented, (2) history of malnutrition, and (3) hospital‐acquired malnutrition. Multivariable logistic regression was performed to determine whether malnutrition was associated with mortality and adverse events, including mechanical ventilation, acute respiratory distress syndrome, extracorporeal membrane oxygenation, and hospital‐acquired pressure injury, in hospitalized patients with COVID‐19.
Results
Of 343,188 patients hospitalized with COVID‐19, 11,206 had a history of malnutrition and 15,711 had hospital‐acquired malnutrition. After adjustment for potential confounders, odds of mortality were significantly higher in patients with a history of malnutrition (odds ratio [OR], 1.71; 95% confidence interval [CI], 1.63–1.79; P < 0.001) and hospital‐acquired malnutrition (OR, 2.5; 95% CI, 2.4–2.6; P < 0.001). Adjusted odds of adverse hospital events were also significantly elevated in both malnutrition groups.
Conclusions
Results indicate the risk of mortality and adverse inpatient events in adults with COVID‐19 is significantly higher in patients with malnutrition. Prevention, diagnosis, and treatment of malnutrition could be a key component in improving outcomes in these patients.</description><subject>Adult</subject><subject>Cohort Studies</subject><subject>COVID-19 - complications</subject><subject>COVID-19 - therapy</subject><subject>Hospitalization</subject><subject>Humans</subject><subject>malnutrition</subject><subject>Malnutrition - complications</subject><subject>nutrition assessment</subject><subject>nutrition support practice</subject><subject>Original Research</subject><subject>outcomes research/quality</subject><subject>pulmonary disease</subject><subject>Respiration, Artificial</subject><subject>United States - epidemiology</subject><issn>0148-6071</issn><issn>1941-2444</issn><issn>1941-2444</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><recordid>eNp1kc1KxDAQx4Moun4cfAHJUQ_VpE2TzUWQ9Wtl8QMWryFNp2ukTWrTKt58BJ_RJ7HrrqIHYWAO8-M3w_wR2qXkkBISHz3W4A5jRocraEAlo1HMGFtFA0LZMOJE0A20GcIjISThhKyjjSTlIpY0HaC7cVVr02Jf4EqXrmsb21rvcF-mtM4aXWLftcZXELB1uNatBdcGnFs9cz5Ajl9s-4BHN_fj04-3dyq30VqhywA7y76Fpudn09FlNLm5GI9OJpFhNB1G2TAVUiYs15DEOstAFKwQpiiEzkUGkGSZBkPSNOMJp0KAkYJCzHNNpQGebKHjhbbusgpy0x_V6FLVja1086q8turvxNkHNfPPqt8pUi57wf5S0PinDkKrKhsMlKV24LugYi5YwiQRc_RggZrGh9BA8bOGEjVPQM0TUPMEenbv910_5PfLe-BoAbzYEl7_N6mr27PrL-UnKEGT0Q</recordid><startdate>202211</startdate><enddate>202211</enddate><creator>Ponce, Jana</creator><creator>Anzalone, Alfred Jerrod</creator><creator>Bailey, Kristina</creator><creator>Sayles, Harlan</creator><creator>Timmerman, Megan</creator><creator>Jackson, Mariah</creator><creator>McClay, James</creator><creator>Hanson, Corrine</creator><general>John Wiley and Sons Inc</general><scope>24P</scope><scope>WIN</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-1040-8750</orcidid></search><sort><creationdate>202211</creationdate><title>Impact of malnutrition on clinical outcomes in patients diagnosed with COVID‐19</title><author>Ponce, Jana ; Anzalone, Alfred Jerrod ; Bailey, Kristina ; Sayles, Harlan ; Timmerman, Megan ; Jackson, Mariah ; McClay, James ; Hanson, Corrine</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4158-b8579934dae32abbe7f4f7cff7ad7bee3bbaec055b636177ec971e26da19ce63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Adult</topic><topic>Cohort Studies</topic><topic>COVID-19 - complications</topic><topic>COVID-19 - therapy</topic><topic>Hospitalization</topic><topic>Humans</topic><topic>malnutrition</topic><topic>Malnutrition - complications</topic><topic>nutrition assessment</topic><topic>nutrition support practice</topic><topic>Original Research</topic><topic>outcomes research/quality</topic><topic>pulmonary disease</topic><topic>Respiration, Artificial</topic><topic>United States - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ponce, Jana</creatorcontrib><creatorcontrib>Anzalone, Alfred Jerrod</creatorcontrib><creatorcontrib>Bailey, Kristina</creatorcontrib><creatorcontrib>Sayles, Harlan</creatorcontrib><creatorcontrib>Timmerman, Megan</creatorcontrib><creatorcontrib>Jackson, Mariah</creatorcontrib><creatorcontrib>McClay, James</creatorcontrib><creatorcontrib>Hanson, Corrine</creatorcontrib><creatorcontrib>National COVID Cohort Collaborative (N3C) Consortium</creatorcontrib><creatorcontrib>National COVID Cohort Collaborative (N3C) Consortium</creatorcontrib><collection>Wiley Open Access</collection><collection>Wiley Online Library Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>JPEN. Journal of parenteral and enteral nutrition</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ponce, Jana</au><au>Anzalone, Alfred Jerrod</au><au>Bailey, Kristina</au><au>Sayles, Harlan</au><au>Timmerman, Megan</au><au>Jackson, Mariah</au><au>McClay, James</au><au>Hanson, Corrine</au><aucorp>National COVID Cohort Collaborative (N3C) Consortium</aucorp><aucorp>National COVID Cohort Collaborative (N3C) Consortium</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of malnutrition on clinical outcomes in patients diagnosed with COVID‐19</atitle><jtitle>JPEN. Journal of parenteral and enteral nutrition</jtitle><addtitle>JPEN J Parenter Enteral Nutr</addtitle><date>2022-11</date><risdate>2022</risdate><volume>46</volume><issue>8</issue><spage>1797</spage><epage>1807</epage><pages>1797-1807</pages><issn>0148-6071</issn><issn>1941-2444</issn><eissn>1941-2444</eissn><abstract>Background
Coronavirus disease 2019 (COVID‐19) is now the third leading cause of death in the United States. Malnutrition in hospitalized patients increases risk of complications. However, the effect of malnutrition on outcomes in patients infected is unclear. This study aims to identify the impact of malnutrition on mortality and adverse hospital events in patients hospitalized with COVID‐19.
Methods
This study used data from the National COVID Cohort Collaborative (N3C), a COVID‐19 repository containing harmonized, longitudinal electronic health record data from US health systems. Malnutrition was categorized into three groups based on condition diagnosis: (1) none documented, (2) history of malnutrition, and (3) hospital‐acquired malnutrition. Multivariable logistic regression was performed to determine whether malnutrition was associated with mortality and adverse events, including mechanical ventilation, acute respiratory distress syndrome, extracorporeal membrane oxygenation, and hospital‐acquired pressure injury, in hospitalized patients with COVID‐19.
Results
Of 343,188 patients hospitalized with COVID‐19, 11,206 had a history of malnutrition and 15,711 had hospital‐acquired malnutrition. After adjustment for potential confounders, odds of mortality were significantly higher in patients with a history of malnutrition (odds ratio [OR], 1.71; 95% confidence interval [CI], 1.63–1.79; P < 0.001) and hospital‐acquired malnutrition (OR, 2.5; 95% CI, 2.4–2.6; P < 0.001). Adjusted odds of adverse hospital events were also significantly elevated in both malnutrition groups.
Conclusions
Results indicate the risk of mortality and adverse inpatient events in adults with COVID‐19 is significantly higher in patients with malnutrition. Prevention, diagnosis, and treatment of malnutrition could be a key component in improving outcomes in these patients.</abstract><cop>United States</cop><pub>John Wiley and Sons Inc</pub><pmid>35672915</pmid><doi>10.1002/jpen.2418</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0002-1040-8750</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | JPEN. Journal of parenteral and enteral nutrition, 2022-11, Vol.46 (8), p.1797-1807 |
| issn | 0148-6071 1941-2444 1941-2444 |
| language | eng |
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| source | Wiley |
| subjects | Adult Cohort Studies COVID-19 - complications COVID-19 - therapy Hospitalization Humans malnutrition Malnutrition - complications nutrition assessment nutrition support practice Original Research outcomes research/quality pulmonary disease Respiration, Artificial United States - epidemiology |
| title | Impact of malnutrition on clinical outcomes in patients diagnosed with COVID‐19 |
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