Abstract
Background & aims: Coronavirus disease 2019 (COVID-19) may associate with clinical manifestations, ranging from alterations in smell and taste to severe respiratory distress requiring intensive care, that might associate with weight loss and malnutrition. We aimed to assess the incidence of unintentional weight loss and malnutrition in COVID-19 survivors.
Methods: In this post-hoc analysis of a prospective observational cohort study, we enrolled all adult (age ≥18 years) patients with a confirmed diagnosis of COVID-19 who had been discharged home from either a medical ward or the Emergency Department of San Raffaele University Hospital, and were re-evaluated after remission at the Outpatient COVID-19 Follow-Up Clinic of the same Institution from April 7, 2020, to May 11, 2020. Demographic, anthropometric, clinical and biochemical parameters upon admission were prospectively collected. At follow-up, anthropometrics, the mini nutritional assessment screening and a visual analogue scale for appetite were assessed.
Results: A total of 213 patients were included in the analysis (33% females, median age 59.0 [49.5-67.9] years, 70% overweight/obese upon initial assessment, 73% hospitalised). Sixty-one patients (29% of the total, and 31% of hospitalised patients vs. 21% of patients managed at home, p = 0.14) had lost >5% of initial body weight (median weight loss 6.5 [5.0-9.0] kg, or 8.1 [6.1-10.9]%). Patients who lost weight had greater systemic inflammation (C-reactive protein 62.9 [29.0-129.5] vs.48.7 [16.1-96.3] mg/dL; p = 0.02), impaired renal function (23.7% vs. 8.7% of patients; p = 0.003) and longer disease duration (32 [27-41] vs. 24 [21-30] days; p = 0.047) as compared with those who did not lose weight. At multivariate logistic regression analysis, only disease duration independently predicted weight loss (OR 1.05 [1.01-1.10] p = 0.022).
Conclusions: COVID-19 might negatively impact body weight and nutritional status. In COVID-19 patients, nutritional evaluation, counselling and treatment should be implemented at initial assessment, throughout the course of disease, and after clinical remission. CLINICALTRIALS.
Gov registration: NCT04318366 .
Keywords: COVID-19; Malnutrition; Nutritional evaluation; Outpatient management; SARS-CoV2; Weight loss.
【저자키워드】 COVID-19, SARS-CoV2, Malnutrition, weight loss, Nutritional evaluation, Outpatient management, 【초록키워드】 Treatment, Coronavirus disease 2019, intensive care, C-reactive protein, renal function, clinical manifestations, Survivors, weight, Patient, age, Follow-up, systemic inflammation, incidence, demographic, university, disease, Admission, COVID-19 patients, Outpatient, Analysis, Emergency, nutritional status, weight loss, Visual Analogue Scale, post-hoc analysis, alteration, median age, institution, multivariate logistic regression, clinic, Severe respiratory distress, overweight/obese, Department, females, hospitalised, discharged home, initial, Course, greater, enrolled, predicted, collected, median, hospitalised patient, biochemical parameter, diagnosis of COVID-19, initial body, lost weight, prospective observational cohort, were assessed, 【제목키워드】 risk, prospective cohort study, weight loss, post-hoc analysis, independent, clinically,