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Meta-Analysis
. 2021 Jun:43:174-183.
doi: 10.1016/j.clnesp.2021.03.002. Epub 2021 Mar 17.

Prevalence and outcomes of malnutrition among hospitalized COVID-19 patients: A systematic review and meta-analysis

Semagn Mekonnen Abate  1 , Yigrem Ali Chekole  2 , Mahlet Birhane Estifanos  3 , Kalkidan Hassen Abate  4 , Robel Hussen Kabthymer  3
Affiliations
Meta-Analysis

Prevalence and outcomes of malnutrition among hospitalized COVID-19 patients: A systematic review and meta-analysis

Semagn Mekonnen Abate et al. Clin Nutr ESPEN. 2021 Jun.

Abstract

Background: Malnutrition is inevitable in patients with Coronavirus Disease 2019 (COVID-19) due to its effect on the gastrointestinal system, immune system, and high metabolic activity. However, the prevalence of malnutrition and its outcomes is uncertain. This study aimed to investigate the prevalence and outcome of malnutrition among patients with COVID-19.

Method: A comprehensive search was conducted in PubMed/Medline; Science direct and LILACS from December 29, 2019 to September, 2020 without language restriction. All observational studies reporting the prevalence of malnutrition were included while case reports and reviews were excluded. The data were extracted with two independent authors with a customized format and the disagreements were resolved by the other authors. The methodological quality of included studies was evaluated using a standardized critical appraisal tool.

Results: A total of 511 articles were identified from different databases and 27 articles were selected for evaluation after the successive screening. Fourteen articles with 4187 participants were included. The pooled prevalence of malnutrition among hospitalized patients with COVID-19 was 49.11% (95% CI: 31.67 to 66.54). The odd of mortality among patients COVID-19 with malnutrition was 10 times more likely as compared to those who were well-nourished.

Conclusion: The prevalence of malnutrition and mortality associated with malnutrition among COVID-19 hospitalized patients was very high which entails a mitigating strategy by different stakeholders to prevent and manage malnutrition and its outcomes.

Registration: This systematic review was registered in Prospero's international prospective register of systematic reviews (CRD42020215396).

Keywords: COVID-19; Malnutrition; Mortality; NUTRIC; Prevalence.

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Conflict of interest statement

Declaration of competing interest The authors declare that there are no competing interests.

Figures

Fig. 1
Fig. 1
Prisma flow chart.
Fig. 2
Fig. 2
Forest plot for the prevalence of malnutrition among hospitalized patients with COVID-19: The midpoint of each line illustrates the prevalence; the horizontal line indicates the confidence interval, and the diamond shows the pooled prevalence.
Fig. 3
Fig. 3
Forest plot for subgroup analysis of the prevalence of malnutrition among hospitalized patients with COVID-19 by age group: The midpoint of each line illustrates the prevalence; the horizontal line indicates the confidence interval, and the diamond shows the pooled prevalence.
Fig. 4
Fig. 4
Forest plot for subgroup analysis of the prevalence of malnutrition among hospitalized patients with COVID-19 by country: The midpoint of each line illustrates the prevalence; the horizontal line indicates the confidence interval, and the diamond shows the pooled prevalence.
Fig. 5
Fig. 5
Forest plot for the prevalence of perioperative complication among surgical patients with COVID-19: The midpoint of each line illustrates the prevalence; the horizontal line indicates the confidence interval, and the diamond shows the pooled prevalence.
Fig. 6
Fig. 6
Forest plot for the prevalence of mortality among hospitalized malnourished patients with COVID-19: The midpoint of each line illustrates the prevalence; the horizontal line indicates the confidence interval, and the diamond shows the pooled prevalence.
Fig. 7
Fig. 7
Forest plot showing pooled odds ratio (log scale) of the associations between malnutrition and its determinants (GIT symptoms; Gender; CVD; Hypertension).
Fig. 8
Fig. 8
Funnel plot to assess publication bias. The vertical line indicates the effect size whereas the diagonal line indicates the precision of individual studies with a 95% confidence interval.
See this image and copyright information in PMC

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References

    1. Alzahrani S.H., Alamri S.H. Prevalence of malnutrition and associated factors among hospitalized elderly patients in King Abdulaziz University Hospital, Jeddah, Saudi Arabia. BMC Geriatr. 2017;17:136. - PMC - PubMed
    1. Arbab K., Majid H., Jafri L., Akram B., Raheem A., Jamil B. Assessing nutritional status of critically ill patients using serum Prealbumin levels. J Ayub Med Coll Abbottabad. 2019;31:178–181. - PubMed
    1. Asadi-Pooya A.A., Simani L. Central nervous system manifestations of COVID-19: a systematic review. J Neurol Sci. 2020:116832. - PMC - PubMed
    1. Azzolino D., Saporiti E., Proietti M., Cesari M. Nutritional considerations in frail older patients with COVID-19. J Nutr Health Aging. 2020;1 - PMC - PubMed
    1. Barazzoni R., Bischoff S.C., Breda J., Wickramasinghe K., Krznaric Z., Nitzan D. Elsevier; 2020. ESPEN expert statements and practical guidance for nutritional management of individuals with SARS-CoV-2 infection. - PMC - PubMed