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. 2022 Aug;46(6):1441-1448.
doi: 10.1002/jpen.2318. Epub 2022 Feb 16.

High neutrophil-to-lymphocyte ratio at intensive care unit admission is associated with nutrition risk in patients with COVID-19

Paula M Martins  1 , Tatyanne L N Gomes  2 , Emanoelly P Franco  1 , Liana L Vieira  1 , Gustavo D Pimentel  2
Affiliations

High neutrophil-to-lymphocyte ratio at intensive care unit admission is associated with nutrition risk in patients with COVID-19

Paula M Martins et al. JPEN J Parenter Enteral Nutr. 2022 Aug.

Abstract

Background: Inflammation plays a crucial role in nutrition status and can be useful in early nutrition risk screening of patients during the coronavirus disease 2019 (COVID-19) pandemic. Thus, this study aimed to assess the association between systemic inflammatory markers and nutrition risk tools in intensive care unit (ICU) patients with COVID-19.

Methods: Patients with confirmed COVID-19 and ICU admission were enrolled in a retrospective, observational, cross-sectional study. The medians of C-reactive protein (CRP; ≥13.8 mg/dl) and the neutrophil-to-lymphocyte ratio (NLR; ≥12.6) upon admission were used to dichotomize patients.

Results: Of the 73 patients, 63% were men; the average age was 56 years, and the median length of hospital stay was 10 (25th: 4; 75th: 17) days. When nutrition risk screening tools were used, 85% were at risk according to Nutritional Risk Screening (≥3 points), whereas 42% had high risk according to the Modified Nutrition Risk in the Critically Ill (mNUTRIC; ≥5 points), and 57% were moderately or severely malnourished according to the Subjective Global Assessment (B or C). Mortality was higher in the group with NLR ≥12.6 than in the group with NLR <12.6, with no difference between CRP groups. A significant association was found only between NLR and mNUTRIC, even when adjusted by sex, age, and body mass index (odds ratio, 1.36; 95% CI, 1.06-1.76; P = 0.016), but not between CRP and nutrition risk.

Conclusion: Although the inflammatory marker CRP is the most used in hospital clinical practice, we found that only NLR was associated with nutrition risk (NUTRIC score).

Keywords: COVID-19; ICU; inflammation; nutrition status.

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Conflict of interest statement

None declared.

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