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. 2022 Apr;37(2):393-401.
doi: 10.1002/ncp.10846. Epub 2022 Feb 28.

Increased nutrition risk at admission is associated with longer hospitalization in children and adolescents with COVID-19

Patrícia Zamberlan  1 , Ana Paula de Carvalho Panzeri Carlotti  2 , Karina Helena Canton Viani  1 , Isadora Souza Rodriguez  3 , Josiane de Carvalho Simas  3 , Ariadne Beatriz Silvério  2 , Leila Costa Volpon  2 , Werther Brunow de Carvalho  4 , Artur Figueiredo Delgado  4
Affiliations

Increased nutrition risk at admission is associated with longer hospitalization in children and adolescents with COVID-19

Patrícia Zamberlan et al. Nutr Clin Pract. 2022 Apr.

Abstract

Background: We investigated the association of nutritional risk and inflammatory marker level with length of stay (LOS) in children and adolescents hospitalized for COVID-19 infection in two pediatric teaching hospitals in a developing country.

Methods: This was a cross-sectional analytical retrospective study performed in two pediatric hospitals. We included the data from all children and adolescents who were hospitalized with a SARS-CoV-2 infection between March and December 2020. Demographic, anthropometric, clinical, and laboratory data were extracted from electronic medical records. Nutritional risk was assessed according to the STRONGkids tool within 24 hours of admission and was categorized into two levels: ≥4 (high risk) and <4 (moderate or low risk). Means or medians were compared between nutritional risk groups using the t test and Mann-Whitney U test, respectively. The association of nutritional risk and inflammatory markers with LOS was estimated using the Kaplan-Meier method and log-rank test. Cox proportional-hazard and linear regression models were performed, and adjusted for sex, age, and respiratory symptoms.

Results: From a total of 73 patients, 20 (27.4%) had a STRONGkids score ≥4 at admission, which was associated with a longer LOS even after adjusting (β = 12.30; 1.74-22.9 95% CI; P = 0.023). The same association was observed between LOS and all laboratory markers except for D-dimer.

Conclusion: Among children and adolescents with COVID-19, a STRONGkids score ≥4 at admission, lower values of albumin, lymphocytes, and hemoglobin, and higher CRP values were associated with longer LOS.

Keywords: COVID-19; SARS-CoV-2; hospitalized child; inflammation; length of stay; malnutrition; nutrition assessment; nutrition risk; pediatrics.

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Conflict of interest statement

None declared.

Figures

Figure 1
Figure 1
Study flowchart. CRP, C‐reactive protein; LOS, length of stay; SARS‐CoV‐2, severe acute respiratory syndrome coronavirus 2
Figure 2
Figure 2
Kaplan‐Meier curves for length of stay (discharge) of children and adolescents with coronavirus disease 2019 according to nutrition risk at admission (STRONGkids ≥4 and STRONGkids <4)
Figure 3
Figure 3
Kaplan‐Meier curves for length of stay (discharge) of children and adolescents with coronavirus disease 2019 according to (A) lymphocyte count, (B) serum albumin level, (C) D‐dimer, (D) hemoglobin, and (E) CRP. CRP, C‐reactive protein
See this image and copyright information in PMC

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