Nutritional and Functional Impact of Acute SARS-CoV-2 Infection in Hospitalized Patients

Abstract

Aim: To assess the prevalence of malnutrition, frailty, and sarcopenia and the relationships between them in patients hospitalized for COVID-19. Methods: This was a cross-sectional study of the prevalence, determinants, and associations between malnutrition (GLIM 2019 criteria), sarcopenia (SARC-F scale, dynamometry, and calf circumference), and frailty (FRAIL scale) upon discharge following hospitalization for COVID 19. Results: A total of 101 patients (67.3% men, mean age 66.3 years) were recruited. Malnutrition was diagnosed in 49.5%, sarcopenia in 32.7%, and frailty in 28.7% of patients. Of the patients with malnutrition, 48% were also sarcopenic, and 42% were frail. There was a significant association between malnutrition and the severity of pneumonia according to the CURB-65 scale (odds ratio [OR] 2.61, p = 0.036), between sarcopenia and a Barthel score lower than 60 points (OR 29.52, p < 0.001), and between frailty and both a Barthel score lower than 60 points (OR 32.27, p < 0.001) and a length of hospital stay of over 30 days (OR 9.11, p = 0.008). Conclusions: Malnutrition, sarcopenia, and frailty are prevalent and interrelated entities in patients hospitalized for acute SARS CoV-2 infection, especially in patients with greater baseline functional impairment prior to admission and a higher infection severity.

Keywords: SARS-CoV-2; frailty; malnutrition; sarcopenia.

Figure 1

Prevalence of malnutrition and its components, sarcopenia, and frailty in the study sample. Prevalence expressed as percentage (%). Diagnosis of malnutrition was according to GLIM 2019 criteria (Global Leadership Initiative of Malnutrition). Sarcopenia was diagnosed according to the SARC-F screening tool. Frailty categorization by FRAIL scale (Fatigue, Resistance, Ambulation, Illnesses, Loss of Weight). BMI: body mass index.