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. 2023 Oct;35(10):2257-2265.
doi: 10.1007/s40520-023-02526-4. Epub 2023 Sep 4.

Malnutrition in COVID-19 survivors: prevalence and risk factors

Matteo Tosato  1 , Riccardo Calvani  2   3 , Francesca Ciciarello  1 , Vincenzo Galluzzo  1 , Anna Maria Martone  1   4 , Maria Beatrice Zazzara  1 , Cristina Pais  1 , Giulia Savera  1 , Maria Camprubi Robles  5 , Maria Ramirez  5 , Francesco Landi  1   4 ; Gemelli Against COVID-19 Post-Acute Care Team
Collaborators, Affiliations

Malnutrition in COVID-19 survivors: prevalence and risk factors

Matteo Tosato et al. Aging Clin Exp Res. 2023 Oct.

Abstract

Background: Nutritional status is a critical factor throughout COVID-19 disease course. Malnutrition is associated with poor outcomes in hospitalized COVID-19 patients.

Aim: To assess the prevalence of malnutrition and identify its associated factors in COVID-19 survivors.

Methods: Study cohort included 1230 COVID-19 survivors aged 18-86 attending a post-COVID-19 outpatient service. Data on clinical parameters, anthropometry, acute COVID-19 symptoms, lifestyle habits were collected through a comprehensive medical assessment. Malnutrition was assessed according to Global Leadership Initiative on Malnutrition (GLIM) criteria.

Results: Prevalence of malnutrition was 22% at 4-5 months after acute disease. Participants who were not hospitalized during acute COVID-19 showed a higher frequency of malnutrition compared to those who needed hospitalization (26% versus 19%, p < 0.01). Malnutrition was found in 25% COVID-19 survivors over 65 years of age compared to 21% younger participants (p < 0.01). After multivariable adjustment, the likelihood of being malnourished increased progressively and independently with advancing age (Odds ratio [OR] 1.02; 95% CI 1.01-1.03) and in male participants (OR 5.56; 95% CI 3.53-8.74). Malnutrition was associated with loss of appetite (OR 2.50; 95% CI 1.73-3.62), and dysgeusia (OR 4.05; 95% CI 2.30-7.21) during acute COVID-19.

Discussion: In the present investigation we showed that malnutrition was highly prevalent in a large cohort of COVID-19 survivors at 4-5 months from acute illness.

Conclusions: Our findings highlight the need to implement comprehensive nutritional assessment and therapy as an integral part of care for COVID-19 patients.

Keywords: Anorexia of aging; GLIM criteria; Geriatrics; Long Covid; Nutritional status.

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Conflict of interest statement

None of the participants in the Gemelli Against COVID-19 Post-Acute Care Study Group has any conflict of interest. MCR and MR are employees of Abbott Nutrition.

Figures

Fig. 1
Fig. 1
Prevalence of malnutrition identified by GLIM criteria according to gender, hospitalization and age group
Fig. 2
Fig. 2
Prevalence of persisting symptoms according to sex and malnutrition status
See this image and copyright information in PMC

References

    1. Katona P, Katona-Apte J. The interaction between nutrition and infection. Clin Infect Dis. 2008;46:1582–1588. doi: 10.1086/587658. - DOI - PubMed
    1. Bourke CD, Berkley JA, Prendergast AJ. Immune dysfunction as a cause and consequence of malnutrition. Trends Immunol. 2016;37:386–398. doi: 10.1016/j.it.2016.04.003. - DOI - PMC - PubMed
    1. Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395:1054–1062. doi: 10.1016/S0140-6736(20)30566-3. - DOI - PMC - PubMed
    1. James PT, Ali Z, Armitage AE, et al. The role of nutrition in COVID-19 susceptibility and severity of disease: a systematic review. J Nutr. 2021;151:1854–1878. doi: 10.1093/jn/nxab059. - DOI - PMC - PubMed
    1. di Filippo L, de Lorenzo R, D’Amico M, et al. COVID-19 is associated with clinically significant weight loss and risk of malnutrition, independent of hospitalisation: a post-hoc analysis of a prospective cohort study. Clin Nutr. 2021;40:2420–2426. doi: 10.1016/j.clnu.2020.10.043. - DOI - PMC - PubMed