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. 2023 Nov 9;15(22):4727.
doi: 10.3390/nu15224727.

Exploring the Association between Delirium and Malnutrition in COVID-19 Survivors: A Geriatric Perspective

Sarah Damanti  1   2 , Marta Cilla  3 , Giordano Vitali  2 , Valeria Tiraferri  1 , Chiara Pomaranzi  1 , Giulia De Rubertis  1 , Rebecca De Lorenzo  1 , Giuseppe Di Lucca  4 , Raffaella Scotti  4 , Emanuela Messina  5 , Raffaele Dell'Acqua  5 , Monica Guffanti  5 , Paola Cinque  5 , Antonella Castagna  1   5 , Patrizia Rovere-Querini  1   2   6 , Moreno Tresoldi  4
Affiliations

Exploring the Association between Delirium and Malnutrition in COVID-19 Survivors: A Geriatric Perspective

Sarah Damanti et al. Nutrients. .

Abstract

Older individuals face an elevated risk of developing geriatric syndromes when confronted with acute stressors like COVID-19. We assessed the connection between in-hospital delirium, malnutrition, and frailty in a cohort of COVID-19 survivors. Patients aged ≥65, hospitalized in a tertiary hospital in Milan for SARS-CoV-2 pneumonia, were enrolled and screened for in-hospital delirium with the 4 'A's Test (4AT) performed twice daily (morning and evening) during hospital stay. Malnutrition was assessed with the malnutrition universal screening tool (MUST) at hospital admission and with the mini-nutritional assessment short-form (MNA-SF) one month after hospital discharge. Frailty was computed with the frailty index one month after hospital discharge. Fifty patients (median age 78.5, 56% male) were enrolled. At hospital admission, 10% were malnourished. The 13 patients (26%) who developed delirium were frailer (7 vs. 4), experienced a higher in-hospital mortality (5 vs. 3), and were more malnourished one month after discharge (3 of the 4 patients with delirium vs. 6 of the 28 patients without delirium who presented at follow up). The 4AT scores correlated with the MNA-SF scores (r = -0.55, p = 0.006) and frailty (r = 0.35, p = 0.001). Frailty also correlated with MUST (r = 0.3, p = 0.04), MNA-SF (r = -0.42, p = 0.02), and hospitalization length (r = 0.44, p = 0.001). Delirium, malnutrition, and frailty are correlated in COVID-19 survivors. Screening for these geriatric syndromes should be incorporated in routine clinical practice.

Keywords: COVID-19 survivors; delirium; frailty; geriatric syndromes; malnutrition.

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Conflict of interest statement

The authors declare no conflict of interest.

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