Undernutrition risk is independently associated with worsened indicators of hospital rehabilitation in COVID-19 patients

ABSTRACT

Objective

This study was designed to analyze the association between the risk of undernutrition and indicators of hospital rehabilitation in patients with COVID-19 while controlling for confounding variables.

Methods

This was an analytical study conducted by analyzing the medical records of patients with COVID-19. A total of 562 adult patients were eligible for the study. In addition to the risk of undernutrition (independent variable), indicators of hospital rehabilitation (dependent variables) were evaluated. These indicators included the length of hospital stay, clinical outcome (discharge or death), food intake, mobility (bedridden status), the use of mechanical ventilation, and the need for enteral nutrition. Pre-existing comorbidities (confounding/control variables) were grouped into cardiovascular, metabolic/endocrine, neurological, chronic obstructive pulmonary disease, and other categories (neoplasms, multiple sclerosis, and kidney disease). A dichotomization model was applied for data analysis. The Chi-Square test was used to verify the association between the risk of undernutrition and the dependent variables. Associations with a significance level of P < 0.05 were subjected to Poisson regression to identify the prevalence ratio.

Results

Patients at risk of undernutrition had a 90% higher chance of being bedridden and were 35 times more likely to experience a decrease in food intake. They also had an 89% higher chance of using invasive mechanical ventilation and a 91% higher chance of requiring enteral nutrition. Additionally, individuals at risk of undernutrition had a 73% higher chance of death. Adjustment for comorbidities did not alter these associations, demonstrating that the risk of undernutrition is independently associated with indicators of hospital rehabilitation.

Conclusion

The risk of undernutrition is independently associated with worsened indicators of hospital rehabilitation in patients with COVID-19, including higher prevalence of mortality.

KEYWORDS:

• Nutritional status
• SARS-CoV-2
• hospital medicine
• physical and rehabilitation medicine
• malnutrition

Declaration of financial/other relationships

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Acknowledgments

The authors express their gratitude to the management of the Hospital Santa Casa de Londrina-PR-Brazil for authorizing the research, particularly to the institution’s IT department for their essential assistance in the data acquisition process. Finally, the authors would like to acknowledge the support provided by FUNADESP (Fundação Nacional de Desenvolvimento do Ensino Superior Particular) through the research grants awarded.

Author contributions

VE Pinheiro and J Casonatto equally contributed to the conception and design of the research; AS Ribeiro and CAM Camillo contributed to the design of the research; VE Pinheiro and J Casonatto contributed to the acquisition and analysis of the data; AS Ribeiro and CAM Camillo contributed to the interpretation of the data; and VE Pinheiro and J Casonatto drafted the manuscript. All authors critically revised the manuscript, agree to be fully accountable for ensuring the integrity and accuracy of the work, and read and approved the final manuscript.

Additional information

Funding

This paper was not funded.