| Relationship between the Geriatric Nutrition Risk Index and the prognosis of severe coronavirus disease 2019 in Korea |
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Hye Ju Yeo, MD, PhD1,2,3, Daesup Lee4, Mose Chun4, Jin Ho Jang, MD1,2,3, Sunghoon Park, MD, PhD5, Su Hwan Lee, MD6, Onyu Park, BN3, Tae Hwa Kim, PhD1,2,3, Woo Hyun Cho, MD, PhD1,2,3 |
1Department of Internal Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Republic of Korea
2Division of Allergy, Pulmonary and Critical Care Medicine, Department of Internal Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Republic of Korea
3Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
4Department of emergency medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Republic of Korea
5Department of Pulmonary, Allergy and Critical Care Medicine, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea
6Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea |
Correspondence:
Woo Hyun Cho, Tel: 82-55-360-2120, Fax: 82-55-360-2157,
Email: chowh@pusan.ac.kr
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Received: 23 July 2024 • Revised: 29 November 2024 • Accepted: 2 January 2025
*Hye Ju Yeo and Daesup Lee contributed equally to this study as co-first authors. |
| Abstract |
Background
Malnutrition exacerbates the prognosis of various diseases; however, its specific impact on severe coronavirus disease (COVID-19) outcomes remains underexplored.
Methods
This multicenter study in Korea assessed the nutritional status of 1,088 adults with severe COVID-19 using the Geriatric Nutritional Risk Index (GNRI) based on serum albumin levels and body weight. The patients were divided into the GNRI>98 (no-risk) and GNRI≤98 (risk) groups. Propensity score matching, adjusted for demographic and clinical variables, was performed.
Results
Of the 1,088 patients, 642 (59%) were at risk of malnutrition. Propensity score matching revealed significant differences in hospital (34.3% vs. 19.4%, p < 0.001) and intensive care unit (ICU) (31.5% vs. 18.9 %, p < 0.001) mortality between the two groups. Risk group was associated with increased hospital mortality rate in the multivariate Cox regression analyses after propensity matching (hazard ratio (HR): 1.64, p = 0.001). Among the 670 elderly patients, 450 were at risk of malnutrition. Moreover, the risk group exhibited a higher hospital mortality (52.1% vs. 29.5%, p < 0.001) and ICU mortality rates (47.2% vs. 29.1%, p < 0.001). Risk group was significantly associated with increased hospital mortality rates in the multivariate analyses after propensity matching (HR: 1.66, p = 0.001).
Conclusion
Malnutrition, as indicated by a low GNRI, was associated with increased mortality in patients with severe COVID-19. A similar effect was also observed in the elderly population. These findings highlight the importance of nutritional assessment and effective interventions for patients with severe COVID-19. |
| Key Words:
GNRI, COVID, mortality, malnutrition |
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