comparison of the clinical implications among two different nutritional indices in CORD-Papers-2021-10-25 (Version 1)

Title: Comparison of the Clinical Implications among Two Different Nutritional Indices in Hospitalized Patients with COVID-19
Abstract: Background: Coronavirus disease 2019 (COVID 19) is an emerging infectious disease.It was first reported in Wuhan, China, and then broke out on a large scale around the world.This study aimed to assess the clinical significance of two different nutritional indices in 245 patients with COVID 19. Methods: In this retrospective single center study, we finally included 245 consecutive patients who confirmed COVID 19 in Wuhan University Zhongnan Hospital from January 1 to February 29. Cases were classified as either discharged or dead. Demographic, clinical and laboratory datas were registered, two different nutritional indices were calculated: (i)the Controlling nutritional status (CONUT) score; (ii) prognostic nutritional index (PNI). We used univariate and multivariate logistic regression analysis to explore the relationship between nutritional indices and hospital death . Results: 212 of them were discharged and 33 of them died. In hospital mortality was signifcantly higher in the severe group of PNI than in the moderate and normal groups. It was also significantly worse in the severe CONUT group than in the moderate, mild , and normal CONUT groups. Multivariate logistic regression analysis showed the CONUT score (odds ratio3.371,95%CI (1.124 10.106), p = 0.030) and PNI(odds ratio 0.721,95% CI(0.581 0.896),P=0.003) were independent predictors of all cause death at an early stage; Multivariate logistic regression analysis also showed that the severe group of PNI was the independent risk predictor of in hospital death(odds ratio 24.225, 95% CI(2.147 273.327), p=0.010).The CONUT score cutoff value was 5.5 (56.00 and 80.81%; AUC 0.753; 95% CI(0.644 0.862);respectively).The PNI cutoff value was 40.58 (81.80 and 66.20%; AUC 0.778; 95% CI(0.686 0.809); respectively).We use PNI and the COUNT score to assess malnutrition, which can have a prognosis effect of COVID 19 patients. Conclusion:The CONUT score and PNI could be a reliable prognostic marker of all cause death in patients with COVID 19. Keywords: Coronavirus disease 2019; nutrition; indicies; prognosis
Published: 5/1/2020
DOI: 10.1101/2020.04.28.20082644
DOI_URL: http://doi.org/10.1101/2020.04.28.20082644
Author Name: chen, l
Author link: https://covid19-data.nist.gov/pid/rest/local/author/chen_l
Author Name: Du, X
Author link: https://covid19-data.nist.gov/pid/rest/local/author/du_x
Author Name: Liu, Y
Author link: https://covid19-data.nist.gov/pid/rest/local/author/liu_y
Author Name: Chen, J
Author link: https://covid19-data.nist.gov/pid/rest/local/author/chen_j
Author Name: Peng, L
Author link: https://covid19-data.nist.gov/pid/rest/local/author/peng_l
Author Name: Cheng, Z
Author link: https://covid19-data.nist.gov/pid/rest/local/author/cheng_z
Author Name: Wang, H H X
Author link: https://covid19-data.nist.gov/pid/rest/local/author/wang_h_h_x
Author Name: Luo, M
Author link: https://covid19-data.nist.gov/pid/rest/local/author/luo_m
Author Name: Jin, Y
Author link: https://covid19-data.nist.gov/pid/rest/local/author/jin_y
Author Name: Zhao, Y
Author link: https://covid19-data.nist.gov/pid/rest/local/author/zhao_y
sha: 3f4db5187921e3f4afefed35e1ee96bd02f7a063
license: medrxiv
source_x: MedRxiv; WHO
source_x_url: https://www.who.int/
url: https://doi.org/10.1101/2020.04.28.20082644 http://medrxiv.org/cgi/content/short/2020.04.28.20082644v1?rss=1
has_full_text: TRUE
Keywords Extracted from Text Content: PNI 2.147-273.327 Wuhan University Zhongnan Hospital COVID-19 patients Coronavirus disease 2019 medRxiv preprint CI(0.686-0.809 1.124-10.106 CI(0.581-0.896),P=0.003 PNI(odds COVID-19patients Wuhan, coronary heart Procalcitonin(PCT mild-(n = 6 fat-derived serum albumin COVID-19 patients medRxiv ALT gastrointestinal spinal Sodium(Na+ worse).One cholesterol blood cell peripheral blood lymphocyte count(unit/L);Patients PT albumin cardiovascular COVID-19 gastrointestinal tumors Prothrombin normal-PNI Platelets survivors PNI<35 discharged(Tabel A Potassium(K+ Alanine aminotransferase https://doi.org/10.1101/2020.04 PNI HDL ofall-cause malignant tumors coronavirus 2 prealbumin membrane potassium uric acid platelets hemoglobin UA ECMO heart lymphocyte WBC Heart malabsorption,which malignancies Diastolic pressure Fisher's body muscle vasopressors medRxiv preprint theCONUT Wuhan human vitamins mortalitys [6 Systolic pressure people blood lipids AUC lymphocytes Hubei, China TC RA [8 peripheral lymphocytes cell PCT intestinal edema serum creatinine severe-PNI high density lipoprotein patient [2] [2] [2] patients China [1 albumin [28] . SARS CoV-2 coronavirus disease 2019 sodium creatinine anorexia D-dimer
Extracted Text Content in Record: First 5000 Characters:Background: Coronavirus disease 2019 is an emerging infectious disease.It was first reported in Wuhan, China, and then broke out on a large scale around the world.This study aimed to assess the clinical significance of two different nutritional indices in 245 patients with COVID-19. In this retrospective single-center study, we finally included 245 consecutive patients who confirmed COVID-19 in Wuhan University Zhongnan Hospital from January 1 to February 29. Cases were classified as either discharged or dead. Demographic, clinical and laboratory datas were registered, two different nutritional indices were calculated: (i)the Controlling nutritional status (CONUT) score; (ii) prognostic nutritional index (PNI). We used univariate and multivariate logistic regression analysis to explore the relationship between nutritional indices and hospital death . Results: 212 of them were discharged and 33 of them died. In-hospital mortality was signifcantly higher in the severe group of PNI than in the moderate and normal groups. It was also significantly worse in the severe-CONUT group than in the moderate-, mild-, and normal-CONUT groups. Multivariate logistic regression analysis showed the CONUT score (odds ratio3.371,95%CI (1.124-10.106), p = 0.030) and PNI(odds ratio 0.721,95% CI(0.581-0.896),P=0.003) were independent predictors of all-cause death at an early stage; Multivariate logistic regression analysis also showed that the severe group of PNI was the independent risk predictor of in-hospital death(odds ratio 24.225, 95% CI (2.147-273.327) , p=0.010).The CONUT score cutoff value was 5.5 (56.00 and 80.81%; AUC 0.753; 95% CI (0.644-0.862) ;respectively).The PNI cutoff value was 40.58 (81.80 and 66.20%; AUC 0.778; 95% CI(0.686-0.809); respectively).We use PNI and the COUNT score to assess malnutrition, which : medRxiv preprint can have a prognosis effect of COVID-19patients. The CONUT score and PNI could be a reliable prognostic marker of all-cause deathin patients with COVID-19. In December 2019, coronavirus disease 2019 , also called severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) occurred in Wuhan, Hubei, China. The disease quickly and violently broke out in other provinces of China and other parts of the world. The numbers of confirmed cases have risen rapidly in the past three months. As of February 20, 2020, it has caused more than 75,000 confirmed COVID-19 cases in China [1] . The epidemiological and clinical characteristics of COVID-19 have been known through previous reports. According to Huang et al., COVID-19 patients had fever, myalgia ,fatigue and dry cough [2] [2] [2] . But apart from the typical symptoms, there wereasymptomatic patients and atypical symptoms, such as diarrhea and headache [3] .Although most patients were considered to have a good prognosis, elderly patients and patients with chronic underlying diseases or severe clinical symptoms may have a poor prognosis [4] . In addition, high SOFA scores and d-dimers greater than 1 μg / L might serve as risk factors to help clinicians identify patients with poor prognosis early [5] . Nutritional status has attracted more and more attention in various clinical fields. Generally, malnutrition is considered an indicator related to increased morbidity and mortalitys [6] . Therefore, the assessments of early nutritional status of different diseases are important means to identify malnutrition, nutritional risks, and possible benefit to nutritional interventions, as well as a prerequisite for guiding nutritional treatment plans. Ideal nutritional risk screening tools and nutrition assessment methods should accurately reflect the nutritional status of the body and predict the occurrence of malnutrition-related complications. Traditional measurement methods, such as height or body mass index (BMI) or laboratory indicators, such as albumin, prealbumin and total cholesterol levels, have been used to assess the nutritional status of individuals [7] . However, they are limited to reflecting a small portion of nutritional risks and cannot be comprehensive assessement .Interestingly, some studies have shown that malnutrition is linked to the inflammatory response of chronic diseases and the development of autoimmune diseases. At the same time, abnormal nutritional status is related to the prognosis of malignancies and other diseases, such as heart failure, adult spinal deformity and RA [8, 9, 10, 11, 12] . Therefore, understanding nutritional status aims to elucidate the prognostic significance of various diseases. This suggests that assessing nutritional status has clinical significance nutritional status on the outcome of COVID-19 patients. Current assessments of the serious consequences and risk factors for death of COVID-19 are not numerous and limitative [19] . Therefore, the purpose of this study was to (i) investigate the relationship between two different nutritional indices and clinical characteristics of patients with COVID-19, and (ii)
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