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Clinical Significance of Prognostic Nutrition Index in Hospitalized Patients With Covid-19: Results From Single-Center Experience With Systematic Review and Meta-Analysis Publisher Pubmed



Rashedi S1 ; Keykhaei M2 ; Pazoki M3 ; Ashraf H4, 5 ; Najafi A6 ; Kafan S3 ; Peirovi N1 ; Najmeddin F7 ; Jazayeri SA8 ; Kashani M4 ; Moharari RS1 ; Montazeri M9
Authors
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Authors Affiliations
  1. 1. School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Department of Pulmonary Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Research Development Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
  5. 5. Cardiac Primary Prevention Research Center (CPPRC), Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
  6. 6. Department of Anesthesiology and Critical Care, Tehran University of Medical Sciences, Sina Hospital, Tehran, Iran
  7. 7. Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
  8. 8. Department of Medical Laboratory, Tehran University of Medical Sciences, Tehran, Iran
  9. 9. Department of Infectious Diseases, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran

Source: Nutrition in Clinical Practice Published:2021


Abstract

Background: We aimed to ascertain risk indicators of in-hospital mortality and severity as well as to provide a comprehensive systematic review and meta-analysis to investigate the prognostic significance of the prognostic nutrition index (PNI) as a predictor of adverse outcomes in hospitalized coronavirus disease 2019 (COVID-19) patients. Methods: In this cross-sectional study, we studied patients with COVID-19 who were referred to our hospital from February 16 to November 1, 2020. Patients with either a real-time reverse-transcriptase polymerase chain reaction test that was positive for COVID-19 or high clinical suspicion based on the World Health Organization (WHO) interim guidance were enrolled. A parallel systematic review/meta-analysis (in PubMed, Embase, and Web of Science) was performed. Results: A total of 504 hospitalized COVID-19 patients were included in this study, among which 101 (20.04%) patients died during hospitalization, and 372 (73.81%) patients were categorized as severe cases. At a multivariable level, lower PNI, higher lactate dehydrogenase (LDH), and higher D-dimer levels were independent risk indicators of in-hospital mortality. Additionally, patients with a history of diabetes, lower PNI, and higher LDH levels had a higher tendency to develop severe disease. The meta-analysis indicated the PNI as an independent predictor of in-hospital mortality (odds ratio [OR] = 0.80; P <.001) and disease severity (OR = 0.78; P =.009). Conclusion: Our results emphasized the predictive value of the PNI in the prognosis of patients with COVID-19, necessitating the implementation of a risk stratification index based on PNI values in hospitalized patients with COVID-19. © 2021 American Society for Parenteral and Enteral Nutrition
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