Malnutrition in COVID-19 survivors: prevalence and risk factors
Matteo Tosato, Riccardo Calvani, Francesca Ciciarello, Vincenzo Galluzzo, Anna Maria Martone, Maria Beatrice Zazzara, Cristina Pais, Giulia Savera, Maria Camprubi Robles, Marı́a Jesús Ramı́rez-Expósito, Francesco Landi, Gemelli Against COVID-19 Post-Acute Care Team, Francesco Landi, Elisa Gremese, Roberto Bernabei, Massimo Fantoni, Antonio Gasbarrini, Matteo Tosato, Carlo Romano Settanni, Serena Porcari, Francesca Benvenuto, Giulia Bramato, Vincenzo Brandi, Angelo Carfì, Francesca Ciciarello, Maria Rita Lo Monaco, Anna Maria Martone, Emanuele Marzetti, Carmen Napolitano, Vincenzo Galluzzo, Francesco Pagano, Cristina Pais, Sara Rocchi, Elisabetta Rota, Andrea Salerno, Matteo Tosato, Marcello Tritto, Riccardo Calvani, Maria Beatrice Zazzara, Lucio Catalano, Anna Picca, Giulia Savera, Mariaelena D’Elia, Damiano Biscotti, Roberto Cauda, Rita Murri, Antonella Cingolani, G. Ventura, Eleonora Taddei, Davide Moschese, Arturo Ciccullo, Massimo Fantoni, Leonardo Stella, Giovanni Addolorato, Francesco Franceschi, Geltrude Mingrone, Maria Assunta Zocco, Maurizio Sanguinetti, Paola Cattani, Simona Marchetti, Brunella Posteraro, Michela Sali, Alessandra Bizzarro, Alessandra Lauria, Stanislao Rizzo, Maria Cristina Savastano, Gloria Gambini, Grazia Maria Cozzupoli, Carola Culiersi, Giulio Cesare Passàli, Gaetano Paludetti, Jacopo Galli, Fabrizio Crudo, Giovanni Di Cintio, Ylenia Longobardi, Laura Tricarico, Mariaconsiglia Santantonio, Tiziana Di Cesare, Mariateresa Guarino, Marco Corbò, Stefano Settimi, Dario Antonio Mele, Francesca Brigato, Danilo Buonsenso, Piero Valentini, Dario Sinatti, Gabriella De Rose, Luca Richeldi, F. Lombardi, Angelo Calabrese, Francesco Varone, Paolo Maria Leone, Matteo Siciliano, Giuseppe Maria Corbo, Giuliano Montemurro, Mariarosaria Calvello, Enrica Intini, Jacopo Simonetti, Giuliana Pasciuto, Veronica Adiletta
Abstract
BACKGROUND: Nutritional status is a critical factor throughout COVID-19 disease course. Malnutrition is associated with poor outcomes in hospitalized COVID-19 patients. AIM: To assess the prevalence of malnutrition and identify its associated factors in COVID-19 survivors. METHODS: Study cohort included 1230 COVID-19 survivors aged 18-86 attending a post-COVID-19 outpatient service. Data on clinical parameters, anthropometry, acute COVID-19 symptoms, lifestyle habits were collected through a comprehensive medical assessment. Malnutrition was assessed according to Global Leadership Initiative on Malnutrition (GLIM) criteria. RESULTS: Prevalence of malnutrition was 22% at 4-5 months after acute disease. Participants who were not hospitalized during acute COVID-19 showed a higher frequency of malnutrition compared to those who needed hospitalization (26% versus 19%, p < 0.01). Malnutrition was found in 25% COVID-19 survivors over 65 years of age compared to 21% younger participants (p < 0.01). After multivariable adjustment, the likelihood of being malnourished increased progressively and independently with advancing age (Odds ratio [OR] 1.02; 95% CI 1.01-1.03) and in male participants (OR 5.56; 95% CI 3.53-8.74). Malnutrition was associated with loss of appetite (OR 2.50; 95% CI 1.73-3.62), and dysgeusia (OR 4.05; 95% CI 2.30-7.21) during acute COVID-19. DISCUSSION: In the present investigation we showed that malnutrition was highly prevalent in a large cohort of COVID-19 survivors at 4-5 months from acute illness. CONCLUSIONS: Our findings highlight the need to implement comprehensive nutritional assessment and therapy as an integral part of care for COVID-19 patients.