Evaluation of the nutritional prognosis index associated with disease severity, comorbidities, laboratory test results, and clinical outcome in patients infected with COVID-19
Keywords:
COVID-19, Death, Disease severity, Nutritional prognostic indexAbstract
Objective
The COVID-19 has resulted in a global pandemic, and markers for disease prognosis have been studied, such as the Prognostic Nutritional Index. This study aimed to evaluate the associations of the index with disease severity, comorbidities, laboratory test results, and clinical outcomes.
Methods
This retrospective, cross-sectional study was conducted with patients with a positive SARS-CoV RNA result from 2020 to 2022. Measures were Prognostic Nutritional Index, disease severity, comorbidities, laboratory tests, and clinical outcome. Prognostic Nutritional Index was calculated using the equation: serum albumin [g/dL] x 10 + total lymphocyte count [per mm3 x 0,005). Participants were categorized into severe malnutrition (PNI <35), mild malnutrition (PNI 35-38), and no malnutrition (>38).
Results
The sample (53% male) had a mean age of 56.77±17.42 years. Among those classified as Prognostic Nutritional Index 2, only 23.4% were discharged from the hospital, which was associated with higher mortality (p<0.01). PNI classification was associated with disease severity (p=0.01), and the highest proportion of critically ill patients was found in the PNI 2 group (60%). PNI 2 also evidenced
significantly lower levels of hemoglobin, hematocrit, lymphocytes, and albumin (all with p<0.01). In the multivariate analysis, Prognostic Nutritional Index 1 and Prognostic Nutritional Index 2 groups had a higher risk of mortality (OR: 2.54; 95% CI: 1.73-3.72) and cardiomyopathies (OR: 1.92; 95% CI: 1.00-3.69).
Conclusion
The results suggest that Prognostic Nutritional Index may be a relevant marker for risk stratification in COVID-19 patients, with Prognostic Nutritional Index levels 1 and 2 proportionally associated with greater disease severity and mortality.
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Copyright (c) 2025 Vinicius Camilo Silva de Alencar, Rozangela Maria de Almeida Fernandes Wyszomirska, Aryana Isabelle de Almeida Neves Siqueira, Josué de Oliveira Leitão, Layane Victoria Ananias da Silva, Leonardo Martins Aboim Inglês
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