Association between malnutrition and post–acute COVID-19 sequelae: A retrospective cohort study, 2024, Ponce et al.

Association between malnutrition and post–acute COVID-19 sequelae: A retrospective cohort study
Jana Ponce; A. Jerrod Anzalone; Makayla Schissel; Kristina Bailey; Harlan Sayles; Megan Timmerman; Mariah Jackson; Jonathan Tefft; Corrine Hanson;

BACKGROUND
Long coronavirus disease consists of health problems people experience after being infected with severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2). These can be severe and include respiratory, neurological, and gastrointestinal symptoms, with resulting detrimental impacts on quality of life. Although malnutrition has been shown to increase risk of severe disease and death during acute infection, less is known about its influence on post–acute COVID‐19 outcomes. We addressed this critical gap in knowledge by evaluating malnutrition's impact on post–COVID‐19 sequelae.

METHODS
This study leveraged the National COVID Cohort Collaborative to identify a cohort of patients who were at least 28 days post–acute COVID‐19 infection. Multivariable Cox proportional hazard models evaluated the impact of malnutrition on the following postacute sequelae of SARS‐CoV‐2: (1) death, (2) long COVID diagnosis, (3) COVID‐19 reinfection, and (4) other phenotypic abnormalities. A subgroup analysis evaluated these outcomes in a cohort of hospitalized patients with COVID‐19 with hospital‐acquired (HAC) malnutrition.

RESULTS
The final cohort included 4,372,722 individuals, 78,782 (1.8%) with a history of malnutrition. Individuals with malnutrition had a higher risk of death (adjusted hazard ratio [aHR]: 2.10; 95% CI: 2.04–2.17) and SARS‐CoV‐2 reinfection (aHR: 1.52; 95% CI: 1.43–1.61) in the postacute period than those without malnutrition. In the subgroup, those with HAC malnutrition had a higher risk of death and long COVID diagnosis.

CONCLUSIONS
Nutrition screening for individuals with acute SARS‐CoV‐2 infection may be a crucial step in mitigating life‐altering, negative postacute outcomes through early identification and intervention of patients with malnutrition.

Link | PDF (Journal of Parenteral and Enteral Nutrition) [Open Access]

 

Not looking at malnutrition following LC, instead —

 

See also —

Malnutrition and the Post-Acute Sequelae of Severe Acute Respiratory Syndrome Coronavirus 2 Infection: A Multi-Institutional Population-Based Propensity Score-Matched Analysis (2024)
Lee, Cheng-Ya; Liang, Yung-Chun; Hsu, Wan-Hsuan; Tsai, Ya-Wen; Liu, Ting-Hui; Huang, Po-Yu; Chuang, Min-Hsiang; Hung, Kuo-Chuan; Lee, Mei-Chuan; Yu, Tsung; Lai, Chih-Cheng; Weng, Tzu-Chieh; Wu, Jheng-Yan

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has led to a global health crisis, exacerbating issues like malnutrition due to increased metabolic demands and reduced intake during illness. Malnutrition, a significant risk factor, is linked to worse outcomes in patients with COVID-19, such as increased mortality and extended hospital stays. This retrospective cohort study investigated the relationship between malnutrition and clinical outcomes within 90–180 days using data obtained from the TriNetX database.

Patients aged >18 years diagnosed with COVID-19 between 1 January 2022, and 31 March 2024 were enrolled in the study. The propensity score-matching (PSM) method was used to match patients with malnutrition (malnutrition group) and those without malnutrition (control group). The primary composite outcome was the cumulative hazard ratio (HR) for post-COVID-19 condition, all-cause hospitalization, and all-cause mortality between 90 days and 180 days after COVID-19 diagnosis. The secondary outcomes were the individual components of the primary outcomes. Two cohorts, each consisting of 15,004 patients with balanced baseline characteristics, were identified using PSM.

During the 90–180-day follow-up period, the malnutrition group exhibited a higher incidence of all-cause hospitalization, mortality, or post-COVID-19 condition (HR = 2.315, 95% confidence interval: 2.170–2.471, p < 0.0001). Compared with patients with COVID-19 without malnutrition, those with malnutrition may be associated with a higher risk of adverse clinical outcomes.

Link | PDF (Life) [Open Access]