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Published in: BMC Infectious Diseases 1/2024

Open Access 01-12-2024 | COVID-19 | Research

Poor nutritional status is associated with the severity of omicron infection in the older adults

Authors: Xiaohan Gu, Yongchao Guo, Yongmei Shi, Yaxiong Lu, Shihan Yang, Yongmei Jiang, Qianwen Jin, Qing Yun Li

Published in: BMC Infectious Diseases | Issue 1/2024

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Abstract

Background

The Omicron wave of Coronavirus disease 2019 (COVID-19) remains the dominant strain worldwide. The studies of nutritional status in geriatric people with COVID-19 Omicron variant are limited. Thus, the aim of this study was to investigate the incidence of poor nutritional status among Omicron infected older patients, and to explore the correlation between the nutritional status and the severity of Omicron infection in older patients.

Methods

This is a retrospective cross-sectional study. According to the clinical symptoms, patients were divided into two groups: mild and moderate to severe. Mini Nutritional Assessment short-form (MNA-SF) was conducted when patients were admitted and poor nutritional status was defined as MNA-SF score of 0–11. The inflammatory markers including neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR) and systemic inflammatory index (SII) were calculated and compared between two groups.

Results

Total of 324 patients were enrolled, with median [interquartile range (IQR)] age of 73 (17) years. Overall, 241 cases were mild, 83 cases were moderate to severe at the time of diagnosis and that 54.3% of patients had poor nutritional status. Patients with poor nutritional status were found to be older (P < 0.001) and less vaccinated (P < 0.001), with a longer virus shedding duration (P = 0.022), more comorbidities (≥ 2) (P = 0.004) and higher value of NLR (P < 0.001), PLR (P < 0.001) and SII (P = 0.012). Vaccination, cycle threshold value in ORF1ab gene (OR CT value) and female, higher MNA-SF score was negatively connected with probability of moderate to severe infection. For every 1 score increase in MNA-SF, the odds ratio of moderate to severe infection decreased by 14.8% [adjusted odds ratio (aOR), 0.852; 95% confidence interval (CI): 0.734–0.988; P = 0.034].

Conclusions

Older patients with poor nutritional status are more likely to develop moderate to severe Omicron infection.
Literature
1.
go back to reference Umakanthan S, Sahu P, Ranade AV, Bukelo MM, Rao JS, Abrahao-Machado LF, et al. Origin, transmission, diagnosis and management of coronavirus Disease 2019 (COVID-19). Postgrad Med J. 2020;96(1142):753–8.PubMed Umakanthan S, Sahu P, Ranade AV, Bukelo MM, Rao JS, Abrahao-Machado LF, et al. Origin, transmission, diagnosis and management of coronavirus Disease 2019 (COVID-19). Postgrad Med J. 2020;96(1142):753–8.PubMed
2.
go back to reference Gangavarapu K, Latif AA, Mullen JL, Alkuzweny M, Hufbauer E, Tsueng G et al. Outbreak.info genomic reports: scalable and dynamic surveillance of SARS-CoV-2 variants and mutations. Res Sq. 2022. Gangavarapu K, Latif AA, Mullen JL, Alkuzweny M, Hufbauer E, Tsueng G et al. Outbreak.info genomic reports: scalable and dynamic surveillance of SARS-CoV-2 variants and mutations. Res Sq. 2022.
3.
go back to reference Cao Y, Wang J, Jian F, Xiao T, Song W, Yisimayi A, et al. Omicron escapes the majority of existing SARS-CoV-2 neutralizing antibodies. Nature. 2022;602(7898):657–63.CrossRefPubMed Cao Y, Wang J, Jian F, Xiao T, Song W, Yisimayi A, et al. Omicron escapes the majority of existing SARS-CoV-2 neutralizing antibodies. Nature. 2022;602(7898):657–63.CrossRefPubMed
4.
5.
go back to reference Johnson AG, Amin AB, Ali AR, Hoots B, Cadwell BL, Arora S, et al. COVID-19 incidence and death rates among unvaccinated and fully vaccinated adults with and without booster doses during periods of Delta and Omicron variant emergence– 25 U.S. jurisdictions, April 4-December 25, 2021. MMWR Morb Mortal Wkly Rep. 2022;71(4):132–8.CrossRefPubMedPubMedCentral Johnson AG, Amin AB, Ali AR, Hoots B, Cadwell BL, Arora S, et al. COVID-19 incidence and death rates among unvaccinated and fully vaccinated adults with and without booster doses during periods of Delta and Omicron variant emergence– 25 U.S. jurisdictions, April 4-December 25, 2021. MMWR Morb Mortal Wkly Rep. 2022;71(4):132–8.CrossRefPubMedPubMedCentral
6.
go back to reference Hu B, Guo H, Zhou P, Shi ZL. Characteristics of SARS-CoV-2 and COVID-19. Nat Rev Microbiol. 2021;19(3):141–54.CrossRefPubMed Hu B, Guo H, Zhou P, Shi ZL. Characteristics of SARS-CoV-2 and COVID-19. Nat Rev Microbiol. 2021;19(3):141–54.CrossRefPubMed
7.
go back to reference Song F, Ma H, Wang S, Qin T, Xu Q, Yuan H, et al. Nutritional screening based on objective indices at admission predicts in-hospital mortality in patients with COVID-19. Nutr J. 2021;20(1):46.CrossRefPubMedPubMedCentral Song F, Ma H, Wang S, Qin T, Xu Q, Yuan H, et al. Nutritional screening based on objective indices at admission predicts in-hospital mortality in patients with COVID-19. Nutr J. 2021;20(1):46.CrossRefPubMedPubMedCentral
8.
go back to reference Li T, Zhang Y, Gong C, Wang J, Liu B, Shi L, et al. Prevalence of Malnutrition and analysis of related factors in elderly patients with COVID-19 in Wuhan, China. Eur J Clin Nutr. 2020;74(6):871–5.CrossRefPubMedPubMedCentral Li T, Zhang Y, Gong C, Wang J, Liu B, Shi L, et al. Prevalence of Malnutrition and analysis of related factors in elderly patients with COVID-19 in Wuhan, China. Eur J Clin Nutr. 2020;74(6):871–5.CrossRefPubMedPubMedCentral
9.
go back to reference Moscatelli F, Sessa F, Valenzano A, Polito R, Monda V, Cibelli G et al. COVID-19: role of Nutrition and Supplementation. Nutrients. 2021;13(3). Moscatelli F, Sessa F, Valenzano A, Polito R, Monda V, Cibelli G et al. COVID-19: role of Nutrition and Supplementation. Nutrients. 2021;13(3).
10.
go back to reference Schols AM, Ferreira IM, Franssen FM, Gosker HR, Janssens W, Muscaritoli M, et al. Nutritional assessment and therapy in COPD: a European Respiratory Society statement. Eur Respir J. 2014;44(6):1504–20.CrossRefPubMed Schols AM, Ferreira IM, Franssen FM, Gosker HR, Janssens W, Muscaritoli M, et al. Nutritional assessment and therapy in COPD: a European Respiratory Society statement. Eur Respir J. 2014;44(6):1504–20.CrossRefPubMed
11.
go back to reference Alwarith J, Kahleova H, Crosby L, Brooks A, Brandon L, Levin SM, et al. The role of nutrition in Asthma prevention and treatment. Nutr Rev. 2020;78(11):928–38.CrossRefPubMedPubMedCentral Alwarith J, Kahleova H, Crosby L, Brooks A, Brandon L, Levin SM, et al. The role of nutrition in Asthma prevention and treatment. Nutr Rev. 2020;78(11):928–38.CrossRefPubMedPubMedCentral
12.
go back to reference Aiello A, Farzaneh F, Candore G, Caruso C, Davinelli S, Gambino CM, et al. Immunosenescence and its Hallmarks: how to oppose aging strategically? A review of potential options for therapeutic intervention. Front Immunol. 2019;10:2247.CrossRefPubMedPubMedCentral Aiello A, Farzaneh F, Candore G, Caruso C, Davinelli S, Gambino CM, et al. Immunosenescence and its Hallmarks: how to oppose aging strategically? A review of potential options for therapeutic intervention. Front Immunol. 2019;10:2247.CrossRefPubMedPubMedCentral
13.
go back to reference Bencivenga L, Rengo G, Varricchi G. Elderly at time of COronaVIrus Disease 2019 (COVID-19): possible role of immunosenescence and Malnutrition. Geroscience. 2020;42(4):1089–92.CrossRefPubMedPubMedCentral Bencivenga L, Rengo G, Varricchi G. Elderly at time of COronaVIrus Disease 2019 (COVID-19): possible role of immunosenescence and Malnutrition. Geroscience. 2020;42(4):1089–92.CrossRefPubMedPubMedCentral
14.
go back to reference Gao YD, Ding M, Dong X, Zhang JJ, Kursat Azkur A, Azkur D, et al. Risk factors for severe and critically ill COVID-19 patients: a review. Allergy. 2021;76(2):428–55.CrossRefPubMed Gao YD, Ding M, Dong X, Zhang JJ, Kursat Azkur A, Azkur D, et al. Risk factors for severe and critically ill COVID-19 patients: a review. Allergy. 2021;76(2):428–55.CrossRefPubMed
15.
go back to reference Lu G, Zhang Y, Zhang H, Ai J, He L, Yuan X, et al. Geriatric risk and protective factors for serious COVID-19 outcomes among older adults in Shanghai Omicron wave. Emerg Microbes Infect. 2022;11(1):2045–54.CrossRefPubMedPubMedCentral Lu G, Zhang Y, Zhang H, Ai J, He L, Yuan X, et al. Geriatric risk and protective factors for serious COVID-19 outcomes among older adults in Shanghai Omicron wave. Emerg Microbes Infect. 2022;11(1):2045–54.CrossRefPubMedPubMedCentral
16.
go back to reference Wierdsma NJ, Kruizenga HM, Konings LA, Krebbers D, Jorissen JR, Joosten MI, et al. Poor nutritional status, risk of Sarcopenia and nutrition related complaints are prevalent in COVID-19 patients during and after hospital admission. Clin Nutr ESPEN. 2021;43:369–76.CrossRefPubMedPubMedCentral Wierdsma NJ, Kruizenga HM, Konings LA, Krebbers D, Jorissen JR, Joosten MI, et al. Poor nutritional status, risk of Sarcopenia and nutrition related complaints are prevalent in COVID-19 patients during and after hospital admission. Clin Nutr ESPEN. 2021;43:369–76.CrossRefPubMedPubMedCentral
17.
go back to reference Kaiser MJBJ, Ramsch C, Uter W, Guigoz Y, Cederholm T, Thomas DR, Anthony P, Charlton KE, Maggio M, Tsai AC, Grathwohl D, Vellas B, Sieber CC, MNA-International Group. Validation of the Mini Nutritional Assessment short-form (MNA-SF): a practical tool for identification of nutritional status. J Nutr Health Aging. 2009;13(9):782–8.CrossRefPubMed Kaiser MJBJ, Ramsch C, Uter W, Guigoz Y, Cederholm T, Thomas DR, Anthony P, Charlton KE, Maggio M, Tsai AC, Grathwohl D, Vellas B, Sieber CC, MNA-International Group. Validation of the Mini Nutritional Assessment short-form (MNA-SF): a practical tool for identification of nutritional status. J Nutr Health Aging. 2009;13(9):782–8.CrossRefPubMed
18.
go back to reference Fois AG, Paliogiannis P, Scano V, Cau S, Babudieri S, Perra R et al. The systemic inflammation index on Admission predicts In-Hospital mortality in COVID-19 patients. Molecules. 2020;25(23). Fois AG, Paliogiannis P, Scano V, Cau S, Babudieri S, Perra R et al. The systemic inflammation index on Admission predicts In-Hospital mortality in COVID-19 patients. Molecules. 2020;25(23).
19.
go back to reference Motti ML, Tafuri D, Donini L, Masucci MT, De Falco V, Mazzeo F. The role of nutrients in Prevention, Treatment and Post-coronavirus Disease-2019 (COVID-19). Nutrients. 2022;14(5). Motti ML, Tafuri D, Donini L, Masucci MT, De Falco V, Mazzeo F. The role of nutrients in Prevention, Treatment and Post-coronavirus Disease-2019 (COVID-19). Nutrients. 2022;14(5).
20.
go back to reference Chen YKS, Garibaldi BT, Li H, Wu C, Osevala NM, Li T, Margolick JB, Pawelec G, Leng SX. Aging in COVID-19: vulnerability, immunity and intervention. Ageing Res Rev. 2021 Jan. Chen YKS, Garibaldi BT, Li H, Wu C, Osevala NM, Li T, Margolick JB, Pawelec G, Leng SX. Aging in COVID-19: vulnerability, immunity and intervention. Ageing Res Rev. 2021 Jan.
21.
22.
go back to reference Zhou Z, Zhao N, Shu Y, Han S, Chen B, Shu X. Effect of gastrointestinal symptoms in patients with COVID-19. Gastroenterology. 2020;158(8):2294–7.CrossRefPubMed Zhou Z, Zhao N, Shu Y, Han S, Chen B, Shu X. Effect of gastrointestinal symptoms in patients with COVID-19. Gastroenterology. 2020;158(8):2294–7.CrossRefPubMed
23.
go back to reference Bedock D, Couffignal J, Bel Lassen P, Soares L, Mathian A, Fadlallah JP et al. Evolution of Nutritional Status after Early Nutritional Management in COVID-19 hospitalized patients. Nutrients. 2021;13(7). Bedock D, Couffignal J, Bel Lassen P, Soares L, Mathian A, Fadlallah JP et al. Evolution of Nutritional Status after Early Nutritional Management in COVID-19 hospitalized patients. Nutrients. 2021;13(7).
24.
go back to reference Azzolino D, Passarelli PC, De Angelis P, Piccirillo GB, D’Addona A, Cesari M. Poor oral health as a determinant of Malnutrition and Sarcopenia. Nutrients. 2019;11(12). Azzolino D, Passarelli PC, De Angelis P, Piccirillo GB, D’Addona A, Cesari M. Poor oral health as a determinant of Malnutrition and Sarcopenia. Nutrients. 2019;11(12).
25.
go back to reference Can B, Senturk Durmus N, Olgun Yildizeli S, Kocakaya D, Ilhan B, Tufan A. Nutrition risk assessed by Nutritional Risk Screening 2002 is associated with in-hospital mortality in older patients with COVID-19. Nutr Clin Pract. 2022;37(3):605–14.CrossRefPubMedPubMedCentral Can B, Senturk Durmus N, Olgun Yildizeli S, Kocakaya D, Ilhan B, Tufan A. Nutrition risk assessed by Nutritional Risk Screening 2002 is associated with in-hospital mortality in older patients with COVID-19. Nutr Clin Pract. 2022;37(3):605–14.CrossRefPubMedPubMedCentral
27.
28.
go back to reference Smith DJHA, Leung GM, Xu W, Schluter WW, Novak RT, Marston B, Hersh BS. COVID-19 Mortality and Vaccine Coverage - Hong Kong Special Administrative Region, China, January 6, 2022-March 21, 2022. 2022 Apr 15. p. 545–8. Smith DJHA, Leung GM, Xu W, Schluter WW, Novak RT, Marston B, Hersh BS. COVID-19 Mortality and Vaccine Coverage - Hong Kong Special Administrative Region, China, January 6, 2022-March 21, 2022. 2022 Apr 15. p. 545–8.
29.
Metadata
Title
Poor nutritional status is associated with the severity of omicron infection in the older adults
Authors
Xiaohan Gu
Yongchao Guo
Yongmei Shi
Yaxiong Lu
Shihan Yang
Yongmei Jiang
Qianwen Jin
Qing Yun Li
Publication date
01-12-2024
Publisher
BioMed Central
Keyword
COVID-19
Published in
BMC Infectious Diseases / Issue 1/2024
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/s12879-023-08959-6

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