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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

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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