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Patients with malnutrition may be more likely to have severe COVID-19 outcomes

COVID-19 malnutrition studyA CHOC-led study published in Scientific Reports concludes that adults and children with COVID-19 who have a history of malnutrition may have an increased likelihood of death and the need for mechanical ventilation.

Malnutrition hampers the proper functioning of the immune system and is known to increase the risk of severe infections for other viruses, but the potential long-term effects of malnutrition on COVID-19 outcomes are less clear.

Louis Ehwerhemuepha, PhD, and five other CHOC colleagues investigated associations between history of malnutrition diagnoses and subsequent COVID-19 severity, using medical records for 8,604 children and 94,495 adults (older than 18 years) who were hospitalized with COVID-19 in the United States between March and June 2020. Patients with a diagnosis of malnutrition between 2015 and 2019 were compared to patients without.

Of 520 (6%) children with severe COVID-19, 39 (7.5%) had a previous diagnosis of malnutrition, compared to 125 (1.5%) of 7,959 (98.45%) children with mild COVID-19. Of 11,423 (11%) adults with severe COVID-19, 453 (4%) had a previous diagnosis of malnutrition, compared to 1,557 (1.8%) of 81,515 (98.13%) adults with mild COVID-19.

Children older than five and adults aged 18 to 78 years with previous diagnoses of malnutrition were found to have higher odds of severe COVID-19 than those with no history of malnutrition in the same age groups, according to the study, published July 22, 2021.

“A crossover effect was observed at 4 years for children and at 79 years for adults,” Ehwerhemuepha said.

The authors suggest that public health interventions for those at highest risk of malnutrition may help mitigate the higher likelihood of severe COVID-19 in this group.

Just hours after the study was published, it was in the top 5 percent of all research tracked by Altmetric, with mentions in 23 news reports and 59 tweets. It is ranked No. 1 compared to studies of similar age from Scientific Reports.

Ehwerhemuepha led and supervised the study along with Caroline Steele, the previous director of clinical nutrition and lactation services at CHOC. Also contributing to the study were CHOC colleagues Dr. Kenneth Grant, a gastroenterologist; Dr. Rachel Marano, a hospitalist; Dr. Antonio Arrieta, medical director, infectious diseases; and Dr. Bill Feaster, chief health information officer.