Malnutrition and the Post-Acute Sequelae of Severe Acute Respiratory Syndrome Coronavirus 2 Infection: A Multi-Institutional Population-Based Propensity Score-Matched Analysis

Author:

Lee Cheng-Ya1,Liang Yung-Chun2,Hsu Wan-Hsuan2,Tsai Ya-Wen3,Liu Ting-Hui4ORCID,Huang Po-Yu2,Chuang Min-Hsiang5,Hung Kuo-Chuan67ORCID,Lee Mei-Chuan89,Yu Tsung8,Lai Chih-Cheng710ORCID,Weng Tzu-Chieh11,Wu Jheng-Yan812ORCID

Affiliation:

1. Division of Cardiovascular Surgery, Department of Surgery, Chi Mei Medical Center, Tainan 710, Taiwan

2. Department of Internal Medicine, Chi Mei Medical Center, Tainan 710, Taiwan

3. Division of Preventive Medicine, Chi Mei Medical Center, Tainan 710, Taiwan

4. Department of Psychiatry, Chi Mei Medical Center, Tainan 710, Taiwan

5. Division of Nephrology, Department of Internal Medicine, Chi Mei Medical Center, Tainan 710, Taiwan

6. Department of Anesthesiology, Chi Mei Medical Center, Tainan 710, Taiwan

7. School of Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung City 804, Taiwan

8. Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan

9. Department of Pharmacy, Chi Mei Medical Center, Tainan 710, Taiwan

10. Department of Intensive Care Medicine, Chi Mei Medical Center, Tainan 710, Taiwan

11. Division of Hospital Medicine, Department of Internal Medicine, Chi Mei Medical Center, Tainan 710, Taiwan

12. Department of Nutrition, Chi Mei Medical Center, Tainan 710, Taiwan

Abstract

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.

Publisher

MDPI AG

Reference46 articles.

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