What is the predictive value of the prognostic nutritional index for the severity of COVID-19 hospitalized patients ?

Abstract

Objective: Malnutrition is a risk factor for severe coronavirus disease 2019 (COVID-19) and early nutritional risk assessment should be performed consistently and promptly to determine the proper nutritional therapy and lead to a good prognosis. We aimed to investigate the predictive value of the prognostic nutritional index (PNI) in determining the severity of hospitalized COVID-19 patients.Methods: In this retrospective single-center research, a total of 686 hospitalized adult patients with COVID19 between April 2020-June 2020 were analyzed. Demographic, clinical, radiological and laboratory data were registered from patient files. Nutritional status was evaluated using the BMI and PNI. Patients were divided into three groups according to PNI values: severe (PNI ≤ 35), moderate (35(PNI≥38).Results: The study group's average PNI score was 35.56 ± 4.58.PNI values were found to be normal in 37.3 percent (N: 256) of the patients, moderate in 28.3 percent (N: 194), and severe in 34.4 percent (N: 236). Male patients, those over the age of 65, referred patients, intubated patients, and those who died were at a higher risk of severe PNI. Patients with normal computed tomography scans were found to have a higher incidence in the normal PNI. The length of hospitalization increased in proportion to the severity of PNI. As the severity of the PNI category increased, so did albumin, C reactive protein, D-dimer, ferritin, lactate dehydrogenase, and neutrophil levels. The total protein value decreased, as the severity of the PNI category increased.Conclusion: PNI can be determined easily and quickly using routine blood tests and it can be useful for early detection of potentially fatal illnesses, giving medical care and improving prognosis.