Prognostic Role of Malnutrition Diagnosed by Bioelectrical Impedance Vector Analysis in Older Adults Hospitalized with COVID-19 Pneumonia: A Prospective Study

Background: Little is known on the clinical relevance of the nutritional status and body composition of patients hospitalized with SARS-CoV-2 infection. The aim of our study was to assess the prevalence of malnutrition in patients with COVID-19 pneumonia using bioelectrical impedance vector analysis (BIVA), and to evaluate the relationship of their nutritional status with the severity and outcome of disease. Methods: Among 150 consecutive patients who were hospitalized with COVID-19 pneumonia, 37 (24.3%) were classified as malnourished by BIVA, and were followed-up for 60 days from admission. Outcome measures were differences in the need for invasive mechanical ventilation, in-hospital mortality, and the duration of hospital stay in survivors. Results: During 60 days of follow-up, 10 (27%) malnourished patients and 13 (12%) non-malnourished patients required invasive mechanical ventilation (p = 0.023), and 13 (35%) malnourished patients and 9 (8%) non-malnourished patients died (p < 0.001). The average duration of the hospital stay in survivors was longer in patients with malnutrition (18.2 ± 15.7 vs. 13.2 ± 14.8 days, p < 0.001). In survival analyses, mechanical ventilation free (log-rank 7.887, p = 0.050) and overall (log-rank 17.886, p < 0.001) survival were significantly longer in non-malnourished than malnourished patients. The Cox proportional ratio showed that malnutrition was associated with an increased risk of mechanical ventilation (HR 4.375, p = 0.004) and death (HR 4.478, p = 0.004) after adjusting for major confounders such as age, sex, and BMI. Conclusions: Malnutrition diagnosed with BIVA was associated with worse outcomes in hospitalized patients with COVID-19 pneumonia.

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Assessment of nutritional status in free-living elderly individuals by bioelectrical impedance vector analysis

Nutrition ◽

10.1016/j.nut.2008.07.014 ◽

2009 ◽

Vol 25 (1) ◽

pp. 3-5 ◽

Cited By ~ 23

Author(s):

Roberto Buffa ◽

Giovanni Floris ◽

Elisabetta Marini

Keyword(s):

Nutritional Status ◽

Bioelectrical Impedance ◽

Vector Analysis ◽

Free Living ◽

Elderly Individuals ◽

Bioelectrical Impedance Vector Analysis ◽

Impedance Vector

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Bioelectrical impedance vector analysis for nutritional status assessment in systemic sclerosis and association with disease characteristics

The Journal of Rheumatology ◽

10.3899/jrheum.200964 ◽

2020 ◽

pp. jrheum.200964

Author(s):

Marco Di Battista ◽

Simone Barsotti ◽

Alessia Monaco ◽

Alessandra Rossi ◽

Alessandra Della Rossa ◽

...

Keyword(s):

Systemic Sclerosis ◽

Nutritional Status ◽

Surrogate Marker ◽

Bioelectrical Impedance ◽

Abdominal Distension ◽

Vector Analysis ◽

Microvascular Damage ◽

Bioelectrical Impedance Vector Analysis ◽

Damage Accrual ◽

Impedance Vector

Objective To use bioelectrical impedance vector analysis (BIVA) in a cohort of systemic sclerosis (SSc) patients in order to assess their nutritional status in comparison to other groups of patients and to find any correlation with clinical characteristics and outcome of the disease. Methods We retrospectively collected data from 50 SSc patients who underwent BIVA for clinical suspicion of malnutrition, and compared them with patients affected by other chronic autoimmune rheumatic diseases (OCAD, n.27) or only symptomatic (n.15), and with 50 healthy controls (HC). Results SSc patients presented significantly lower values of phase angle (PhA), basal metabolic rate (BMR), body cellular mass (BCM) and an increase in extracellular water (ECW) (p<0.01 for all) than HC, unlike body mass index (BMI). No significant differences were found between SSc and OCAD. Among SSc patients, age directly correlated with ECW (ρ=0.342; p=0.015) and inversely with PhA (ρ=-0.366; p=0.009). Female sex, anaemia, hypoalbuminemia, reflux and early satiety/abdominal distension associated with relevant alterations in BIVA results. BIVA parameters were significantly different when cardiopulmonary and microvascular involvement was present. Four patients died during the study: they had significantly (p≤0.01) lower PhA, BMR and BCM, with an increased ECW. Conclusion BIVA, unlike BMI, allowed an accurate characterization of SSc patients at risk of malnutrition, correlating with serological malnutrition markers, with SSc-specific organ manifestations (cardiopulmonary involvement and microvascular damage) and with mortality. BIVA parameters might represent a surrogate marker of damage accrual that leads to malnutrition, thus playing a leading role in the prognostic stratification of SSc patients.

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