Annals of Clinical Nutrition and Metabolism

Original Articles

Evaluation of the modified Nutrition Risk in Critically Ill score in Korean critically ill patients with COVID-19: a retrospective cohort study: Won Ho Han, Jong-Mog Lee, Jae Hoon Lee, Hyun Mi Lee, Ji-Yeon Kim, Mok Young Jang, Sung-Sik Han; Ann Clin Nutr Metab 2025;17(2):125-131. Published online August 1, 2025; DOI: https://doi.org/10.15747/ACNM.25.0009

Abstract PDF Supplementary Material: Purpose
We evaluated the efficacy of the modified Nutrition Risk in Critically Ill (mNUTRIC) score for malnutrition screening and its association with mortality in intensive care unit (ICU) patients with COVID-19.
Methods
The nutritional status of 129 COVID-19 ICU patients admitted between February 2021 and May 2022 was assessed using American Society for Parenteral and Enteral Nutrition/Academy of Nutrition and Dietetics (ASPEN/AND) criteria. The sensitivity, specificity, and clinical correlations of the mNUTRIC score were analyzed.
Results
Of the 129 patients, 35 (27.1%) met the ASPEN/AND malnutrition criteria. Multivariable analysis identified the mNUTRIC score, underlying malignancy, and mechanical ventilation as significant factors associated with malnutrition. The mNUTRIC score had a sensitivity of 77.1% and specificity of 63.8% (area under the curve [AUC], 0.71; 95% confidence interval [CI], 0.62–0.79) for diagnosing malnutrition, improving to 88.6% and 80.9%, respectively, after adjusting for malignancy and ventilation (AUC, 0.89; 95% CI, 0.82–0.95). Patients with a low mNUTRIC score had a mortality rate of 2.9% and a median ICU stay of 7.7 days (range, 0–84.2 days), whereas those with a high score (≥5) had a mortality rate of 13.1% and a median ICU stay of 10.2 days (range, 1.4–88.5 days) (P=0.046 and P=0.011, respectively).
Conclusion
The mNUTRIC score is an effective screening tool for malnutrition in ICU patients with COVID-19, especially those with malignancy or requiring mechanical ventilation, and is strongly associated with mortality and length of ICU stay.

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Effects of nutritional status and support on the survival of COVID-19 patients in a single tertiary-center intensive care unit in Korea: a case-control study: Na Gyeong Lee, Hye Jin Kim, Ji Gyeong Kang, Do Hyeon Jeon, Mi Seung Kwak, So Hyun Nam; Ann Clin Nutr Metab 2023;15(1):30-37. Published online April 1, 2023; DOI: https://doi.org/10.15747/ACNM.2023.15.1.30

Purpose: It is important to understand the nutritional status of critically ill COVID-19 patients and to provide adequate associated support. We attempted to determine how nutritional status and the amount of nutritional support provided to critically ill patients affect their survival.
Methods: We retrospectively reviewed the medical records of patients admitted to the intensive care unit of Dong-A University Hospital between January and December 2021. We divided the patients into survivors and those who died during COVID-19 treatment and compared and analyzed their clinical parameters, nutrition-related indicators, nutritional status, and nutritional support.
Results: Of 70 patients reviewed, 57 survived. Mortality was higher in the older group (P=0.006). The patients who underwent ventilator, extracorporeal membrane oxygenation, or continuous renal replacement therapy showed higher mortality. Nutritional status at the time of admission and the nutritional requirements did not differ among patient groups. However, the actual amounts of calories (P<0.001) and protein (P=0.019) supplied were lower in the mortality group. Serum C-reactive protein level was higher (P=0.002) and serum albumin level was lower in those who did not survive (P<0.001) compared with surviving patients at discharge.
Conclusion: We did not determine whether the initial nutritional status of patients with COVID-19 affected their survival due to various factors associated with the severity of the disease. However, given the similarities between disease severity and nutritional status at the time of admission, our results indicate that adequate nutritional support can contribute to survival in critically ill COVID-19 patients with pneumonia.

Citations

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The association between enteral nutrition with survival of critical patients with COVID‐19
Maryam Gholamalizadeh, Zahra Salimi, Khadijeh Abbasi Mobarakeh, Zahra Mahmoudi, Shirin Tajadod, Mahdi Mousavi Mele, Farkhondeh Alami, Bojlul Bahar, Saeid Doaei, Sara Khoshdooz, Masoume Rahvar, Somayeh Gholami, Masoume Pourtaleb
Immunity, Inflammation and Disease.2024;[Epub] CrossRef

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