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COVID-19 Patients With Malnutrition Have Higher Risk of Severe Outcomes

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, according to a study published in Scientific Reports.

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, a data scientist at CHOC Children’s Hospital in Orange, California, and colleagues investigated associations between malnutrition diagnoses and subsequent COVID-19 severity, using medical records for 8,604 children and 94,495 adults (older than age 18) 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 with patients without such a diagnosis.

Of 520 (6%) children with severe COVID-19, 39 (7.5%) had a previous diagnosis of malnutrition, compared with 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 with 1,557 (1.8%) of 81,515 (98.13%) adults with mild COVID-19.

Children older than 5 and adults aged 18 to 78 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. Children younger than 5 experienced even greater COVID severity from a history of malnutrition. Interestingly, adults aged 79 and older who weren’t malnourished were found to have higher odds of severe COVID-19 compared with those of the same age who were malnourished. However, the risk of severe COVID-19 in adults with and without malnutrition continued to rise with age above 79 years.

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.