The use of prognostic nutritional index (PNI) and selected inflammatory indicators for predicting malnutrition in COVID-19 patients: A retrospective study

Background: Malnutrition causes diverse alterations in the immune system, and COVID-19 is an infection affecting the immune system, consequently leading to malnutrition.Aims: This study aimed to investigate the use of prognostic nutritional index (PNI) and selected in-flammatory indices for malnutrition screening among COVID-19 hospitalized patients. Material and methodology: This is a single-center retrospective study that enrolled 289 hospitalized COVID-19 patients between 1st January to 30th April 2021, their median age was 59 years. Demographic and biochemical data were collected from patients' records. The PNI, platelet-to-lymphocyte ratio (PLR), neu-trophil-to-lymphocyte ratio (NLR), and an early warning score to predict mortality risk (ANDC) were cal-culated. Univariate and multivariate logistic regression analyses were performed. A P-value of < 0.05 was considered statistically significant.Results: about 30 % of patients were admitted to the intensive care unit (ICU), and ICU patients had sig-nificantly higher levels of white blood cell (WBCs) count, neutrophils, C-reactive protein (C-RP), and D- dimer (P < 0.05). On the other hand, they had significantly lower levels of lymphocytes and serum albumin (P < 0.001; for both). Those with high ANDC scores were more likely to develop severe conditions affecting nutritional status compared to non-ICU (OR = 1.04, 95 % CI:1.014-1.057; P < 0.001). ANDC showed good discrimination ability with an AUC of 0.784 (cut-off value > 68.19 score).Conclusion: It is suggested that ANDC could be used as a predictor for nutritional status and severity in COVID-19 hospitalized patients. (c) 2022 The Author(s). Published by Elsevier Ltd on behalf of King Saud Bin Abdulaziz University for Health Sciences. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/ 4.0/).