The relationship between micronutrient status, frailty, systemic inflammation, and clinical outcomes in patients admitted to hospital with COVID-19

The relationship between micronutrient status, frailty, systemic inflammation, and clinical outcomes in patients admitted to hospital with COVID-19

Micronutrients have been associated with disease severity and poorer clinical outcomes in patients with COVID-19. However, there is a paucity of studies examining if the relationship with micronutrient status and clinical outcomes is independent of recognised prognostic factors, specifically frailty...

Full description

Saved in:
Bibliographic Details
Published in:Journal of translational medicine Vol. 21; no. 1; p. 284
Main Authors: McGovern, Josh, Wadsworth, John, Catchpole, Anthony, Richards, Conor, McMillan, Donald C, Kelliher, Tadhg, Goodall, Emma, Murray, Ellie, Melaugh, Terry, McPhillips, Shannon, Brice, Kathryn, Barbour, Katie, Robinson, Sophie, Moffitt, Peter, Kemp, Olivia, Talwar, Dinesh, Maguire, Donogh
Format: Journal Article
Language:English
Published: England BioMed Central Ltd 28-04-2023
BioMed Central
BMC
Subjects:
Care and treatment
Chronic fatigue syndrome
Clinical outcomes
Coronaviruses
COVID-19
COVID-19 - complications
Dosage and administration
Female
Frailty
Frailty - complications
Hemoglobin
Hospital patients
Hospitals
Humans
Inflammation
Laboratories
Male
Malnutrition
Micronutrients
Mortality
Patients
Plasma
Research ethics
Retrospective Studies
Selenium
Thiamine
Vitamin B1
United Kingdom
United Kingdom > UK
United States > US
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Micronutrients have been associated with disease severity and poorer clinical outcomes in patients with COVID-19. However, there is a paucity of studies examining if the relationship with micronutrient status and clinical outcomes is independent of recognised prognostic factors, specifically frailty and the systemic inflammatory response (SIR). The aim of the present study was to examine the relationship between micronutrient status, frailty, systemic inflammation, and clinical outcomes in patients admitted with COVID-19. Retrospective analysis of prospectively collected data was performed on patients with confirmed COVID-19, admitted to hospital between the 1st April 2020-6th July 2020. Clinicopathological characteristics, frailty assessment, biochemical and micronutrient laboratory results were recorded. Frailty status was determined using the Clinical Frailty scale. SIR was determined using serum CRP. Clinical outcomes of interest were oxygen requirement, ITU admission and 30-day mortality. Categorical variables were analysed using chi-square test and binary logistics regression analysis. Continuous variables were analysed using the Mann-Whitney U or Kruskal Wallis tests. 281 patients were included. 55% (n = 155) were aged ≥ 70 years and 39% (n = 109) were male. 49% (n = 138) of patients were frail (CFS > 3). 86% (n = 242) of patients had a serum CRP > 10 mg/L. On univariate analysis, frailty was significantly associated with thirty-day mortality (p < 0.001). On univariate analysis, serum CRP was found to be significantly associated with an oxygen requirement on admission in non-frail patients (p = 0.004). Over a third (36%) of non-frail patients had a low vitamin B1, despite having normal reference range values of red cell B2, B6 and selenium. Furthermore, serum CRP was found to be significantly associated with a lower median red cell vitamin B1 (p = 0.029). Vitamin B1 stores may be depleted in COVID-19 patients experiencing a significant SIR and providing rationale for thiamine supplementation. Further longitudinal studies are warranted to delineate the trend in thiamine status following COVID-19.
Bibliography:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ISSN:1479-5876
1479-5876
DOI:10.1186/s12967-023-04138-y