COVID-19 and malnutrition during the second wave: The experience in a low-Intensive Care Unit in Milan

Background: Malnutrition is high in hospitalized COVID-19 patients, influencing disease severity and progression. It is therefore important to identify nutritional status markers. Objective: The aim of this study was to investigate, in patients affected by COVID-19, the relationship between body composition, assessed by bioelectrical impedance analysis, inflammatory state, and risk of malnutrition. Methods: Between November and December 2020, patients hospitalized for COVID-19 at the low-intensive care unit of Policlinico in Milan were enrolled. Anthropometric data, complete blood count, albumin, and body composition parameters were collected. The Malnutrition Universal Screening Tool was used to identify the risk of malnutrition. Results: Twenty-seven patients (74% males), with age of 63 ± 14 years, were included. The length of hospital stay (LOS) was 34.5 ± 31.5 days. All patients lost weight, with a mean of approximately 8%. Fat free mass was negatively correlated with LOS (r 2 = 0.222; p = 0.013), as well as neutrophils to lymphocytes (NLR) ratio was negatively correlated with albumin (r 2 = 0.215, p = 0.017) and positively correlated with body weight loss (r 2 = 0.194; p = 0.022). Conclusion: Nutritional screening and NLR assessment helped identify COVID-19 patients at high risk of malnutrition, allowing them to receive the necessary nutritional support.