Nutritional Risk Score (NRS-2002) as a Predictor of In-Hospital Mortality in COVID-19 Patients: A Retrospective
Jan Ilkowski1, Przemysław Guzik2,3, Aleksandra Kaluźniak-Szymanowska4
1Department of Emergency Medicine, Poznan University of Medical Sciences, 61-701 Poznan, Poland.
Nutrients
|April 12, 2025
Summary
Malnutrition significantly increases the risk of in-hospital death for COVID-19 patients. Using the Nutritional Risk Score (NRS-2002) can help identify at-risk individuals for early intervention.
Area of Science:
- Medical Research
- Clinical Nutrition
- Infectious Diseases
Background:
- Malnutrition is a significant, yet underrecognized, factor impacting COVID-19 patient outcomes.
- Poor nutritional status impairs immune function and increases susceptibility to infections.
- The precise impact of malnutrition on COVID-19 mortality requires further investigation.
Purpose of the Study:
- To evaluate the association between malnutrition, assessed by the Nutritional Risk Score (NRS-2002), and in-hospital mortality in COVID-19 patients.
- To determine if malnutrition is an independent predictor of mortality in hospitalized COVID-19 cases.
Main Methods:
- Retrospective analysis of 222 COVID-19 patients hospitalized during the Delta variant surge.
- Malnutrition defined as NRS-2002 score ≥ 3.
- Univariate and adjusted Cox proportional hazard models used to assess mortality risk.
Main Results:
- Malnutrition (NRS ≥ 3) was a strong predictor of in-hospital mortality (Hazard Ratios 3.19-5.88, p < 0.01).
- Adjusted models demonstrated a substantial impact of malnutrition on mortality risk.
- The models explained a significant portion of mortality variance (Nagelkerke's R² 0.66-0.77).
Conclusions:
- Nutritional status is a critical determinant of survival in hospitalized COVID-19 patients.
- Routine integration of the NRS-2002 can facilitate early identification of high-risk patients.
- Further research into nutritional interventions for severe COVID-19 and other inflammatory conditions is warranted.
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