Evaluation of Nutritional Status Among COVID-19 Patients Admitted to the Intensive Care Unit in Jeddah, Saudi Arabia: A Cross-Sectional Observational Study (Corrected Proof)

Abstract

Background: Patients with Coronavirus disease 2019 (COVID-19) frequently require admission to Intensive Care Units (ICUs) due to the vast range of severe clinical symptoms associated with the virus. Within this cohort, nutritional status has emerged as a critical determinant of clinical outcomes. Malnutrition is associated with a poor prognosis among hospitalized patients with COVID-19; an exacerbated inflammatory state combined with inadequate food intake often results in prolonged ICU stays and elevated mortality rates.

Aims: This study aimed to evaluate the nutritional status of COVID-19 patients admitted to the ICU and to identify correlations between nutritional indicators and clinical outcomes.

Materials and methods: A cross-sectional observational study was conducted over a six-month period at the National Guard Hospital in Jeddah. A total of 173 laboratory-confirmed COVID-19 patients admitted to the ICU were enrolled. Data were extracted from electronic medical records, encompassing demographic, comorbidities, and ICU length of stay (LOS). Clinical parameters included the route and timing of nutritional support (enteral, parenteral, or oral). Nutritional risk was quantified using the Malnutrition Universal Screening Tool (MUST). Statistical analyses were performed using IBM SPSS version 24, with the threshold for significance established at p < 0.05.

Results: The study population comprised 88 females (51%)) and 85 males (49%). A majority (59%) of the cohort were aged 66 years or older. Comorbidities were present in 94% of patients with hypertension, diabetes mellitus, and renal, cardiac, and respiratory disorders being the most prevalent. Furthermore, 34% of the participants were classified as obese and 25% as overweight. Base on MUST scores, 40% of patients were at low risk, 37% at moderate risk, and 40% at high risk of malnutrition. Significant reductions in serum albumin and hemoglobin levels were observed. The median ICU LOS was 8 days. Statistical analysis revealed that LOS was significantly correlated (p < 0.05) with age, nutritional status, feeding modality, and biochemical markers (serum albumin and hemoglobin). Notably, 100% of the patients initiated nutritional support within the first 48 hours of ICU admission.

Conclusion: Malnutrition is highly prevalent among COVID-19 patients in the ICU and is strongly associated with low serum albumin and hemoglobin levels. Patients with pre-existing hypertension and diabetes appear more susceptible to ICU admission. Given that ICU length of stay is significantly influenced by age, nutritional status, feeding method, and serum albumin and hemoglobin levels, the systematic evaluation of nutritional status and malnutrition management should be routinely integrated into the standard of care for COVID-19 patients the intensive care settings.

Keywords: COVID-19; Intensive Care Unit (ICU); Malnutrition; Nutrition Status; Length of Stay (LOS); Albumin; Hemoglobin.