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Chinese medical journal · Oct 2021
Observational StudyUsefulness of the CONUT index upon hospital admission as a potential prognostic indicator of COVID-19 health outcomes.
- Adrián K Bengelloun, Guillermo J Ortega, Julio Ancochea, Ancor Sanz-Garcia, Diego A Rodríguez-Serrano, Guillermo Fernández-Jiménez, Rosa Girón, Elena Ávalos, Joan B Soriano, and de UlíbarriJ IgnacioJIServicios de Neumología, Admisión y Documentación Clínica, Cuidados Intensivos y Nutrición y Dietética; Hospital Universitario de La Princesa, Madrid, Spain..
- Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain.
- Chin. Med. J. 2021 Oct 26; 135 (2): 187193187-193.
BackgroundIn-hospital mortality in patients with coronavirus disease 2019 (COVID-19) is high. Simple prognostic indices are needed to identify patients at high-risk of COVID-19 health outcomes. We aimed to determine the usefulness of the CONtrolling NUTritional status (CONUT) index as a potential prognostic indicator of mortality in COVID-19 patients upon hospital admission.MethodsOur study design is of a retrospective observational study in a large cohort of COVID-19 patients. In addition to descriptive statistics, a Kaplan-Meier mortality analysis and a Cox regression were performed, as well as receiver operating curve (ROC).ResultsFrom February 5, 2020 to January 21, 2021, there was a total of 2969 admissions for COVID-19 at our hospital, corresponding to 2844 patients. Overall, baseline (within 4 days of admission) CONUT index could be scored for 1627 (57.2%) patients. Patients' age was 67.3 ± 16.5 years and 44.9% were women. The CONUT severity distribution was: 194 (11.9%) normal (0-1); 769 (47.2%) light (2-4); 585 (35.9%) moderate (5-8); and 79 (4.9%) severe (9-12). Mortality of 30 days after admission was 3.1% in patients with normal risk CONUT, 9.0% light, 22.7% moderate, and 40.5% in those with severe CONUT (P < 0.05). An increased risk of death associated with a greater baseline CONUT stage was sustained in a multivariable Cox regression model (P < 0.05). An increasing baseline CONUT stage was associated with a longer duration of admission, a greater requirement for the use of non-invasive and invasive mechanical ventilation, and other clinical outcomes (all P < 0.05). The ROC of CONUT for mortality had an area under the curve (AUC) and 95% confidence interval of 0.711 (0.676-0746).ConclusionThe CONUT index upon admission is potentially a reliable and independent prognostic indicator of mortality and length of hospitalization in COVID-19 patients.Copyright © 2022 The Chinese Medical Association, produced by Wolters Kluwer, Inc. under the CC-BY-NC-ND license.
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