Malnutrition persistent in patients with COVID-19 at 3- and 6-months post-infection
For patients with COVID-19, at 3- and 6-months, malnutrition was the most persistent gastrointestinal sequalae, according to a study published in Clinical Gastroenterology and Hepatology.
“It’s overall reassuring that most GI symptoms, for patients who presented with severe COVID-19, resolve within 3 to 6 months,” Arvind Trindade, MD, FASGE, director of endoscopy, Long Island Jewish Medical Center, Northwell Health System in New York, told Healio Gastroenterology. “Inability to gain weight in patients diagnosed with COVID and malnutrition is a lingering symptom that deserves more attention. These patients should follow up with a nutritionist. Future research needs to identify the mechanism of why these patients are unable to gain weight. In addition, we will be looking at 1-year follow up data to determine if this resolves within this time span.”
Trindade and colleagues conducted a retrospective study of 17,462 patients with COVID-19 who were hospitalized at 12 hospitals included in the Northwell Health System in New York. The research was performed through the Feinstein Institutes for Medical Research.
“Patients were included if 1) tested positive for SARS-CoV-2 nasal swab PCR 2) were hospitalized with GI manifestations on initial presentation 3) had 3 and/or 6 months follow up as an outpatient post-hospitalization or repeat hospitalization,” the investigators wrote.
According to the investigators, 3,229 of the hospitalized patients with COVID-19 had GI manifestations and 715 patients had 788 distinct GI manifestations and 3 and/or 6 months outpatient follow up data post-discharge.
Initial GI symptoms included gastroenteritis (n = 414; 52.5%), GI bleeding (n = 161; 20.4%), malnutrition (n = 181; 23%) and idiopathic pancreatitis (n = 4; 0.5%), according to study data. Gastroenteritis resolved at 3 months in 323 patients and at 6 months for 210 patients. GI bleeding resolved at 3 months in 138 patients and in 89 patients at 6 months.
The researchers reported that at 3 months, the inability for weight regain remained in 81 patients, and in 33 patients at 6 months. Pancreatitis attributed to viral etiology resolved in all patients in 3 and 6 months.
“For patients with malnutrition, median weight on admission was 156.4 pounds [IQR 131.7-193],” Rivzi and colleagues wrote. “Median weight loss for patients at 3 months was –4.9 pounds [IQR –16.7 to +6.6] and at 6 months –2.2 pounds [–19.6 to 11.8], respectively. Interestingly, 81 (59.1%) patients were unable to gain weight at 3 months and 44 (56.4 %) were unable to gain weight at 6 months. For patients with malnutrition unable to gain weight at follow up, median weight loss was –14.7 pounds [IQR –26.6 to –7.9] at 3 months and –17.8 pounds [IQR –35.2 to –6.5] at 6 months.”