The predictive value of prognostic nutritional index for the severity of coronavirus disease 2019

Hu, Xiang; Deng, Huihui; Wang, Yuxia; Chen, Lingqiao; Gu, Xuemei; Wang, Xiaobo

Background & Aims: Malnutrition plays a critical role in the onset and progress of coronavirus disease 2019 (COVID-19). The present study was to explore the association of prognostic nutritional index (PNI) with the severity of COVID-19 and its predictive value of the severe form of COVID-19. Methods: The clinical data were collected from 122 patients with COVID-19 hospitalized in the Sixth People's hospital of Wenzhou, which is the specialized infectious hospital affiliated to Wenzhou Central Hospital. PNI = serum albumin (g/L) + 5 × total lymphocyte count (/nL). Results: The study population consisted of 105 patients with common form (86.1%) and 17 patients with severe form (13.9%) of COVID-19. PNI was significantly declined from patients with common to severe form of COVID-19 (P = 0.029) regardless of gender, age range, and body mass index (BMI)-category. After adjustment of gender, age, indexes of liver and renal function, C-reactive protein, and current smoking, PNI remained to be independently and inversely associated with the severity of COVID-19 (odd ratio = 0.797, P = 0.030). Receiver operating characteristic showed PNI had similar accuracy for prediction of severe form of COVID-19 compared to its combination with gender, age, and BMI (P = 0.402). PNI < 49 were defined as a cut-off value for predicting the severe form of COVID-19. Conclusions: Poorer nutritional status predisposed patients with COVID-19 to severe form. Independently associated with the severity of COVID-19, PNI could serve as a simple, fast, and effective predictor among patients with different gender, age, and BMI.