Malnutrition is associated with hyperinflammation and immunosuppression in COVID-19 patients: A prospective observational study

Background Coronavirus disease 2019 (COVID-19) is spreading globally and has caused many deaths. This study investigated, for the first time, COVID-19 patients' nutrition status and its effects on their inflammatory and immune responses. Methods Forty-seven COVID-19 patients were recruited for this prospective study. According to the subjective global assessment at admission, patients were divided into the normal nutrition (NN), risk of malnutrition (RMN), or MN group. Serum cytokines and whole blood T-cell subpopulations were measured to assess the inflammatory and immune responses in COVID-19 patients. Analysis of covariance and chi(2) tests were used. Results On admission, the incidences of MN and the RMN in COVID-19 patients were 17.0% and 38.3%, respectively. The MN group had a higher proportion with severe/critical COVID-19 and a longer hospitalization duration than the NN group. Serum interleukin (IL) 6 concentrations were elevated in 97.9% of the patients and were the highest in malnourished patients. The IL-4 and IL-10 levels were elevated in 46.8% and 48.9% of the patients, respectively. The proportion of CD8+ T cells was significantly lower in the MN group than in the NN group. Conclusion A high proportion of COVID-19 patients are malnourished or at risk of malnuourishment, especially those with severe disease. MN is associated with hyperinflammation and immunosuppression in COVID-19 patients, and it may contribute to disease progression.

Automated summary

This study found that a significant proportion of COVID-19 patients are malnourished or at risk of malnutrition, especially those with severe disease. Malnutrition is associated with hyperinflammation and immunosuppression in COVID-19 patients, and may contribute to disease progression.