Abstract:
Coronavirus disease 2019 (COVID-19) is associated with high risk of malnutrition, primarily in older people; assessing nutritional risk using appropriate screening tools is critical. This systematic review identified applicable tools and assessed their measurement properties. Literature was searched in the MEDLINE, Embase, and LILACS databases. Four studies conducted in China met the eligibility criteria. Sample sizes ranged from six to 182, and participants\' ages from 65 to 87 years. Seven nutritional screening and assessment tools were used: the Nutritional Risk Screening 2002 (NRS-2002), the Mini Nutritional Assessment (MNA), the MNA-short form (MNA-sf), the Malnutrition Universal Screening Tool (MUST), the Nutritional Risk Index (NRI), the Geriatric NRI (GNRI), and modified Nutrition Risk in the Critically ill (mNUTRIC) score. Nutritional risk was identified in 27.5% to 100% of participants. The NRS-2002, MNA, MNA-sf, NRI, and MUST demonstrated high sensitivity; the MUST had better specificity. The MNA and MUST demonstrated better criterion validity. The MNA-sf demonstrated better predictive validity for poor appetite and weight loss; the NRS-2002 demonstrated better predictive validity for prolonged hospitalization. mNUTRIC score demonstrated good predictive validity for hospital mortality. Most instruments demonstrate high sensitivity for identifying nutritional risk, but none are acknowledged as the best for nutritional screening in older adults with COVID-19.
摘要:
2019年冠状病毒病(COVID-19)与营养不良的高风险有关,主要是老年人;使用适当的筛查工具评估营养风险至关重要。本系统综述确定了适用的工具并评估了其测量特性。文献在MEDLINE中搜索,Embase,和LILACS数据库。在中国进行的四项研究符合资格标准。样本量从6到182不等,参与者年龄从65到87岁。使用了七种营养筛查和评估工具:2002年营养风险筛查(NRS-2002),迷你营养评估(MNA),MNA短形式(MNA-SF),营养不良通用筛查工具(MUST),营养风险指数(NRI)老年NRI(GNRI),和改善危重疾病(mNUTRIC)评分中的营养风险。在27.5%至100%的参与者中发现了营养风险。NRS-2002,MNA,MNA-sf,NRI,并且必须表现出高灵敏度;必须具有更好的特异性。MNA和MUST证明了更好的标准有效性。MNA-sf对食欲不振和体重减轻表现出更好的预测有效性;NRS-2002对长期住院表现出更好的预测有效性。mNUTRIC评分对医院死亡率表现出良好的预测有效性。大多数仪器显示出识别营养风险的高灵敏度,但没有一项被认为是COVID-19老年人营养筛查的最佳方法。