Exploring the Association between Delirium and Malnutrition in COVID-19 Survivors: A Geriatric Perspective

• Published in: Nutrients Vol. 15; no. 22; p. 4727
• Main Authors: Damanti, Sarah, Cilla, Marta, Vitali, Giordano, Tiraferri, Valeria, Pomaranzi, Chiara, De Rubertis, Giulia, De Lorenzo, Rebecca, Di Lucca, Giuseppe, Scotti, Raffaella, Messina, Emanuela, Dell’Acqua, Raffaele, Guffanti, Monica, Cinque, Paola, Castagna, Antonella, Rovere-Querini, Patrizia, Tresoldi, Moreno
• Format: Journal Article
• Language: English
• Published: Basel MDPI AG 01.11.2023
• Subjects: Body mass index; COVID-19; COVID-19 survivors; Delirium; frailty; geriatric syndromes; Geriatrics; Health aspects; Hospital patients; Hospitalization; Hospitals; Malnutrition; Metabolism; Mortality; Nutrition; Older people; Pandemics; Patients; Pneumonia; Product/Service Evaluations; Questionnaires; Severe acute respiratory syndrome coronavirus 2
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu15224727

Older individuals face an elevated risk of developing geriatric syndromes when confronted with acute stressors like COVID-19. We assessed the connection between in-hospital delirium, malnutrition, and frailty in a cohort of COVID-19 survivors. Patients aged ≥65, hospitalized in a tertiary hospital in Milan for SARS-CoV-2 pneumonia, were enrolled and screened for in-hospital delirium with the 4 ‘A’s Test (4AT) performed twice daily (morning and evening) during hospital stay. Malnutrition was assessed with the malnutrition universal screening tool (MUST) at hospital admission and with the mini-nutritional assessment short-form (MNA-SF) one month after hospital discharge. Frailty was computed with the frailty index one month after hospital discharge. Fifty patients (median age 78.5, 56% male) were enrolled. At hospital admission, 10% were malnourished. The 13 patients (26%) who developed delirium were frailer (7 vs. 4), experienced a higher in-hospital mortality (5 vs. 3), and were more malnourished one month after discharge (3 of the 4 patients with delirium vs. 6 of the 28 patients without delirium who presented at follow up). The 4AT scores correlated with the MNA-SF scores (r = −0.55, p = 0.006) and frailty (r = 0.35, p = 0.001). Frailty also correlated with MUST (r = 0.3, p = 0.04), MNA-SF (r = −0.42, p = 0.02), and hospitalization length (r = 0.44, p = 0.001). Delirium, malnutrition, and frailty are correlated in COVID-19 survivors. Screening for these geriatric syndromes should be incorporated in routine clinical practice.