Nutritional Status at Admission and Clinical Outcomes in Hospitalized Patients with COVID-19: Results from the MODIeCOSe in Italy Study
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background/Objectives: Poor nutritional status is common among hospitalized patients and may adversely affect the response to severe acute illness. We investigated the association between nutritional status at hospital admission and clinical outcomes in patients hospitalized with COVID-19 during the first two pandemic waves in Italy. Methods: This retrospective multicenter study included 1187 patients hospitalized with COVID-19 across nine Italian centers participating in the MODIeCOSe in Italia registry. Nutritional status was assessed using the Controlling Nutritional Status (CONUT) score, the Prognostic Nutritional Index (PNI), and available anthropometric measures. The primary outcome was a composite of in-hospital death or transfer to an intensive care unit (ICU). Multivariable logistic regression was used to assess the independent association between nutritional status and outcome. Results: Overall, 275 patients (23.2%) experienced the composite adverse outcome. CONUT score was higher in patients with an adverse than in those with a favorable outcome (4.4 ± 2.3 vs. 3.4 ± 1.8; p < 0.001), whereas PNI did not differ significantly. Patients with an adverse outcome also had lower body weight, BMI, waist circumference, and waist-to-height ratio, although anthropometric data were available only in subsets of the cohort. In the main multivariable model adjusted for admission PaO2/FiO2 and relevant clinical covariates, higher CONUT remained independently associated with adverse outcome (OR 1.65, 95% CI 1.12–2.45 per 1-SD increase; p = 0.01). The association was similar in a sensitivity analysis excluding PaO2/FiO2 (OR 1.79, 95% CI 1.28–2.49; p < 0.001). Conclusions: A higher CONUT score at admission was independently associated with an increased risk of in-hospital death or ICU transfer, supporting its prognostic relevance as an immuno-nutritional index in hospitalized patients with COVID-19.
Source: Nutrients
DOI: 10.3390/nu18203378
Authors: Carola Buscemi, Matteo Monami, Cristiana Randazzo, Anna Maria Barile, Benedetta Ragghianti, Chiara Davoli, Enrico Maria Trecarichi, Helen Linda Morrone, Bruno Tassone, Piero Colombrita, Carlo Cottone, Maria Elena Greggi, Paolo Sbraccia, Valeria Guglielmi, Frida Leonetti, Danila Capoccia, Alexis Elias Malavazos, Sara Basilico, Ferruccio Santini, Alessandro Antonelli, Nicola Viola, Carlo Torti, Silvio Buscemi
Institutions: Ospedale Vincenzo Cervello, University of Palermo, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Azienda Ospedaliera Universitaria Policlinico "Paolo Giaccone" di Palermo, Magna Graecia University, Azienda Ospedaliero-Universitaria "Renato Dulbecco", Link Campus University, University of Rome Tor Vergata, Policlinico Tor Vergata, Ospedale Santa Maria Goretti, University of Milan, IRCCS Policlinico San Donato, University of Pisa, Agostino Gemelli University Polyclinic
Language: English
Subfield: Physiology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,499
OpenAlex ID: W7222079430