Nutritional Disorders and Their Clinical Impact in Older Adults With COVID-19: A Retrospective Study From Qatar

Introduction Older adults were at a higher risk of developing nutritional disorders, hospitalization, and death because of the coronavirus 2019 (COVID-19) pandemic. The burden of malnutrition and overnutrition in institutionalized older adults is a critical but under-researched factor of COVID-19 outcomes, particularly in the Middle East, where scarce data are available. The purpose of this study was to find out the prevalence of nutritional disorders among older patients with COVID-19 and to identify risk factors and clinical outcomes in Qatar. Methods A total of 55 adults aged over 60 years with confirmed COVID-19 diagnoses between March and August 2020 were identified from long-term care facilities and home-based health services in Qatar. Retrospective data on nutritional disorders, risk factors, and clinical outcomes were collected. SPSS Statistics version 28 (IBM Corp., Armonk, NY, USA) was used to analyze the data. Results The majority of the cohort were overnourished (n=34, 62%) or malnourished (n=16, 29%), and the rest of them had a normal nutritional status (n=5, 9%). The cohort was 60% females (n=33) and 40% males (n=22) and the mean age was 78.7+9.9 years. The malnourished cohort was associated with feeding problems (p<0.01), gastrointestinal symptoms (p<0.04), and nasogastric tube feeding dependency (p<0.003). Multivariate analysis showed the gastrointestinal symptoms as common predictors of nutritional disorders (p=0.03) and mortality (p=0.006). The mortality rate was 74% (n=41). The independent variables that were also associated with death were hydration status (p<0.001), infection (p<0.001), use of a nasogastric tube (p<0.002), and readmission (p<0.002). Conclusions The prevalence of nutritional disorders is high in older COVID-19 patients, and overnutrition (imbalanced nutrition) is more widespread than malnutrition. There is a high correlation between nutritional disorders and gastrointestinal symptoms, and mortality as well. Additional factors that were associated with mortality to a significant level were hydration status, infection, readmission, and the use of a nasogastric tube. Thus, it is essential to focus on the nutritional assessment and management of older COVID-19 patients and similar severe infections.