Nutritional risk screening tools for older adults with COVID-19: a systematic review

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 wa...

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Authors: Evangelista, Karine Cavalcanti Maurício de Sena, Silva, David Franciole Oliveira, Lima, Severina Carla Vieira Cunha, Marchioni, Dirce Maria, Cobucci, Ricardo Ney, Andrade, Fábia Barbosa de
Format: article
Status:Published version
Publication Date:2020
Country:Brasil
Institution:Universidade Federal do Rio Grande do Norte (UFRN)
Repository:Repositório Institucional da UFRN
Language:English
OAI Identifier:oai:repositorio.ufrn.br:123456789/59850
Online Access:https://repositorio.ufrn.br/handle/123456789/59850
http://dx.doi.org/10.3390/nu12102956
Access Level:Open access
Keyword:Nutritional screening
Nutritional risk
Nutritional assessment
Malnutrition
Elderly
COVID-19
Coronavirus
Description
Summary: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