A Correlation between Nutritional Adequacy and Clinical Outcomes among Children Critically Hospitalized with COVID-19

Introduction: Malnutrition is a prominent cause of mortality and morbidity in hospitalized children. Comorbidity of infection and malnutrition can exacerbate nutritional deficiencies and worsen healing. This study aimed to evaluate nutritional status, dietary intake adequacy, and their correlation with clinical outcomes among children diagnosed with coronavirus disease 2019 (COVID-19). Methods: This prospective observational study was conducted on 30 children admitted to the pediatric intensive care unit (PICU) ward of Akbar Hospital, Mashhad University of Medical Sciences, Mashhad, Iran, for eight weeks. Age, gender, and nutritional status (weight-for-lengths/heights z-scores, based on the World Health Organization child growth standards) of critically ill children with COVID-19 were recorded and evaluated upon admission. Dietary intake and its adequacy were also calculated during hospitalization. Then, the correlation between mentioned variables with clinical outcomes was examined. Results: Out of 30 patients, malnutrition was severe in 16.7%, moderate in 16.7%, while nutrition status was normal in 66.7% of patients. There was no significant correlation between z-scores and mortality or length of stay. However, significant differences were found between energy intake adequacy and length of hospitalization (p 0.001), as well as protein intake adequacy and mortality (p=0.008). Conclusion: The study showed a significant correlation between dietary intake adequacy and clinical outcomes, suggesting the role of optimizing nutrition therapy in ameliorating clinical consequences in critically ill children.