A Correlation between Nutritional Adequacy and Clinical Outcomes among Critically Children Hospitalized With Covid-19

Malnutrition is a prominent cause of mortality and morbidity in hospitalized children. The accompaniment of malnutrition with infectious diseases worsens the healing process and intensifies nutritional deficiencies. This study was done to assess the nutritional status, and dietary intake adequacy, and their relationship with clinical outcomes among children diagnosed with COVID-19 disease and admitted to the pediatric intensive care unit (PICU).  In this prospective observational study, we collected the data of 30 children admitted to the PICU ward of Akbar Hospital, Mashhad University of Medical Sciences, Mashhad, Iran, during 8 weeks. The age, gender, and nutritional status (by z-scores of weight-for-length/ height, based on the World Health Organization child growth standards) of critically ill children with COVID-19 were recorded and evaluated upon admission time. Dietary intake and its adequacy were also calculated during hospitalization. The correlation between mentioned variables with clinical outcomes was examined.  Out of the 30 patients, the malnutrition rate was 16.7% severe, 16.7% moderate, and 66.7% normal. In correlation between variables, it was no significant difference between z-scores with mortality, and length of stay, but statistically, remarkable differences were found between energy intake adequacy and length of hospitalization (p<0.001), and between protein intake adequacy and mortality (p=0.008).  The study showed that there is a significant relationship between dietary intake adequacy and clinical outcomes, suggesting the role of optimizing nutrition therapy in ameliorating clinical consequences in critically ill children.