Predictive Value of Prognostic Nutritional Index in Children with COVID-۱۹

Background and aim: Severe malnutrition might contribute the poor outcomes in COVID-۱۹. This study aims to investigate the relationship between prognostic nutritional index (PNI) and mortality in children with COVID-۱۹ infection and its predictive value for predicting poor prognosis.Methods: A case control study using medical records of paediatric patients with COVID-۱۹ was conducted from June ۲۰۲۰-July ۲۰۲۲. Subjects were divided into two groups: non-survived and survived. PNI value were calculated as ۱۰ x serum albumin (g/dL) + ۰.۰۰۵ x total lymphocyte count (/mm۳). PNI was compared with nutritional status and several markers that have been used in COVID-۱۹, including (۱) neutrophil to lymphocyte ratio (NLR), (۲) systemic immune inflammation index (SII), and (۳) platelet to lymphocyte ratio (PLR).Results: Among ۱۲۴ eligible subjects, ۳۴ (۲۷.۴۱%) were in the non-survived group and ۹۰ (۷۲.۵۸%) children in the survived group. Children with severe malnutrition had lower albumin and a greater risk of death than those with good nutrition. PNI, NLR, and SII were significantly correlated with the mortality children with COVID-۱۹ except for PLR; P = ۰.۰۰۱, P = ۰.۰۰۱, P = ۰.۰۲۱, and P = ۰.۱۱۸, respectively. Receiver operating characteristic curves stated that PNI (AUC = ۰.۷۴۱, P < ۰.۰۰۰۱). The cut-off values of PNI were ۴۱.۹۷۵ with sensitivities of ۷۳.۵% and specificities of ۷۳.۳%. PNI value <۴۱.۹۷۵ had a ۷.۶۴ times greater risk of mortality (P < ۰.۰۰۰۱).Conclusion: PNI might be used as predictive value for predicting poor outcome in children with COVID-۱۹ infection.

Keywords:

COVID-۱۹ , children , Albumin , Nutritional Status , prognostic nutritional index