Malnutrition increases risk of mortality from COVID-19

Jana Ponce, PhD

Groundbreaking research from the University of Nebraska Medical Center College of Allied Health Professions on “The Impact of Malnutrition on Clinical Outcomes in Patients Diagnosed with COVID-19” is one of five finalists for an award from the American Society for Parenteral and Enteral Nutrition (ASPEN). 

Jana Ponce, PhD, assistant professor of medical nutrition education, said UNMC researchers found that among patients hospitalized with COVID-19, the presence of malnutrition increased the risk of mortality by 2.5 times, and the risk of being mechanically ventilated by 5.7 times. 

Dr. Ponce said her team used data from the National COVID Cohort Collaborative (N3C), a nationally representative electronic health record repository that includes data contributed by Nebraska Medicine. 

“These results highlight the importance of early recognition of malnutrition risk and effective nutrition interventions in COVID-19 patients,” Dr. Ponce said. 

Dr. Ponce will present her team’s abstract at ASPEN’s 2022 annual conference as a candidate for the Harry M. Vars Research Award. The award honors any early career investigator who has submitted a top-scoring original abstract, and demonstrates excellence via a manuscript and oral presentation at the conference. 

Malnutrition can increase complications in hospitalized patients, Dr. Ponce said. Malnutrition happens when the body is deprived of vitamins, minerals and other nutrients it needs to maintain healthy tissues and organ function, according to Johns Hopkins University. 

But the effect of malnutrition on clinical outcomes in those hospitalized with COVID-19 hadn’t been studied. 

That makes UNMC’s research novel. But it’s also meaningful in real-world applications for health care systems and the patients they serve, said Corrine Hanson, PhD, director of UNMC’s division of medical nutrition education. 

Dr. Hanson said the work of Dr. Ponce and her team demonstrates “the commitment of UNMC to creating a healthy future for all individuals.” 

Said Dr. Hanson, “Combined with the Nebraska Medicine malnutrition initiatives led by Megan Timmerman, the value of our joint mission statement and our dedication to extraordinary care is clear.” 

Timmerman, assistant professor of medical nutrition education and manager of nutrition care at Nebraska Medicine, said UNMC research has improved and influenced clinical care at Nebraska Medicine, and vice versa. 

A four-year effort, along with Margaret Rajnic from the clinical quality and patient safety team, has strengthened the early identification of patients with malnutrition at Nebraska Medicine, Timmerman said. 

“As a result, malnutrition diagnosis rates have increased by 12.9% and an additional critical care nutrition therapist has been added to the team, providing increased and consistent coverage for COVID-19 patients,” Timmerman said. 

As a result of Ponce’s research, Nebraska Medicine nutrition care, in collaboration with UNMC medical nutrition, has established best practice guidelines for staff who work with COVID-19 patients.  

Collaborators included: 

Jana Ponce, PhD, Corrine Hanson, PhD, Megan Timmerman, Mariah Jackson, College of Allied Health Professions, Division of Medical Nutrition Education. Drs. Ponce and Timmerman: Nebraska Medicine, Department of Pharmaceutical and Nutrition Care. 

Jerrod Anzalone, biomedical informatics graduate program, data access/program coordinator, Great Plains IDeA-CTR. 

Kristina Bailey, MD, associate professor of pulmonary, critical care and sleep, College of Medicine, Veterans Administration Nebraska-Iowa Health Systems. 

Harlan Sayles, College of Public Health, Department of Biostatistics. 

We are Nebraska Medicine and UNMC. Our mission is to lead the world in transforming lives to create a healthy future for all individuals and communities through premier educational programs, innovative research and extraordinary patient care.  

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