Clinical significance of prognostic nutrition index in hospitalized patients with COVID‐19: Results from single‐center experience with systematic review and meta‐analysis

Background We aimed to ascertain risk indicators of in‐hospital mortality and severity as well as to provide a comprehensive systematic review and meta‐analysis to investigate the prognostic significance of the prognostic nutrition index (PNI) as a predictor of adverse outcomes in hospitalized coronavirus disease 2019 (COVID‐19) patients. Methods In this cross‐sectional study, we studied patients with COVID‐19 who were referred to our hospital from February 16 to November 1, 2020. Patients with either a real‐time reverse‐transcriptase polymerase chain reaction test that was positive for COVID‐19 or high clinical suspicion based on the World Health Organization (WHO) interim guidance were enrolled. A parallel systematic review/meta‐analysis (in PubMed, Embase, and Web of Science) was performed. Results A total of 504 hospitalized COVID‐19 patients were included in this study, among which 101 (20.04%) patients died during hospitalization, and 372 (73.81%) patients were categorized as severe cases. At a multivariable level, lower PNI, higher lactate dehydrogenase (LDH), and higher D‐dimer levels were independent risk indicators of in‐hospital mortality. Additionally, patients with a history of diabetes, lower PNI, and higher LDH levels had a higher tendency to develop severe disease. The meta‐analysis indicated the PNI as an independent predictor of in‐hospital mortality (odds ratio [OR] = 0.80; P < .001) and disease severity (OR = 0.78; P = .009). Conclusion Our results emphasized the predictive value of the PNI in the prognosis of patients with COVID‐19, necessitating the implementation of a risk stratification index based on PNI values in hospitalized patients with COVID‐19.