Early oral nutritional supplement improves COVID-19 outcomes among hospitalized older patients during the omicron wave

Abstract: Journal Pre-proof Early oral nutritional supplement improves COVID-19 outcomes among hospitalized older patients during the omicron wave Ying Chen , Yinfan Wu , Wei Ran , Jingjue Yuan , Zhangwei Yang , Shunjie Chen , Ying Wang PII: DOI: Reference: S0899-9007(23)00116-8 https://doi.org/10.1016/j.nut.2023.112087 NUT 112087 To appear in: Nutrition Received date: Revised date: Accepted date: 19 February 2023 16 May 2023 17 May 2023 Please cite this article as: Ying Chen , Yinfan Wu , Wei Ran , Jingjue Yuan , Zhangwei Yang , Shunjie Chen , Ying Wang , Early oral nutritional supplement improves COVID-19 outcomes among hospitalized older patients during the omicron wave, Nutrition (2023), doi: https://doi.org/10.1016/j.nut.2023.112087 This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. © 2023 Published by Elsevier Inc. Highlights ONS use among 1181 older patients with COVID-19 was retrospectively studied. ONS use was associated with a lower risk of in-hospital death. Early ONS could also reduce hospital length of stay and days of viral clearance. Timely nutritional support is important for COVID-19 geriatrics. 1 Original Investigation Early oral nutritional supplement improves COVID-19 outcomes among hospitalized older patients during the omicron wave Ying Chen1#, Yinfan Wu1#, Wei Ran1, Jingjue Yuan1, Zhangwei Yang2, Shunjie Chen2*, Ying Wang1* 1 Department of Clinical Nutrition, Shanghai Fourth People’s Hospital, School of Medicine, Tongji University, Shanghai, 200434, China 2 Department of Medical Administration, Shanghai Fourth People’s Hospital, School of Medicine, Tongji University, Shanghai, 200434, China # These authors contributed equally to this work. * Correspondence author: Shunjie Chen, Ph.D. E-mail: chenshunjie77csj@163.com. Ying Wang, Ph.D. E-mail: 18916484569@163.com; 2 Abstract Background: The effect of and optimal timing for initiating oral nutritional supplement (ONS) on hospitalized older patients with the Omicron variant infection remain unclear. Methods: We collected data from confirmed COVID-19 patients between April 2022 to June 2022 at Shanghai Fourth People’s Hospital, one of the designated medical centers for COVID-19 in Shanghai, China. Patients were identified as ONS users or non-ONS users, and the former was further defined as early ONS (ONS initiated within 48h from hospital admission), and late ONS (ONS initiated after 48 h) users. We conducted a retrospective cohort design as primary analysis and a case-control design as sensitivity analysis to explore the associations between ONS and clinical outcomes. Results: A total of 1181 hospitalized patients ≥60 years old were included in our study. The mean age of the entire cohort was 78.0, and most patients were female (57.7%). The mortalities after PSM were 1.2% and 4.3% in the ONS group and non-ONS groups, respectively (P = 0.032). Subgroup analysis results showed that patients with early-ONS had significantly shorter hospital..