Malnutrition Increases Hospital Length of Stay and Mortality among Adult Inpatients with COVID-19

Tyrus Vong, Lisa R. Yanek, Lin Wang, Huimin Yu, Christopher Fan, Elinor Zhou, Sun Jung Oh, Daniel Szvarca, Ahyoung Kim, James J. Potter, Gerard E. Mullin

Research output: Contribution to journalArticlepeer-review


Background: Malnutrition has been linked to adverse health economic outcomes. There is a paucity of data on malnutrition in patients admitted with COVID-19. Methods: This is a retrospective cohort study consisting of 4311 COVID-19 adult (18 years and older) inpatients at 5 Johns Hopkinsaffiliated hospitals between 1 March and 3 December 2020. Malnourishment was identified using the malnutrition universal screening tool (MUST), then confirmed by registered dietitians. Statistics were conducted with SAS v9.4 (Cary, NC, USA) software to examine the effect of malnutrition on mortality and hospital length of stay among COVID-19 inpatient encounters, while accounting for possible covariates in regression analysis predicting mortality or the log-transformed length of stay. Results: COVID-19 patients who were older, male, or had lower BMIs had a higher likelihood of mortality. Patients with malnutrition were 76% more likely to have mortality (p < 0.001) and to have a 105% longer hospital length of stay (p < 0.001). Overall, 12.9% (555/4311) of adult COVID-19 patients were diagnosed with malnutrition and were associated with an 87.9% increase in hospital length of stay (p < 0.001). Conclusions: In a cohort of COVID-19 adult inpatients, malnutrition was associated with a higher likelihood of mortality and increased hospital length of stay.

Original languageEnglish (US)
Article number1310
Issue number6
StatePublished - Mar 1 2022


  • COVID-19
  • Malnutrition
  • Mortality
  • Nutrition
  • SARS-CoV-2
  • Vitamin D

ASJC Scopus subject areas

  • Food Science
  • Nutrition and Dietetics


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