Table 5.
Diagnostic performance of Nutritional Screening Tools identifying older adults with COVID-19 at nutritional risk or with malnutrition.
| Author | Screening Tool | Reference Standard | TP | FP | FN | TN | Sensitivity (95%CI) | Specificity (95% CI) | PPV (%) | NPV (%) | Other Analysis |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Liu et al., 2020 [46] | NRS-2002 | BMI | 7 | 113 | 0 | 21 | 100 (59 to 100) | 16 (10 to 23) | 5.8 | 100 | - |
| Liu et al., 2020 [46] | NRS-2002 | MUST | 57 | 63 | 1 | 20 | 98 (91 to 100) | 24(15 to 35) | 47.5 | 95.2 | - |
| Liu et al., 2020 [46] | NRS-2002 | MNA-sf | 102 | 18 | 7 | 14 | 94 (87 to 97) | 44 (26 to 62) | 85.0 | 66.7 | - |
| Liu et al., 2020 [46] | NRS-2002 | NRI | 98 | 22 | 3 | 18 | 97 (92 to 99) | 45 (29 to 62) | 81.7 | 85.7 | - |
| Liu et al., 2020 [46] | MUST | BMI | 7 | 51 | 0 | 83 | 100 (59 to 100) | 62 (53 to 70) | 12.1 | 100 | - |
| Liu et al., 2020 [46] | MUST | NRS-2002 | 57 | 1 | 63 | 20 | 47 (38 to 57) | 95 (76 to 100) | 98.3 | 24.1 | - |
| Liu et al., 2020 [46] | MUST | MNA-sf | 57 | 52 | 1 | 31 | 98 (91 to 100) | 37 (27 to 49) | 52.3 | 96.9 | - |
| Liu et al., 2020 [46] | MUST | NRI | 53 | 5 | 48 | 35 | 52 (42 to 63) | 88 (73 to 96) | 91.4 | 42.2 | - |
| Liu et al., 2020 [46] | MNA-sf | BMI | 7 | 102 | 0 | 32 | 100 (59 to 100) | 24 (17 to 32) | 6.4 | 100 | - |
| Liu et al., 2020 [46] | MNA-sf | NRI | 86 | 23 | 15 | 17 | 85 (77 to 91) | 42 (27 to 59) | 78.9 | 53.1 | - |
| Liu et al., 2020 [46] | MNA-sf | NRS-2002 | 102 | 3 | 22 | 18 | 82 (74 to 99) | 86 (64 to 97) | 97.1 | 45.0 | - |
| Liu et al., 2020 [46] | MNA-sf | MUST | 57 | 1 | 52 | 31 | 52 (43 to 62) | 97 (84 to 100) | 98.3 | 37.4 | - |
| Liu et al., 2020 [46] | NRI | BMI | 7 | 94 | 0 | 40 | 100 (59 to 100) | 30 (22 to 38) | 6.9 | 100 | - |
| Liu et al., 2020 [46] | NRI | MNA-sf | 86 | 15 | 23 | 17 | 79 (70 to 86) | 53 (35 to 71) | 85.2 | 42.5 | - |
| Liu et al., 2020 [46] | NRI | NRS-2002 | 98 | 3 | 22 | 18 | 82 (74 to 88) | 86 (64 to 97) | 97.0 | 45.0 | - |
| Liu et al., 2020 [46] | NRI | MUST | 53 | 48 | 35 | 5 | 60 (49 to 61) | 9 (3 to 21) | 52.5 | 12.5 | - |
| Li et al., 2020 [44] | MNA | BMI | - | - | - | - | - | - | - | - | BMI (kg/m2)—no malnutrition: 25.6 ± 3.0; risk of malnutrition: 23.3 ± 3.4 kg/m2; malnutrition: 21.1 ± 3.6 kg/m2. F or X2 value: 4.106, p = 0.035. |
| Li et al., 2020 [44] | MNA | Calf circumference (cm) | - | - | - | - | - | - | - | - | Calf circumference (cm)—no malnutrition: 33.4 ± 5.6; risk of malnutrition: 31.2 ± 4.8; malnutrition: 28.7 ± 5.7, F or X2 value: 2.518, p = 0.047. |
| Li et al., 2020 [44] | MNA | Albumin (g/L) | - | - | - | - | - | - | - | - | Albumin (g/L)—no malnutrition: 38.5 ± 4.2; risk of malnutrition: 30.1 ± 6.4; malnutrition: 25.7 ± 5.3, F or X2 value: 10.217, p < 0.001. |
| Li et al., 2020 [44] | MNA | TLC | - | - | - | - | - | - | - | - | TLC—no malnutrition: 1.7 ± 0.52; risk of malnutrition: 1.2 ± 0.43, malnutrition: 0.9 ± 0.38, F or X2 value: 11.237, p < 0.001. |
| Li et al., 2020 [44] | MNA | TSFT (mm) | - | - | - | - | - | - | - | - | TSFT (mm)—no malnutrition: 16.8 ± 7.2; risk of malnutrition: 15.7 ± 6.9; malnutrition: 14.9 ± 7.3, F or X2 value: 1.632, p = 0.126. |
| Li et al., 2020 [44] | MNA | MAC (cm) | - | - | - | - | - | - | - | - | MAC (cm)—no malnutrition: 28.7 ± 2.8; risk of malnutrition: 27.6 ± 3.3; malnutrition: 26.5 ± 3.2, F or X2 value: 2.679, p = 0.379. |
| Yuan et al., 2020 [45] | GNRI | TLC | - | - | - | - | - | - | - | - | Of the four patients at nutritional risk, one had low TLC levels and three had normal levels. |
| Zhang et al., 2020 [43] | NUTRIC score | Albumin (g/L) | - | - | - | - | - | - | - | - | High NR group (n = 83): 29 g/L (25–32). Low NR group (n = 53): 30 g/L (28–32), p = 0.107. |
| Zhang et al., 2020 [43] | NUTRIC score | Prealbumin (g/L) | - | - | - | - | - | - | - | - | High NR group (n = 83): 82 g/L (80–122). Low NR group (n = 53): 95 (80–128) g/L, p = 0.281. |
| Zhang et al., 2020 [43] | NUTRIC score | TLC | - | - | - | - | - | - | - | - | High NR group (n = 83): 0.5 × 109/L (0.3–0.7). Low NR group (n = 53): 0.6 × 109/L (0.4–0.9), p = 0.007. |
| Zhang et al., 2020 [43] | NUTRIC score | Creatinine (mmol/L) | - | - | - | - | - | - | - | - | High NR group (n = 83): 90 (65–144) mmol/L. Low NR group (n = 53): 67 (54–85) mmol/L, p < 0.001. |
Abbreviations: BMI, body mass index; CI, Confidence Interval; FN, false negative; FP, false positive; GNRI, Geriatric Nutritional Risk Index; MAC, mid-arm circumference (cm); MNA, Mini Nutritional Assessment; MNA-sf, Mini Nutritional Assessment-short form; MUST, Malnutrition Universal Screening Tool; NPV, negative predictive value; NR, nutritional risk, NRI, Nutritional Risk Index; NRS-2002, Nutritional Risk Screening tool 2002; NUTRIC, Nutrition Risk in the Critically Ill (NUTRIC) scores; PPV, positive predictive value; TLC, total lymphocyte count; TN, true negative; TP, true positive; TSFT, triceps skin-fold thickness (mm).