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Geriatric patients seem to be the most vulnerable group in COVID-19. These patients are usually characterized by impaired mobilization and malnutrition. In addition, obesity has been correlated with increased mortality rates after COVID-19 infection, highlighting the role of nutrition in prognosis of COVID-19 as well. In the past, several indices of nutritional status (GNRI) and functional status (ECOG performance status, Barthel Index, Handgrip Strength) have demonstrated a prognostic ability for hospitalized patients with influenza-like respiratory infections from coronavirus, metapneumovirus, parainfluenza and rhinovirus. Our hypothesis suggests that the previously mentioned nutritional and functional status indices, combined with the pneumonia severity index (CRB-65), could be useful in prognosis of morbidity and mortality of the elderly after the novel COVID-19 infection. Our hypothesis, is the first in the literature, which suggests a prognostic association between nutritional status of patients and COVID-19 infection, offering a quick and low-cost prognostic tool for COVID-19 in the elderly., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Background and Aims: Cancer patients frequently suffer from disease-related malnutrition and functional decline. The aim of the current study is to investigate the association between traditional methods of nutritional assessment (unintentional weight loss, Patient Generated-Subjective Global Assessment, anthropometric measurements), functional assessment and muscle mass assessment in oesophago-gastric cancer patients prior to surgery., Methods: A cross-sectional study was performed in 108 consecutive patients with oesophageal and gastric cancer who were admitted for surgery in the First Department of Surgery, Laikon General Hospital, Athens, Greece. The assessment of muscle mass was based on preoperative Skeletal Muscle Mass Index (SMI) values. The assessment of malnutrition was based on the Patient Generated Subjective Global Assessment, whereas laboratory markers and anthropometric measurements were also recorded. Muscle strength and physical performance were evaluated by measuring patients' handgrip strength and gait speed respectively., Results: 76.8% of the study sample were severely malnourished and moderately or suspected of being malnourished, while the prevalence of low muscle mass was 49.1%. Age was significantly higher in low SMI patients compared to normal SMI individuals (67.2 ± 9.2 vs 60 ± 10.8, p < 0.001). Albumin was significantly lower in low SMI compared to normal SMI patients, as well as BMI, mid-upper arm circumference, calf circumference and corrected mid arm muscle area. Moreover, malnourished patients exhibited higher rates of low muscle mass (57.8% vs 42.2%, p = 0.022) than well-nourished patients. SMI was also significantly correlated with patients' handgrip strength and gait speed., Conclusions: Low muscle mass is strongly correlated with malnutrition and should be taken into consideration when evaluating the nutritional status of patients with oesophago-gastric cancer., (Copyright © 2019 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.)

Malnourished patients undergoing esophagectomy have increased risk of postoperative complications. The aim of the current study was to identify nutritional and functional risk factors for postoperative complications in patients with esophageal and gastroesophageal junction cancer who underwent esophagectomy. Seventy patients who were admitted at the First Department of Surgery, Laikon General Hospital, Athens, Greece, were included in this study. Laboratory data and data regarding nutritional and functional status were recorded preoperatively. Postoperative complications were graded according to Clavien-Dindo classification. Thirty-seven patients (52.9%) developed postoperative complications. Albumin and Geriatric Nutritional Risk Index (GNRI) levels were lower in patients who developed major complications compared to patients who did not develop postoperative complications (3.90 ± 0.44 vs 4.18 ± 0.37 g/dL, p = 0.014 and 107.40 ± 15.76 vs 114.98 ± 12.26, p = 0.050 respectively). Major complications were associated with higher percentage of weight loss (12.1 ± 11.1 vs 6.2 ± 7.5%, p = 0.019) and with low handgrip strength (80 vs 16.9%, p = 0.006). Albumin (3.93 ± 0.18 vs 4.15 ± 0.41 g/dL, p = 0.019) and low muscle mass (22.6 vs 2.8%, p = 0.016) were significantly associated with anastomotic leakage occurence. The incorporation of patients' nutritional and functional status in the preoperative risk assessment might increase prognostic ability concerning postoperative complications of patients undergoing esophagectomy. [ABSTRACT FROM AUTHOR]

Objective: Disease-related malnutrition is a debilitating condition frequently observed in patients with cancer. The aim of the current study was to prospectively examine postoperative changes in nutritional and functional status of patients undergoing surgery for gastric, esophageal, and gastroesophageal junction cancer. Methods: Participants were prospectively recruited from September 2015 to September 2019. The assessment of malnutrition was based on the Patient-Generated Subjective Global Assessment tool. The functional assessment included the evaluation of muscle strength and physical performance, while muscle mass assessment was based on Skeletal Muscle Mass Index (SMI) derived from the analysis of computed tomography scans. The follow up of patients was scheduled at six months postoperatively. Results: A total of 98 patients were analyzed. Mean patient age was 60.79 ± 10.19 years and 80.6% were males. The mean unintentional weight loss at 6months was 11.7 ± 8.0%. Patients who underwent McKeown esophagectomy reported the greatest weight loss postoperatively (16.2 ± 9.6%), whereas the lowest rate of weight loss was observed in patients who underwent partial gastrectomy (5.6 ± 6.7%). The rate of severe malnutrition declined at six months postoperatively (39.7% vs 27%). Muscle strength and physical performance were significantly deteriorated at 6months postoperatively, except for the group of partial gastrectomy, while SMI significantly decreased in all groups of patients except for McKewon esophagectomy group. Finally, the prevalence of low muscle mass increased significantly from 43.5% in the preoperative period to 66.7% at the follow-up. Conclusions: Our study revealed a significant deterioration in gastroesophageal cancer patient nutritional and functional status at six months postoperatively. The high prevalence of malnutrition and low muscle mass requires systematic follow-up and multidirectional monitoring in order to ensure the successful rehabilitation of these patients. [ABSTRACT FROM AUTHOR]