A modified nutrition risk screening 2002 predicts the risk of death among hospitalized patients with COVID-19.

OBJECTIVES: The aim of this study was to evaluate the ability of a modified Nutrition Risk Screening 2002 (modified NRS) compared with other nutrition screening tools such as NRS 2002, Mini Nutrition Assessment Short Form (MNA-SF), and Malnutrition Universal Screening Tool (MUST) on predicting the risk of death in patients with coronavirus disease 2019 (COVID-19). METHODS: We retrospectively collected data of patients who were admitted to the West campus of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology between January 25th, 2020 to April 24th, 2020. The nutritional status of the patients was assessed by modified NRS, NRS 2002, MNA-SF, and MUST. According to the score of modified NRS, patients were divided into malnutrition risk group (score ≥3) and normal nutrition group (score <3). Clinical characteristics were compared between the two groups. Kaplan meier survival curve was used to analyze the difference of compositing survival rate between the two groups. The predictive efficacy of different nutritional scales on the outcome of death was detected by Receiver operating characteristic (ROC) analysis. RESULTS: The modified NRS, NRS 2002, MNA-SF, and MUST identified malnutrition risk in 71.4%, 57.9%, 73.9%, and 43.4% of the patients, respectively. The patients were divided into malnutrition risk group and normal nutrition group by modified NRS score. Patients in the malnutrition risk group were older (65 y vs. 56 y) and with more severe and critical cases (42.30% vs. 5.20%) and diabetes cases (21.50% vs. 9.80%), worse prognosis (death of 13.80% vs. 0.50%), longer hospital stay (29 days vs. 23 days), lower albumin (31.85 g/L vs. 38.55 g/L) and prealbumin (201.95 mg/L vs. 280.25 mg/L) compared with the normal nutrition group (P were <0.001, respectively). There were more patients with chronic respiratory disease in malnutrition risk group (9.70 vs. 2.10%, P = 0.001). BMI was lower in malnutrition risk group (23.45 kg/m2vs. 24.15 kg/m2, P = 0.017). Kaplan meier survival curve demonstrated that the survival of malnutrition risk group was significantly lower than normal nutrition group (P < 0.001). The area under the ROC curve (AUC) of the modified NRS scale (0.895) outperformed NRS 2002 (0.758), MNA-SF (0.688), and MUST (0.485). The former three scales could predict the risk of death (P were < 0.001), while MUST could not (P = 0.690). CONCLUSIONS: Patients with COVID-19 at risk of malnutrition have a worse prognosis than those with normal nutrition. The modified NRS scale could effectively predict the risk of death among patients with COVID-19.

The in vitro antimicrobial activities of four endodontic sealers.

BACKGROUND: The purpose of this study was to investigate the antimicrobial activities of four endodontic sealers (GuttaFlow2, AH Plus, ProRoot MTA and RealSeal) against E. feacalis, E.coli and C.albicans. METHODS: The antimicrobial activities of four endodontic sealers were assessed by both agar diffusion test (ADT) and direct contact test (DCT) in this study. In ADT, the results were reported as the diameter of the growth inhibition zone. Both fresh and 1-day-setting sealers were measured. In DCT, microorganisms in suspension were exposed to the sealers for 10, 30 and 60 min and the survival of microorganisms were determined after exposure at different time points(after mixing, 1 and 7 days). The number of colony-forming unit (CFU) was counted. The results were analyzed with ANOVA and Tukey tests. RESULTS: Both ADT and DCT results showed that Guttaflow2 presented no effect against any tested microorganisms. In ADT, fresh RealSeal had the largest inhibition zone against all tested microbes, followed by AH Plus and ProRoot MTA. ProRoot MTA demonstrated inhibition zones against all the three test microbes after setting for 1 day, while the other three sealers showed no inhibition activity. In DCT, fresh AH Plus had the strongest antimicrobial effects against all the three tested microorganisms for every contact times, while its antimicrobial activity diminished significantly with time. Fresh RealSeal and ProRoot MTA also showed strong antimicrobial effect and still showed antimicrobial effect after 1-day-setting. The antibacterial effects of RealSeal against E. faecalis and antifungal effect of ProRoot MTA were observed after 7 days of setting. CONCLUSIONS: GuttaFlow2 had no antimicrobial activity. Freshly mixed RealSeal and AH Plus demonstrated strong antimicrobial effects. RealSeal showed antimicrobial effects after setting in DCT. ProRoot MTA showed high antimicrobial activity and exhibited anti-inflammation potentials after setting.