ArticleClinical nutrition (Edinburgh, Scotland)2022
Phase angle and standardized phase angle from bioelectrical impedance measurements as a prognostic factor for mortality at 90 days in patients with COVID-19: A longitudinal cohort study.
Article in Clinical nutrition (Edinburgh, Scotland), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 56 papers, 4 of them syntheses that pooled it.
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Who cites it
56 citing papers in PubMed, 4 syntheses or guidelines pooled it, 80 citations in OpenAlex.
- Prevalence and clinical implications of abnormal body composition phenotypes in patients with COVID-19: a systematic review.The American journal of clinical nutrition · 2023Pooled it
- Phase angle and COVID-19: A systematic review with meta-analysis.Reviews in endocrine & metabolic disorders · 2023Pooled it
- Pooled it
- Association between phase angle and adverse clinical outcomes in hospitalized patients with COVID-19: A systematic review.Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition · 2022Pooled it
- Inflammation Course and Skeletal Muscle Wasting Correlation During the First Week in ICU: A New Approach for Personalised Feeding of Critically Ill Patients?Journal of personalized medicine · 2026Article
- Phase Angle Reference Values Measured Using InBody770 in Japanese Individuals With Normal Fluid Balance.Cureus · 2026Article
- Predictive ability of malnutrition screening tools in enterally fed, mechanically ventilated patients with phase angle inference: A prospective observational study.Journal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures) · 2026Article
- "Muscle quality": rethinking an imprecise term.European geriatric medicine · 2026Review
- Novel insights into phase angle in breast cancer - stage-specific associations between body composition and metabolic age.Reports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology · 2026Article
- Body Composition and Eating Habits in Newly Diagnosed Graves' Disease Patients Compared with Euthyroid Controls.Nutrients · 2025Article
- Nutritional and Physical Rehabilitation in Post-Critical Coronavirus Disease 2019 (COVID-19) Ambulatory Patients: The NutriEcoMuscle Study.Nutrients · 2025Observational
- Phase angle as a predictor of prolonged length of hospital stay and adverse outcomes in elderly medical inpatients: a retrospective cohort study.Frontiers in nutrition · 2025Article
- Phase angle associates with severity and mortality in acute-on-chronic liver failure.Frontiers in medicine · 2025Article
- Bioelectrical Impedance Analysis (BIA) detects body resistance increase in dogs undergoing blood donation.Veterinary research communications · 2024Article
- Article
- Multiparametric Approach to the Colorectal Cancer Phenotypes Integrating Morphofunctional Assessment and Computer Tomography.Cancers · 2024Article
- Article
- Total and segmental phase angle in a cohort of hospitalised patients with COVID-19: mortality prediction and changes throughout hospitalisation.The British journal of nutrition · 2024Article
- Nutritional and Morphofunctional Assessment of Post-ICU Patients with COVID-19 at Hospital Discharge: NutriEcoMuscle Study.Nutrients · 2024Observational
- Gender-Related Effectiveness of Personalized Post-COVID-19 Rehabilitation.Journal of clinical medicine · 2024Article
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Authors and funding
7 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND &
aimsSevere acute COVID-19 has taken on pandemic proportions with growing interest in identification of prognostic factors for mortality. Standardized bioelectrical impedance (BI) phase angle (SPhA), which is PhA adjusted by age and sex, has been related to mortality in patients with several diseases but never investigated in COVID-19. Inflammation, a consequence of COVID-19 infection, affects fluid status (hydration) and can be identified with PhA. The aim of this study was to determine the predictive role of PhA on 90 days survival of adults with COVID-19.
methodsWe studied 127 consecutive patients diagnosed with COVID-19. BI measurements determined with a 50 kHz phase-sensitive BI device, body composition parameters and laboratory markers were evaluated as predictors of mortality.
resultsNon-surviving COVID-19 patients had significantly lower PhA and SPhA values (p < 0.001) and increased hydration (p < 0.001) compared to surviving patients. Patients in the lowest SPhA quartile had increased (p < 0.001) mortality and hospital stay, hyperhydration (p < 0.001), increased inflammation biomarkers [CRP (p < 0.001)], decreased nutritional parameters: body mass cell index [BCMI (p < 0.001) albumin (p < 0.001)], and reduced other biomarkers [D-dimer (p = 0.002)]. Multivariate analysis (Cox regression) revealed that PhA and hydration status, adjusted for age, sex, BMI, diabetes, hypertension, dyslipidaemia or heart disease, were associated (p < 0.001) with increased mortality. The hazard ratio was 2.48 (95% CI, 1.60-3.84, p < 0.001) for PhA and 1.12 (95% CI, 1.04-1.20, p = 0.003) for hydration percentage. PhA <3.95° was the cut-off for predicting mortality in acute COVID-19 with 93.8% sensitivity and 66.7% specificity. PhA offers greater sensitivity as a predictive prognostic test at admission, compared to the established analytical parameters of poor prognosis (CRP, lymphocytes, prealbumin).
conclusionsLow PhA (<3.95°), independent of age, sex, BMI, and comorbidities, is a significant predictor of mortality risk in COVID-19. These findings suggest that the evaluation of body composition with single-frequency phase-sensitive BI measurements should be included in the routine clinical assessment of COVID-19 patients at hospital admission to identify patients at increased mortality risk.
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