New Study Explores Hyperinflammatory Nutritional Index in COVID-19 Patients

The HNI aims to capture the relationship between inflammation and nutritional status in COVID-19 patients. CRP levels increase significantly in response to inflammation, while ferritin, which reflects iron storage, can spike in severe cases due to immune response. Conversely, albumin levels tend to drop during inflammation, making it a critical nutritional marker. The composite nature of HNI intends to highlight the burden of both inflammation and nutritional depletion.

In their observational cross-sectional analysis, the researchers evaluated 60 confirmed COVID-19 patients, classifying them into three groups based on care requirements: outpatients, general ward patients, and those in intensive care. They measured various laboratory parameters, including inflammatory markers and cytokines, utilizing previously collected serum samples. Ethical approval for the study was granted, and informed consent was waived since archived specimens were used.

The findings revealed that intensive care patients had significantly higher levels of inflammatory markers, cytokines, β2-microglobulin, and HNI compared to those in lower care levels. This supports existing understanding of severe COVID-19 as associated with heightened immune activity. Notably, HNI demonstrated a high correlation with ferritin (correlation coefficient 0.945), prompting the authors to urge caution in interpretation due to the potential for statistical coupling.

Further evaluations indicated that HNI had an area under the receiver operating characteristic curve of 0.953, suggesting robust diagnostic potential. However, the authors advised caution due to the small sample size and the inherent risks of deriving composite indices from closely related variables.

Ultimately, the authors characterize HNI as an exploratory marker rather than a definitive clinical tool, indicating that while it reflects the combined burden of inflammation and nutritional status, its clinical utility requires further validation in larger cohorts with applicable outcome measures. Additionally, the correlation of β2-microglobulin with HNI aligns with immune activation in severe disease, warranting further investigation.

This study, led by Gülsüm Kaya and including corresponding author Cengiz Karacaer, was published on September 29, 2026, without external funding. It provides a foundational understanding of how simple laboratory measures can potentially track COVID-19 severity, although further research is necessary before adopting HNI as a standard clinical marker.