Impact of COVID-19 in nutritional and functional status of survivors admitted in intensive care units during the first outbreak. Preliminary results of the NUTRICOVID study

Abstract

Background & aims: COVID-19 patients present a high hospitalization rate with a high mortality risk for those requiring intensive care. When these patients have other comorbid conditions and older age, the risk for severe disease and poor outcomes after ICU admission are increased. The present work aims to describe the preliminary results of the ongoing NUTRICOVID study about the nutritional and functional status and the quality of life of adult COVID-19 survivors after ICU discharge, emphasizing the in-hospital and discharge situation of this population. Methods: A multicenter, ambispective, observational cohort study was conducted in 16 public hospitals of the Community of Madrid with COVID-19 survivors who were admitted to the ICU during the first outbreak. Preliminary results of this study include data retrospectively collected. Malnutrition and sarcopenia were screened at discharge using MUST and SARC-F; the use of healthcare resources was measured as the length of hospital stay and requirement of respiratory support and tracheostomy during hospitalization; other study variables were the need for medical nutrition therapy (MNT); and patients' functional status (Barthel index) and health-related quality of life (EQ-5D-5L). Results: A total of 176 patients were included in this preliminary analysis. Most patients were male and older than 60 years, who suffered an average (SD) weight loss of 16.6% (8.3%) during the hospital stay, with a median length of stay of 53 (27e89.5) days and a median ICU stay of 24.5 (11e43.5) days. At discharge, 83.5% and 86.9% of the patients were at risk of malnutrition and sarcopenia, respectively, but only 38% were prescribed MNT. In addition, more than 70% of patients had significant impairment of their mobility and to conduct their usual activities at hospital discharge. Conclusions: This preliminary analysis evidences the high nutritional and functional impairment of COVID-19 survivors at hospital discharge and highlights the need for guidelines and systematic protocols, together with appropriate rehabilitation programs, to optimize the nutritional management of these patients after discharge.

Prevalence of Sarcopenia in Patients With COVID-19: A Systematic Review and Meta-Analysis

“…Among the 2 studies conducted in Spain (41,44), the pooled prevalence of sarcopenia was 89.1% (95% CI: 86.3 to 91.7%, k = 2, I 2 = 15.4%, p = 0.277). The prevalence in the 4 Italy studies (25, 30, 50, 51) was 49.2% (95% CI: 33.6 to 65.0%, k = 4, I 2 = 91.17%, p = 0.000).…”

“…For sarcopenia assessment methods, five studies (26,30,33,42,47) (32,50) and BIA (48,51), which were used by two studies each and yielded a pooled prevalence of 26.7 (95% CI: 23.2 to 30.5%, k = 2, I 2 = 98.90%, p = 0.000) and 0.4% (95% CI: 0.1 to 0.8%, k = 2, I 2 = 97.70%, p = 0.000), respectively. For parameters used to measure sarcopenia, seven studies used skeletal muscle index (SMI) with a pooled prevalence of 49.0% (95% CI: 31.3 to 66.9%, k = 7, I 2 = 97.03%, p = 0.000) (25,29,33,42,47,52,53), 4 studies used SARF-score with a prevalence of 73% (95% CI: 49.3 to 91.3%, k = 4, I 2 = 98.00%, p = 0.000) (31,41,44,45), and two studies used HGS with a prevalence of 26.7% (95% CI: 23.2 to 30.5%, k = 2, I 2 = 98.90%, p = 0.000) (32,50). The subgroup meta-analysis result of parameters used in the remaining studies is shown in Table 3 and Supplementary Figure 6.…”

Investigation in clinical nutrition and generation of new evidence: the NutriCOVer program

“…En el mes de noviembre lo haremos en el congreso de la propia SENDIMAD, que le dedicará un espacio en una mesa redonda. Además, ya está aceptado un artículo en Clinical Nutrition con datos preliminares (6).…”

The relevance of nutritional and metabolic derangements in COVID-19 patients

“…Finally, recent preliminary data have shown a high percentage of malnutrition also among patients who survived at COVID-19 [7] , highlighting the clinical relevance of poor nutritional status not only at baseline, conditioning patients outcomes during ICU stay, but also developed during hospital stay, suggesting the urgent need for clear nutritional therapeutic interventions in this setting.…”