Nutritional Support and Clinical Outcome of Severe and Critical Patients With COVID-19 Pneumonia

Yue, Xiangfeng; Li, Min; Wang, Yu; Zhang, Jing; Wang, Xinyi; Kan, Linwei; Zhang, Xiaojian; Du, Shouying

doi:10.3389/fnut.2020.581679

Cited by 9 publications

(8 citation statements)

References 25 publications

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“…Nevertheless, in their study, the level of energy intake was considerably beyond that delivered to the patients in the current study. In comparison with other studies on critically ill settings, in which protein and energy cutoffs were more than in the present study, these cutoff values were lower (22,23), which is consistent with a few of the same studies on patients with COVID-19. Thus, it is obvious that even negligible differences between these little intakes could significantly alter the hazard of mortality.…”

Section: Discussionsupporting

confidence: 93%

“…These values reached 67.8 and 81.5% target estimated requirements in the late acute phase. Additionally, Yue et al ( 23 ) reported the average of 15.3 kcal/kg/day for actual energy intake and 0.62 g/kg/day for actual protein intake in critically ill patients with COVID-19 for duration of 7 days. The results of our study are closely consistent with these mentioned studies.…”

Section: Discussionmentioning

confidence: 99%

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Protein and Energy Intake Assessment and Their Association With In-Hospital Mortality in Critically Ill COVID-19 Patients: A Prospective Cohort Study

Hajimohammadebrahim-Ketabforoush

Shariatpanahi

Shahbazi

2021

Front. Nutr.

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Background and Aim: It is partially known that nutritional intake could alleviate proteolysis and course of disease severity in patients with COVID-19; however, not enough data are available in this regard. The present study aimed to assess protein and energy intake and their association with in-hospital mortality in critically ill COVID-19 patients.Methods: A total of 126 patients with COVID-19, who were critically ill, ≥5 days and a subset of 111 patients in ICU ≥10 days completed the present prospective observational cohort study.Results: Protein and energy intakes on Day 5 of ICU admission in survivors were 46 and 58% of target values, respectively. These values in non-survivors were 42 and 50% of target values, respectively (p < 0.05). In the sample ≥10 days, protein and energy intakes in survivors reached 64 and 87% of target values, respectively, without statistically significant differences with non-survivors. In the sample ≥5 days, Cox proportional hazard regression was adjusted for GLIM, APACHE II, comorbidity, and age; the results indicated that the patients with protein and energy intake lower than 0.59 g/kg/day and 14 kcal/kg/day, had ~2-fold mortality hazard (protein: HR, 2.38; 95% CI, 1.40–4.03; P = 0.001 and energy: HR, 2.23; 95% CI, 1.27–3.92; P = 0.005).Conclusion: Actual protein and energy intakes in critically ill patients with COVID-19 are in suboptimal levels compared with goal recommendations in these patients. Moreover, higher amounts of protein and energy intakes in the early acute phase were significantly associated with better survival and lower risk of in-hospital mortality.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Protein and Energy Intake Assessment and Their Association With In-Hospital Mortality in Critically Ill COVID-19 Patients: A Prospective Cohort Study

Hajimohammadebrahim-Ketabforoush

Shariatpanahi

Shahbazi

2021

Front. Nutr.

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“…A small retrospective study conducted in severe and critically ill Covid-19 patients in China reported that permissive under feeding is feasible in critically ill Covid-19 patients. 25 Interestingly, the LEEP Covid study reported that measured REE in critically ill Covid-19 patients were at the range of 15-20 kcal/kgBW during the first week, therefore, our study result was in line with LEEP Covid study. 5 Bivariate analysis found that variables which significantly associated with energy target achievement of 20 kcal/kgBW were mNUTRIC score, the use of mechanical ventilator, lactate level and route of nutrition were.…”

Section: Discussionsupporting

confidence: 88%

Energy target achievement and its determinants in critically ill COVID-19 patients in Indonesia

Puruhita

Christianto²,

Sutanto

et al. 2021

World Nutr J

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Introduction. Achievement of energy target in critically ill Covid-19 patients in Intensive Care Unit (ICU) is challenging. This study was aimed to depict the possibility of achieving energy target and its determinants in critically ill Covid-19 patients. Methods. A cross sectional study was conducted in ICU of dr. Kariadi Hospital Semarang, Indonesia. Secondary data were obtained from Covid-19 patients who were in ICU for minimum 3 days, from March to December 2020. Data collected included age, sex, Body Mass Index (BMI), comorbidities, Modified Nutrition Risk in Critically Ill (mNUTRIC) score, energy intake, route of nutrition delivery (enteral or combination of enteral and parenteral nutrition), lactate status, ICU length of stay (LOS), duration of mechanical ventilator and mortality. Risk Prevalence calculations were conducted to measure risks. Variables with significant associations and p< 0.25 were included in multiple logistic regression. Results. A total of 188 subjects were included in the analysis. Most patients were male (62.8%) and obese (61.8%). As much as 56.9% patients were able to achieve energy target of 20 kcal/kgBW on day 3 of ICU stay. Those with low risk mNUTRIC score and nutrition delivery was through enteral and parenteral route were more likely to achieve target energy of 20 kcal/kgBW in the first 3 days in the ICU. Conclusions. Achieving energy target of 20 kcal on day 3 of ICU stay for critically ill Covid-19 patients is feasible. Low mNutric score and nutrition delivery through enteral and parenteral route were two determinants for the achievement.

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“…Hence, the lack of nutrition knowledge among Indonesian participants can likely be explained by differences in the institutional structures of the healthcare systems. Nutritional support is an integral part of COVID-19 treatment, especially in those who are critically ill [29]. Managing nutritional support in critically ill patients requires specific knowledge and skills to prevent poor clinical outcomes [30].…”

Section: Discussionmentioning

confidence: 99%

Adherence to COVID-19 nutritional guidelines and their impact on the clinical outcomes of hospitalized COVID-19 patients

Nguyen

Irnandi

et al. 2021

Clinical Nutrition ESPEN

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Background & Aims Coronavirus disease 2019 (COVID-19) patients are at high risk of malnutrition, and their doctors are part of a multidisciplinary team, including nutritionists. However, adherence to nutritional guidelines may be difficult in the context of capacity constraints during the COVID-19 pandemic. The aim of this study was to investigate barriers to doctors’ adherence to nutritional guidelines and the impacts of guideline adherence on the outcomes of hospitalized COVID-19 patients. Methods A multinational electronic survey involving 51 doctors was conducted between November 2020 and January 2021 from 17 COVID-19-designated hospitals in countries with high (Indonesia) and low (Vietnam) numbers of confirmed COVID-19 cases. Results In general, doctors reported concerns related to nutritional practices in patients with Covid-19 which included feeling stress when performing medical nutritional therapy (65%), lacking self-efficacy or confidence in performing nutritional care (49%), lacking clear nutritional guidelines (45%), and experiencing budget limitations (33%). A regression analysis adjusted for age, country, and the number of hospitalized COVID-19 cases revealed that guideline knowledge (ß: -1.01 (-1.78, -0.23); p=0.012) and awareness of guidelines (ß: -1.37 (-2.66, -0.09); p=0.037) were negatively correlated with the length of stay of critically ill COVID-19 patients, but non-significant after adjusting for specialization of the doctor. When stratified according to country, a significant relationship between guideline adherence and length of stay of critically ill patients was only found in Vietnam [guideline adherence: ß: -0.55 (-1.08, -0.03); p=0.038; guideline knowledge: ß: -1.01 (-1.9, -0.13); p=0.027] after adjusting for age, specialty, and number of hospitalized COVID-19 cases. In Indonesia, the significant relationship between guideline adherence and mortality of COVID-19 patients remained strong (ß: -14 (-27, -1); p=0.033) after adjusting for age, specialty, and number of hospitalized COVID-19 cases Conclusions Inadequate nutritional knowledge is a key barrier to guideline adherence, and this was international and may be related to doctors’ specialties and the COVID-19 pandemic. Adherence to nutritional guidelines may represent a prognostic factor for survival in COVID-19 patients.

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Nutritional Support and Clinical Outcome of Severe and Critical Patients With COVID-19 Pneumonia

Cited by 9 publications

References 25 publications

Protein and Energy Intake Assessment and Their Association With In-Hospital Mortality in Critically Ill COVID-19 Patients: A Prospective Cohort Study

Protein and Energy Intake Assessment and Their Association With In-Hospital Mortality in Critically Ill COVID-19 Patients: A Prospective Cohort Study

Energy target achievement and its determinants in critically ill COVID-19 patients in Indonesia

Adherence to COVID-19 nutritional guidelines and their impact on the clinical outcomes of hospitalized COVID-19 patients

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