Nutritional support protocol for patients with COVID-19

Hinkelmann, Jéssica Viana; Oliveira, Natália; Marcato, Daniela Falcão; Costa, Allana Rúbio Ramos Oliveira; Ferreira, Arícia Mendes; Tomaz, Marcilene; Rodrigues, Thalita Jhennyfer; Mendes, Anangelly Paula

doi:10.1016/j.clnesp.2022.03.002

Cited by 7 publications

(5 citation statements)

References 67 publications

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“…With viral infection, IL-6 production increases, along with macrophage activation syndrome, increasing CRP [47,48]. Highly inflamed individuals have increased nutritional needs, increasing catabolic stress [49]. We believe that there was no association between CC and inflammatory parameters because COVID-19 is an acute disease [35] and may have a low influence on the reduction in muscle mass at the initial moment of the disease.…”

Section: Discussionmentioning

confidence: 96%

Association of Calf Circumference with Clinical and Biochemical Markers in Older Adults with COVID-19 Admitted at Intensive Care Unit: A Retrospective Cross-Sectional Study

Araújo,

Souza,

Giglio

et al. 2024

Diseases

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Background: COVID-19 is an infectious disease characterized by a severe catabolic and inflammatory state, leading to loss of muscle mass. The assessment of muscle mass can be useful to identify nutritional risk and assist in early management, especially in older adults who have high nutritional risks. The aim of this study was to evaluate the association of calf circumference (CC) with clinical and biochemical markers and mortality in older adults with COVID-19 admitted to the intensive care unit (ICU). Methods: A retrospective cross-sectional study was conducted in a public hospital. CC was adjusted for body mass index (BMI), reducing 3, 7, or 12 cm for a BMI of 25–29.9, 30–39.9, and ≥40 kg/m2, respectively, and classified as reduced when <33 cm for women and <34 cm for men. Pearson’s correlation between BMI and CC was performed to assess the association between variables. Regression analysis was adjusted for sex, age, and BMI variables. Cox regression was used to assess survival related to CC. Results: A total of 208 older adults diagnosed with COVID-19 admitted to ICU were included, of which 84% (n = 176) were classified as having reduced CC. These patients were older, with lower BMI, higher nutritional risk, malnourished, and higher concentration of urea and urea–creatinine ratio (UCR) compared with the group with normal CC. There was an association between edematous patients at nutritional risk and malnourished with reduced CC in the Cox regression, either adjusted or not for confounding. Conclusions: CC was not associated with severity, biochemical markers, or mortality in older adults with COVID-19 admitted to the ICU, but it was associated with moderately malnourished patients assessed by subjective global assessment (SGA).

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Section: Discussionmentioning

confidence: 96%

Association of Calf Circumference with Clinical and Biochemical Markers in Older Adults with COVID-19 Admitted at Intensive Care Unit: A Retrospective Cross-Sectional Study

Araújo,

Souza,

Giglio

et al. 2024

Diseases

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“…Furthermore, despite all patients having received nutritional advice to follow after hospital discharge, they were following anti‐inflammatory cortisone therapy from dismission up to 10 days later, which is known to lead to hyperphagia and redistribution of lean mass and fat mass (37). Studies on adults patients, affected by SARS‐CoV‐19, reported that a long stay in the hospital could rise the risk of malnutrition induced by weight loss, reduced appetite, and difficulty in feeding in patients especially those with mechanical ventilation (continuous positive airways pressure mask) (38,39). In children, during the acute phase of MIS‐C, metabolic and fatty acids blood profile alterations were detected (40,41), and long terms effects of malnutrition, such as a loss of lean mass, has been related to SARS‐CoV‐19 severity (8).…”

Section: Discussionmentioning

confidence: 99%

Longitudinal Anthropometry and Body Composition in Children With SARS-CoV-2-Associated Multisystem Inflammatory Syndrome

Profio

Vizzuso

Fiore

et al. 2023

Journal of Pediatric Gastroenterology &Amp; Nutrition

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Objectives: Acute coronavirus disease 2019 infection has been shown to negatively affect body composition among adult and malnourished or obesity children. Our aim is to longitudinally evaluate body composition in children affected by the Multisystem Inflammatory Syndrome (MIS-C). Methods: In this cohort study, we recruited 40 patients affected by MIS-C, aged 2–18 years old, who were admitted in our clinic between December 2020 and February 2021. Physical examination for each participant included weight, height, body mass index (BMI) z score, circumferences, and skinfolds assessment. The same measurements were repeated during outpatient follow-up at 10 (T2), 30 (T3), 90 (T4), and 180 (T5) days after hospital discharge. Fat mass and fat free mass were calculated according to skinfolds predictive equations for children and adolescents. A control group was randomly selected among patients attending a pediatric nutritional outpatient clinic. Results: BMI z score significantly decrease between preadmission and hospital discharge. Similarly, arm circumference z score, arm muscular area z score, and arm fat area z score significantly decreased, during hospital stay. Fat mass index (FMI) significantly increased over time, peaking at T3. Fat free mass index decreased during hospitalization. Conclusions: To the best of our knowledge, this is the first study to assess body composition in a numerically large pediatric MIS-C population from acute infection to 6 months after triggering event. FMI and anthropometric parameters linked to fat deposits were significantly higher 6 months after acute event. Thus, limiting physical activity and having sedentary lifestyle may lead to an accumulation of adipose tissue even in healthy children who experienced MIS-C and long hospitalization.

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“…Lactate and blood gas in the critically ill should be monitored daily when starting nutritional therapy to monitor for tissue hypoperfusion. Albumin and CRP should be checked on admission and every 20 days [ 46 ].…”

Section: Refeeding Syndrome and Nutrition Lab Utilizationmentioning

confidence: 99%

COVID, the Gut, and Nutritional Implications

2023

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Purpose of Review The purpose of this review is to provide an overview of the current literature, recommendations, and practice guidelines on the nutritional management of and implications associated with COVID-19 infection. Recent Findings Particular attention should be paid to the screening, prevention, and treatment of malnutrition in critically ill individuals with COVID-19 infection given the significant risk for complications and poor outcomes. Extrapolation of existing literature for the nutritional support in the critically ill patient has demonstrated early enteral nutrition is safe and well-tolerated in patients with severe COVID-19 infection. Summary Futures studies should focus on the long-term nutritional outcomes for patients who have suffered COVID-19 infection, nutritional outcomes/recommendations for special populations with COVID-19, nutritional outcomes based on the current recommendations and guidelines for nutrition therapy, and the role for micronutrient supplementation in COVID-19 infection.

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Nutritional support protocol for patients with COVID-19

Cited by 7 publications

References 67 publications

Association of Calf Circumference with Clinical and Biochemical Markers in Older Adults with COVID-19 Admitted at Intensive Care Unit: A Retrospective Cross-Sectional Study

Association of Calf Circumference with Clinical and Biochemical Markers in Older Adults with COVID-19 Admitted at Intensive Care Unit: A Retrospective Cross-Sectional Study

Longitudinal Anthropometry and Body Composition in Children With SARS-CoV-2-Associated Multisystem Inflammatory Syndrome

COVID, the Gut, and Nutritional Implications

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