Malnutrition and nutritional therapy in patients with SARS-CoV-2 disease

Malnutrition and nutritional therapy in patients with SARS-CoV-2 disease

The prevalence of malnutrition and the provided nutritional therapy were evaluated in all the patients with SARS-CoV-2 infection (COVID-19) hospitalized in a 3rd level hospital in Italy. A one-day audit was carried out recording: age, measured or estimated body weight (BW) and height, body mass inde...

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Bibliographic Details
Published in:Clinical nutrition (Edinburgh, Scotland) Vol. 40; no. 3; pp. 1330 - 1337
Main Authors: Pironi, Loris, Sasdelli, Anna Simona, Ravaioli, Federico, Baracco, Bianca, Battaiola, Claudia, Bocedi, Giulia, Brodosi, Lucia, Leoni, Laura, Mari, Giulia Aurora, Musio, Alessandra
Format: Journal Article
Language:English
Published: England Elsevier Ltd 01-03-2021
Elsevier Ltd and European Society for Clinical Nutrition and Metabolism
Subjects:
Aged
Aged, 80 and over
C-Reactive Protein - analysis
Comorbidity
COVID-19
COVID-19 - epidemiology
Cross-Sectional Studies
Dietary Proteins - administration & dosage
Energy Intake
Female
GLIM
Hospitalization
Humans
Intensive Care Units
Italy - epidemiology
Male
Malnutrition
Malnutrition - epidemiology
Malnutrition - therapy
Middle Aged
NRS-2002
Nutrition Assessment
Nutrition Therapy - methods
Nutritional therapy
Original
Risk Factors
SARS-CoV-2
Italy
COVID-19
NRS-2002
GLIM
SARS-CoV-2
Malnutrition
Nutritional therapy
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Summary:The prevalence of malnutrition and the provided nutritional therapy were evaluated in all the patients with SARS-CoV-2 infection (COVID-19) hospitalized in a 3rd level hospital in Italy. A one-day audit was carried out recording: age, measured or estimated body weight (BW) and height, body mass index (BMI, kg/m2), 30-day weight loss (WL), comorbidities, serum albumin and C-reactive protein (CRP: nv < 0.5 mg/dL), hospital diet (HD) intake, oral nutritional supplements (ONS), enteral (EN) and parenteral nutrition (PN). Modified NRS-2002 tool and GLIM criteria were used for nutritional risk screening and for the diagnosis of malnutrition, respectively. A total of 268 patients was evaluated; intermediate care units (IMCUs, 61%), sub-intensive care units (SICUs, 8%), intensive care units (ICUs, 17%) and rehabilitation units (RUs, 14%): BMI: <18.5, 9% (higher in RUs, p = 0.008) and ≥30, 13% (higher in ICUs, p = 0.012); WL ≥ 5%, 52% (higher in ICUs and RUs, p = 0.001); CRP >0.5: 78% (higher in ICUs and lower in RUs, p < 0.001); Nutritional risk and malnutrition were present in 77% (higher in ICUs and RUs, p < 0.001) and 50% (higher in ICUs, p = 0.0792) of the patients, respectively. HD intake ≤50%, 39% (higher in IMCUs and ICUs, p < 0.001); ONS, EN and PN were prescribed to 6%, 13% and 5%, respectively. Median energy and protein intake/kg BW were 25 kcal and 1.1 g (both lower in ICUs, p < 0.05) respectively. Most of the patients were at nutritional risk, and one-half of them was malnourished. The frequency of nutritional risk, malnutrition, disease/inflammation burden and decrease intake of HD differed among the intensity of care settings, where the patients were managed according to the severity of the disease. The patient energy and protein intake were at the lowest limit or below the recommended amounts, indicating the need for actions to improve the nutritional care practice.
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ISSN:0261-5614
1532-1983
DOI:10.1016/j.clnu.2020.08.021