Long-term outcomes in critically ill patients who survived COVID-19: The NUTRICOVID observational cohort study

Malnutrition and sarcopenia may last beyond hospital discharge, especially in patients admitted to intensive care units (ICU), having a negative impact on patient recovery and leading to disability, poor quality of life, and additional morbidity. No prior evidence is available for post-ICU managemen...

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Published in:	Clinical nutrition (Edinburgh, Scotland) Vol. 42; no. 10; pp. 2029 - 2035
Main Authors:	Álvarez-Hernández, J., Matía-Martín, P., Cáncer-Minchot, E., Cuerda, C., Sánchez López, I., Gil Martínez, C., Navea Aguilera, C., Velasco, C., Cevallos Peñafiel, V., Maíz Jiménez, M., Moreno, A., González-Sánchez, V., Ramos Carrasco, A., Olivar Roldán, J., Maichle, S., Molina Bahena, B., Palma Milla, S., Galicia, I., Modroño Móstoles, N., Blanca Martínez-Barbeito, M., Mola Reyes, L., Merino Viveros, M., Arhip, L., Del Olmo García, D., Huelves Delgado, M., Gonzalo Montesinos, I., Pelegrina-Cortés, B., Díaz Guardiola, P., Marcuello Foncillas, C., Sampedro-Núñez, M.A., Atienza, E., Hoyas Rodríguez, I., Ramírez Ortiz, M., Morales, A., Valero Zanuy, MaA, Esteban, M.J., Knott, C., Ortiz-Flores, A.E., Gómez Montes, MaP, Ruiz Aguado, M., Montoya Álvarez, T., Sanz Martínez, E., Amengual Galbarte, A., Rodríguez De Codesal, M., Quesada Bellver, B., Pérez-Sádaba, F.J., Lizán, L.
Format:	Journal Article
Language:	English
Published:	Elsevier Ltd 01-10-2023
Subjects:	Coronavirus disease (COVID-19) Functional status Health-related quality of life Intensive care Malnutrition Nutritional therapy Functional status Health-related quality of life Intensive care Malnutrition Coronavirus disease (COVID-19) Nutritional therapy
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Summary:	Malnutrition and sarcopenia may last beyond hospital discharge, especially in patients admitted to intensive care units (ICU), having a negative impact on patient recovery and leading to disability, poor quality of life, and additional morbidity. No prior evidence is available for post-ICU management and follow-up of coronavirus disease 2019 (COVID-19) patients and their long-term evolution. This study reports on the one-year-long evolution of a cohort of COVID-19 survivors after ICU discharge, in terms of nutritional and functional status as well as health-related quality of life (HRQoL). A multicenter, ambispective, observational cohort study (NUTRICOVID study) was conducted in 16 public hospitals located in the Community of Madrid with COVID-19 survivors who were admitted to ICU during the first outbreak. Retrospective and prospective data were collected from hospital admission to one year after discharge. At hospital discharge and at 3, 6 and 12 months post-discharge, the following outcomes were recorded: weight, risk of malnutrition (MUST) and sarcopenia (SARC-F), medical nutrition therapy (MNT), functional status (Barthel index), and HRQoL (EQ-5D-5L). A total of 199 patients (70.4% male, mean age [SD] of 60.7 [10.1]) were included in the study. At hospital discharge, mean weight loss was 16.4% (8.0%), whereas most patients gained weight after discharge with an increase of 16.5% (14.0%) at 12 months. The proportion of patients at high risk of malnutrition decreased from 83.2% at hospital discharge to 2.1% at 12 months. The proportion at risk of sarcopenia decreased from 86.9% at hospital discharge to 13.4% at 12 months. At hospital discharge, 69 patients received MNT by means of oral nutritional supplements (ONS) while two patients required enteral nutrition (EN). At 12 months, only 12 patients continued taking ONS, with no patients taking EN. Regarding functional status, 72.9% of patients were moderately or severely dependent at hospital discharge, whereas 87.2% showed low dependency or independency after 12 months. The EQ-VAS values increased from hospital discharge (39 [21.2]) to 6 months post-discharge and remained steady up to 12 months (72.7 [19.0]). The mean health value improved from hospital discharge (0.25 [0.41]) to 6 months post-discharge (0.80 [0.24]) and was maintained thereafter. Patients’ nutritional and functional impairment at hospital discharge was high, with high dependency status and low HRQoL; however, their situation improved progressively during the 12 months following hospital discharge. Nevertheless, there is a need to define early strategies to optimize the nutritional and functional recovery of COVID-19 patients.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Undefined-3
ISSN:	0261-5614 1532-1983
DOI:	10.1016/j.clnu.2023.08.008