Nutrition delivery across hospitalisation in critically ill patients with COVID-19: An observational study of the Australian experience

• Published in: Australian critical care Vol. 37; no. 3; pp. 422 - 428
• Main Authors: Chapple, Lee-anne S., Ridley, Emma J., Ainscough, Kate, Ballantyne, Lauren, Burrell, Aidan, Campbell, Lewis, Dux, Claire, Ferrie, Suzie, Fetterplace, Kate, Fox, Virginia, Jamei, Matin, King, Victoria, Serpa Neto, Ary, Nichol, Alistair, Osland, Emma, Paul, Eldho, Summers, Matthew J., Marshall, Andrea P., Udy, Andrew
• Format: Journal Article
• Language: English
• Published: Australia Elsevier Ltd 01-05-2024
• Subjects: Adult; Aged; Australia; COVID-19; COVID-19 Testing; Critical Illness; Energy Intake; Female; Hospitalization; Humans; Intensive care; Intensive Care Units; Length of Stay; Male; Middle Aged; Nutrition; Pandemics; Australia; COVID-19; Critical illness; Intensive care; Nutrition
• ISSN: 1036-7314; 1878-1721
• DOI: 10.1016/j.aucc.2023.05.001

Data on nutrition delivery over the whole hospital admission in critically ill patients with COVID-19 are scarce, particularly in the Australian setting.
The objective of this study was to describe nutrition delivery in critically ill patients admitted to Australian intensive care units (ICUs) with coronavirus disease 2019 (COVID-19), with a focus on post-ICU nutrition practices.
A multicentre observational study conducted at nine sites included adult patients with a positive COVID-19 diagnosis admitted to the ICU for >24 h and discharged to an acute ward over a 12-month recruitment period from 1 March 2020. Data were extracted on baseline characteristics and clinical outcomes. Nutrition practice data from the ICU and weekly in the post-ICU ward (up to week four) included route of feeding, presence of nutrition-impacting symptoms, and nutrition support received.
A total of 103 patients were included (71% male, age: 58 ± 14 years, body mass index: 30±7 kg/m2), of whom 41.7% (n = 43) received mechanical ventilation within 14 days of ICU admission. While oral nutrition was received by more patients at any time point in the ICU (n = 93, 91.2% of patients) than enteral nutrition (EN) (n = 43, 42.2%) or parenteral nutrition (PN) (n = 2, 2.0%), EN was delivered for a greater duration of time (69.6% feeding days) than oral and PN (29.7% and 0.7%, respectively). More patients received oral intake than the other modes in the post-ICU ward (n = 95, 95.0%), and 40.0% (n = 38/95) of patients were receiving oral nutrition supplements. In the week after ICU discharge, 51.0% of patients (n = 51) had at least one nutrition-impacting symptom, most commonly a reduced appetite (n = 25; 24.5%) or dysphagia (n = 16; 15.7%).
Critically ill patients during the COVID-19 pandemic in Australia were more likely to receive oral nutrition than artificial nutrition support at any time point both in the ICU and in the post-ICU ward, whereas EN was provided for a greater duration when it was prescribed. Nutrition-impacting symptoms were common.