Nutritional therapy in hospital care of in-patients with Covid-19: evidence, consensus and practice guidelines

Abstract

Objective The objective of this work was to review papers that deal with nutritional therapy of inpatients with Covid-19 from the beginning of the pandemic. The survey covered the period until the month of September 2020. Methods This is a review of the indexed literature (Scopus, Pubmed and Lilacs), including area consensus. Results The review showed that the initial recommendations were based on generic assumptions and, as specific knowledge was being produced, the recommendations became more targeted. Conclusion In the health crisis generated by Covid-19, in the context of uncertainties related to nutritional care procedures, knowledge and action strategies were generated, coordinated by researchers and health professionals.

Long-COVID and Post-COVID Health Complications: An Up-to-Date Review on Clinical Conditions and Their Possible Molecular Mechanisms

“…In addition, this viral infection can lead to destabilization of the liver, which signals a state of maximum alertness for the whole organism, and generates an increase in plasma biochemical markers of tissue aggression produced in response to tissue-damaging agents. Table 2 summarizes all post-and long-term COVID-19 symptoms for each human body system described in this review [6,9,34,50,56,96,99,118,121,122]. Viral infection leads to an aggressive immunological reaction, which directly and indirectly compromises the cardiopulmonary system.…”

“…Gastrointestinal symptoms have been associated with the immune system and changes in intestinal flora, and are related to existing comorbidities in patients affected by the virus [90]. Obesity, old age, diabetes, nutritional diet, and malnutrition are among the factors that can contribute to systemic inflammation and dysfunction of intestinal metabolites [94][95][96].…”

Specific nutrition and metabolic characteristics of critically ill patients with persistent COVID‐19

“…CRRT was used less frequently in patients with COVID‐19 (26.9% vs 13.5% of patients with COVID‐19; P = 0.06). Blood urea levels were significantly higher in the patients with COVID‐19 during the first 10 days vs non‐CO patients—9.6 mmol/L [7.0–14.6] vs 8.6 mmol/L, 4 , 5 , 6 , 12 respectively ( P = 0.012).…”

“…Since the first systematic review by intensivists from Wuhan recommending enteral nutrition (EN) and energy goals of 25–30 kcal/day, 2 several societies, including the European Society for Clinical Nutrition and Metabolism (ESPEN), have attempted to provide guidance with the application of previous general critically ill patients’ recommendations to patients with COVID‐19. 2 , 3 , 4 However, objective data remain limited. Some authors reported unexpected and unprecedented challenges to achieve adequate nutrition with the gastrointestinal (GI) tract's limited tolerance of EN, possibly related to the need for heavy sedation and neuromuscular blockades.…”

A review of natural foods consumed during the COVID-19 pandemic life

“…The number of Covid-19 cases was determined to be 30,000,000 worldwide in September 2020, and the number of deaths on the same date was reported to be over 940,000 [6]. As of February 7, 2021, a total of 106,404,126 laboratory-confirmed cases and 2,321,761 deaths had been documented globally [7].…”