ASPEN Report on Nutrition Support Practice Processes With COVID‐19: The First Response

Mulherin, Diana Wells; Walker, Renee; Holcombe, Beverly; Guenter, Peggi

doi:10.1002/ncp.10553

Cited by 33 publications

(54 citation statements)

References 10 publications

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“…Thus, knowledge gaps are addressed with articles based on theory, experience, prior evidence for extrapolation, and judgment, especially white papers and those in the gray literature. ASPEN 20,75 and the European Society for Clinical Nutrition and Metabolism 76 have already published reports on nutrition management with COVID‐19, with a follow‐up review by Minnelli et al, 77 but it is the strategic planning of nutrition studies to generate original, high‐quality data to close research gaps, which can efficiently advance knowledge and promote optimal, evidence‐based, comprehensive care.…”

Section: Discussionmentioning

confidence: 99%

Clinical Nutrition Research and the COVID‐19 Pandemic: A Scoping Review of the ASPEN COVID‐19 Task Force on Nutrition Research

Mechanick

Carbone

Dickerson

et al. 2020

J Parenter Enteral Nutr

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The purpose of this scoping review by the American Society for Parenteral and Enteral Nutrition (ASPEN) Coronavirus Disease 2019 (COVID‐19) Nutrition Task Force was to examine nutrition research applicable to the COVID‐19 pandemic. The rapid pace of emerging scientific information has prompted this activity to discover research/knowledge gaps. This methodology adhered with recommendations from the Joanna Briggs Institute. There were 2301 citations imported. Of these, there were 439 articles fully abstracted, with 23 main topic areas identified across 24 article types and sourced across 61 countries and 51 specialties in 8 settings and among 14 populations. Epidemiological/mechanistic relationships between nutrition and COVID‐19 were reviewed and results mapped to the Population, Intervention, Comparator, Outcome, and Time (PICO‐T) questions. The aggregated data were analyzed by clinical stage: pre–COVID‐19, acute COVID‐19, and chronic/post–COVID‐19. Research gaps were discovered for all PICO‐T questions. Nutrition topics meriting urgent research included food insecurity/societal infrastructure and transcultural factors (pre–COVID‐19); cardiometabolic‐based chronic disease, pediatrics, nutrition support, and hospital infrastructure (acute COVID‐19); registered dietitian nutritionist counseling (chronic/post–COVID‐19); and malnutrition and management (all stages). The paucity of randomized controlled trials (RCTs) was particularly glaring. Knowledge gaps were discovered for PICO‐T questions on pediatrics, micronutrients, bariatric surgery, and transcultural factors (pre–COVID‐19); enteral nutrition, protein‐energy requirements, and glycemic control with nutrition (acute COVID‐19); and home enteral and parenteral nutrition support (chronic/post–COVID‐19). In conclusion, multiple critical areas for urgent nutrition research were identified, particularly using RCT design, to improve nutrition care for patients before, during, and after COVID‐19.

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Section: Discussionmentioning

confidence: 99%

Clinical Nutrition Research and the COVID‐19 Pandemic: A Scoping Review of the ASPEN COVID‐19 Task Force on Nutrition Research

Mechanick

Carbone

Dickerson

et al. 2020

J Parenter Enteral Nutr

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“…Bolus feeding, however, is neither recommended nor feasible in COVID-19 patients, according to the ASPEN guidelines. 27,45 Protein is one of the most important macronutrients to meet the nutrition need of critically ill patients (both COVID-19 and non-COVID-19). At our center, we frequently used modular for our patients (with a composition of 15 g per 30 mL protein modular).…”

Section: Strategies For Nutrition Support Allocation During the Covidmentioning

confidence: 99%

Challenges of Maintaining Optimal Nutrition Status in COVID‐19 Patients in Intensive Care Settings

Minnelli

Gibbs

Larrivee

et al. 2020

J Parenter Enteral Nutr

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The coronavirus disease 2019 (COVID-19) pandemic has threatened patients, healthcare systems, and all countries across the globe with unprecedented challenges and uncertainties. According to the latest literature, most patients with COVID-19 have mild symptoms that do not require hospital admissions, and only a small percentage of those hospitalized require intensive care. In the intensive care unit (ICU), a registered dietitian nutritionist (RDN) assists the critical care team by formulating, executing, and monitoring the nutrition strategies and interventions to meet the unique requirements of extremely sick patients. However, because of the novelty of COVID-19, the situation is fluid and guidelines continue to be developed and updated. This article discusses the interim guidelines available for the nutrition support of ICU COVID-19 patients and the challenges the critical care team and RDN may face from a nutrition standpoint.

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“…The documents reviewed indicated that if physical assessments of weight and height are not possible due to COVID-adapted ways of working, recalled and subjective measurements could be used as part of “MUST” [ 1 , 5 , 12 ]. Use of technology was also indicated to aid remote consultations and support screening [ 1 , 6 , 7 , 8 , 9 , 14 , 16 ]. Both BAPEN and the BDA highlighted that virtual consultations can gain useful and valid information to enable screening for malnutrition risk [ 5 , 12 ].…”

Section: Resultsmentioning

confidence: 99%

“…Upon hospital discharge, it appears uncommon for enteral tube feeding to continue in patients with COVID-19 into the community unless there is dysphagia or neurological dysfunction [ 3 ]. The NNG and ASPEN detailed some of the logistics involved in discharging a patient home on an enteral feed [ 11 , 16 ]. Most of the guidelines within our search timeframe were about the safety and practice of different methods of tube placement (nasogastric, gastrostomy, categorisation as aerosol generating procedures) in patients with COVID-19 and these were beyond the scope of this review.…”

Section: Resultsmentioning

confidence: 99%

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A Review of Nutrition Support Guidelines for Individuals with or Recovering from COVID-19 in the Community

et al. 2020

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COVID-19 negatively impacts nutritional status and as such identification of nutritional risk and consideration of the need for nutrition support should be fundamental in this patient group. In recent months, clinical nutrition professional organisations across the world have published nutrition support recommendations for health care professionals. This review summarises key themes of those publications linked to nutrition support of adults with or recovering from COVID-19 outside of hospital. Using our search criteria, 15 publications were identified from electronic databases and websites of clinical nutrition professional organisations, worldwide up to 19th June 2020. The key themes across these publications included the importance in the community setting of: (i) screening for malnutrition, which can be achieved by remote consultation; (ii) care plans with appropriate nutrition support, which may include food based strategies, oral nutritional supplements and referral to a dietitian; (iii) continuity of nutritional care between settings including rapid communication at discharge of malnutrition risk and requirements for ongoing nutrition support. These themes, and indeed the importance of nutritional care, are fundamental and should be integrated into pathways for the rehabilitation of patients recovering from COVID-19.

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ASPEN Report on Nutrition Support Practice Processes With COVID‐19: The First Response

Cited by 33 publications

References 10 publications

Clinical Nutrition Research and the COVID‐19 Pandemic: A Scoping Review of the ASPEN COVID‐19 Task Force on Nutrition Research

Clinical Nutrition Research and the COVID‐19 Pandemic: A Scoping Review of the ASPEN COVID‐19 Task Force on Nutrition Research

Challenges of Maintaining Optimal Nutrition Status in COVID‐19 Patients in Intensive Care Settings

A Review of Nutrition Support Guidelines for Individuals with or Recovering from COVID-19 in the Community

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