Home medical nutrition during SARS-CoV-2 pandemic – A position paper

Matras, Przemysław; Kłęk, Stanisław; Folwarski, Marcin; Zmarzły, Anna; Bartoszewska, Lidia; Cebulski, Włodzimierz; Jakubczyk, Marlena; Kamocki, Zbigniew; Klepczyk, Katarzyna; Kunecki, Marek; Ławiński, Michał; Majewska, K.; Matczuk, Maciej; Matysiak-Luśnia, Katarzyna; Sadowski, Maciej; Sobocki, Jacek; Sumlet, M.; Szafrański, Waldemar; Szczepanek, Kinga; Urbanowicz, Krystyna; Zoubek-Wójcik, Agata

doi:10.1016/j.clnesp.2020.05.002

Cited by 10 publications

(12 citation statements)

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“…The need for established strategies for patients’ discharge from the hospital and transfer to the IF unit is underlined [ 17 , 18 ]. Those recommendations are similar to the position paper proposed by the Polish expert group concerning principles of home nutrition during a pandemic [19] .…”

Section: Introductionsupporting

confidence: 61%

“…Considering the rapid growth of the number of HPN patients it can help with the demand of trained medical staff reducing the need for hospital attendance of patients, traveled miles to maximize the high satisfaction from medical care [17] . Other studies confirm that telehealth may be effective and cost-saving [ 18 , 19 ]. Singapore experience shows that the development of IT solutions may enable safe PN and remote monitoring in a hospital setting [20] .…”

Section: Discussionmentioning

confidence: 86%

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Organizational issues of home parenteral nutrition during COVID-19 pandemic: Results from multicenter, nationwide study

et al. 2021

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Objectives Patients on home parenteral nutrition (HPN) are prone to severe complications of SARS-COV-2 infection. The pandemic requires adaptation of the health care standards, including epidemiological surveillance, logistics of home supply and monitoring. Potential lack of medical professionals may worsen the standard of care. The aim of the analysis was to evaluate the medical staff resources in HPN units. Results The study was conducted by major Polish scientific societies in clinical nutrition. A questionnaire was distributed among all Polish adult HPN centers concerning statistics from the first three months of the pandemic (March-May 2020). Data on medical staff resources and organizational issues of the units were collected. Modifications of the home procedures, SARS-CoV-2 infection rates of HPN patients and health care workers (HCW) were analyzed. Influence of the pandemic on the rates of new qualifications for HAN (home artificial nutrition) was estimated. 14 of 17 adult Polish HPN units took part in the study. The point prevalence of HPN in Poland was 30.75 per million citizens. 344 HCW are involved in patients’ care in Polish HPN units; 18.9% are physicians (49%-surgeons, 18.46%-internal medicine specialists, 15.38%-Anesthesiologists, 7.69%-Pediatricians, 1.54%- Palliative care specialists), 32.27% nurses, 5.23% dietitians, 9.01% pharmacists, 4.94% pharmacy technicians, 3.2% pharmacy assistants, 5.81% administrative workers, 3.49% physiotherapists. HAN Patient to HCW ratios for physicians, nurses, pharmacists, dietitians were respectively: 49.5; 29.15; 111.6; 181.6. Medium age of physicians and nurses was: 45.6 and 44.15. 53.8% of physicians and 31.53% of nurses work parallelly in hospital wards. 31 Pharmacists overall are working in all HPN units (2.21 per unit) and 18 dietitians (1.3 per unit). 9 patients had a confirmed COVID-19 infection (4- HPN, 5-HEN). All the units introduced telemedical solutions in the first months of the pandemic. The number of new qualifications for HPN and HEN in the units did not significantly decline in March-May in comparison with a similar period in 2019. Conclusions A shortage of HPN medical professionals requires attention when planning health care organization, especially during a pandemic. Severe restrictions in public health system may not reduce the number of new qualifications for the HPN procedure. There is a need for the continuation of data collection during the evolution of the pandemic as it may have a detrimental impact on HPN including serious issues with access to professional HCW.

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Section: Introductionsupporting

confidence: 61%

Section: Discussionmentioning

confidence: 86%

Organizational issues of home parenteral nutrition during COVID-19 pandemic: Results from multicenter, nationwide study

et al. 2021

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“…Nutrition‐related risk factors are aggravated by quarantine and lockdown (limiting access to nutritious, safe, and affordable foods), interruptions in nutrition support services, increased unemployment with limited financial resources, inaccessible school meals for vulnerable children, more sedentary lifestyles, and higher consumption of unhealthy foods 30,67 . Patients with chronic/post–COVID‐19 may require long‐term EN or PN in skilled facilities or the home setting 68 . Others are likely to require medical nutrition therapy to address underlying malnutrition and/or manage preexisting or newly developed comorbidities 36 .…”

Section: Introductionmentioning

confidence: 99%

“…30,67 Patients with chronic/post-COVID-19 may require longterm EN or PN in skilled facilities or the home setting. 68 Others are likely to require medical nutrition therapy to address underlying malnutrition and/or manage preexisting or newly developed comorbidities. 36 Exercise programs and nutrition may increase the functional capacity of COVID-19 survivors and should start prior to discharge.…”

Section: Introductionmentioning

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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“…dialysis, home enteral or parenteral nutrition). Although a position paper recently addressed the everyday care of home medical nutrition during the COVID-19 pandemic [ 63 ], recommendations on how to accurately obtain anthropometric measurements continuously from these patients at home have not yet been documented.…”

Section: Discussionmentioning

confidence: 99%

Anthropometric assessment in ambulatory nutrition amid the COVID-19 pandemic: Possibilities for the remote and in-person care

Bagni

Ribeiro

Bezerra

et al. 2021

Clinical Nutrition ESPEN

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Home medical nutrition during SARS-CoV-2 pandemic – A position paper

Abstract: Conclusions: the position paper present pragmatic statements for HMN to be implemented in places without existing protocols for SARS-CoV-2 pandemic. They represent the state of knowledge available at the moment and may change should new evidence occurs.

Cited by 10 publications

References 3 publications

Organizational issues of home parenteral nutrition during COVID-19 pandemic: Results from multicenter, nationwide study

Organizational issues of home parenteral nutrition during COVID-19 pandemic: Results from multicenter, nationwide study

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

Anthropometric assessment in ambulatory nutrition amid the COVID-19 pandemic: Possibilities for the remote and in-person care

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