Nutrition in critically ill patients with COVID-19: Challenges and special considerations

Arkin, Nicole; Krishnan, Kumar; Chang, Marvin G.; Bittner, Edward A.

doi:10.1016/j.clnu.2020.05.007

Cited by 51 publications

(86 citation statements)

References 10 publications

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“…On the other hand, the changes induced by the disease itself in the gastrointestinal tract of the patients, along with the elevated sedation required for these patients, makes difficult to provide adequate nutritional support. Bearing this in mind, Arkin et al (2020) provided information regarding several of the considerations that have to be taken into account when nutrition is provided to critically ill patients of COVID-19 [131]. One such consideration is related to the gastrointestinal hypomotility that is commonly found in these patients, which in turn results in enteral feeding intolerance.…”

Section: Nutritional Therapy In Critically Ill Hospitalized Covid-19 mentioning

confidence: 99%

Key Aspects in Nutritional Management of COVID-19 Patients

Fernández‐Quintela

Milton-Laskíbar

Trepiana

et al. 2020

JCM

118

114

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This review deals with the relationship among nutrition, the immune system, and coronavirus disease 2019 (COVID-19). The influence of nutrients and bioactive molecules present in foodstuffs on immune system activity, the influence of COVID-19 on the nutritional status of the patients, and the dietary recommendations for hospitalized patients are addressed. Deficient nutritional status is probably due to anorexia, nausea, vomiting, diarrhea, hypoalbuminemia, hypermetabolism, and excessive nitrogen loss. There is limited knowledge regarding the nutritional support during hospital stay of COVID-19 patients. However, nutritional therapy appears as first-line treatment and should be implemented into standard practice. Optimal intake of all nutrients, mainly those playing crucial roles in immune system, should be assured through a diverse and well-balanced diet. Nevertheless, in order to reduce the risk and consequences of infections, the intakes for some micronutrients may exceed the recommended dietary allowances since infections and other stressors can reduce micronutrient status. In the case of critically ill patients, recently published guidelines are available for their nutritional management. Further, several natural bioactive compounds interact with the angiotensin-converting enzyme 2 (ACE2) receptor, the gateway for severe acute respiratory syndrome (SARS) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Natural bioactive compounds can also reduce the inflammatory response induced by SARS-CoV-2. These compounds are potential beneficial tools in the nutritional management of COVID-19 patients.

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Section: Nutritional Therapy In Critically Ill Hospitalized Covid-19 mentioning

confidence: 99%

Key Aspects in Nutritional Management of COVID-19 Patients

Fernández‐Quintela

Milton-Laskíbar

Trepiana

et al. 2020

JCM

118

114

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“…To avoid greater energy-protein depletion, particularly in patients with COVID-19 not receiving mechanical ventilation, adequate calculation of nutritional needs must precede dietary intervention, accounting for nutritional risk assessed by means of these instruments [94,95]. For patients in the ICU on mechanical ventilation, the European Society for Clinical Nutrition and Metabolism (ESPEN) recommends offering low-calorie nutrition, not to exceed 70% of energy needs [96,97].…”

Section: Discussionmentioning

confidence: 99%

Nutritional Risk Screening Tools for Elderly Patients with COVID-19: A Systematic Review

Silva¹,

Lima²,

Sena-Evangelista³

et al. 2020

Preprint

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Coronavirus disease 2019 (COVID-19) is associated with high risk of malnutrition, primarily in elderly people; assessing nutritional risk using appropriate screening tools is critical. This systematic review identified applicable tools and assessed their measurement properties. Literature was searched in the MEDLINE, Embase, and LILACS databases. Four studies conducted in China met the eligibility criteria. Sample sizes ranged from six to 182, and participants’ ages from 65 to 87 years. Seven nutritional screening and assessment tools were used: the Nutritional Risk Screening 2002 (NRS-2002), Mini Nutritional Assessment (MNA), MNA-short form (MNA-sf), Malnutrition Universal Screening Tool (MUST), Nutritional Risk Index (NRI), Geriatric NRI (GNRI), and modified Nutrition Risk in the Critically ill (mNUTRIC) score. Nutritional risk was identified in 27.5% to 100% of participants. The NRS-2002, MNA, MNA-sf, NRI, and MUST demonstrated high sensitivity; the MUST had better specificity. The MNA and MUST demonstrated better criterion validity. The MNA-sf demonstrated better predictive validity for poor appetite and weight loss; the NRS-2002 demonstrated better predictive validity for prolonged hospitalization. mNUTRIC score demonstrated good predictive validity for hospital mortality. Most instruments demonstrate high sensitivity for identifying nutritional risk, but none are acknowledged as the best for nutritional screening in elderly COVID-19 patients.

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“…21 Recent case studies have also laid bare the importance of specialised nutritional treatment in critically ill patients with COVID-19. 22 A NUTRITION ODYSSEY Together, the papers in the current collection and additional related ones in the journal shed light on the importance of food and nutrients, but also on the importance of more research in the field of nutrition and immune system. Sound large-scale studies are urgently needed.…”

Section: Special Conditions: Clinical Settingmentioning

confidence: 96%

Nutrition is key to global pandemic resilience

Birgisdóttir

2020

BMJNPH

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Nutrition in critically ill patients with COVID-19: Challenges and special considerations

Cited by 51 publications

References 10 publications

Key Aspects in Nutritional Management of COVID-19 Patients

Key Aspects in Nutritional Management of COVID-19 Patients

Nutritional Risk Screening Tools for Elderly Patients with COVID-19: A Systematic Review

Nutrition is key to global pandemic resilience

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