Nutritional and metabolic management of COVID-19 intensive care patients

Abstract

Nutritional and metabolic disturbances are observed in critically ill COVID 19 patients. The aim of this review is to describe these disturbances during the progression of the disease, from the pre intubation through the ventilated condition to the post extubation phase. Analysis of new data describing the prevalence of malnutrition, the modifications in energy expenditure and body composition are guiding medical nutritional therapy to prevent from severe energy deficit and muscle loss. Rehabilitation may be very prolonged and therefore, nutrition is mandatory to decrease this recondition period. This review comments also on the ESPEN nutritional statements.

Serum trace elements levels and clinical outcomes among Iranian COVID-19 patients

“…The latest evidence on coronaviruses indicates that nutritional and metabolic derangements are associated with the disease severity and susceptibility to infection (Jayawardena R. et al, 2020, Lv et al, 2020 , Singer, 2021 , Zeng et al, 2021 ). In this study, we measured serum trace elements status in severe and non-severe COVID-patients.…”

Energy expenditure in COVID‐19 mechanically ventilated patients: A comparison of three methods of energy estimation

“… 13 Interestingly, measured EE increased progressively from week 1 (1568 kcal/day, range 1175–2215 kcal/day) to week 2 (1830 kcal/day, range 1465–2467 kcal/day) and week 3 (2789 kcal/day, range 1776–3262 kcal/day). 13 , 14 In contrast, in a retrospective case series of seven mechanically ventilated patients, the median EE measured by IC was 4044 kcal/day, which was 235.7 ± 51.7% of that predicted by the Penn State equations. With these variations in EE among patients with COVID‐19 recorded by IC, which is a gold standard, use of predictive weight‐based equations as per guidelines may be inadequate to estimate energy requirements.…”

“…Whittle et al, in their longitudinal observational study, described EE in 22 ventilated patients with COVID‐19 measured by IC 13 . Interestingly, measured EE increased progressively from week 1 (1568 kcal/day, range 1175–2215 kcal/day) to week 2 (1830 kcal/day, range 1465–2467 kcal/day) and week 3 (2789 kcal/day, range 1776–3262 kcal/day) 13,14 . In contrast, in a retrospective case series of seven mechanically ventilated patients, the median EE measured by IC was 4044 kcal/day, which was 235.7 ± 51.7% of that predicted by the Penn State equations.…”

An insight to the therapeutic potential of algae-derived sulfated polysaccharides and polyunsaturated fatty acids: Focusing on the COVID-19

“…Nutritional status appears to be a significant factor impacting the outcomes of COVID-19 patients [21] . According to studies, preventive interventions such as public health principles and nutritional support are critical at this moment in the global pandemic of COVID19 [22] , [23] , [24] . As a general conclusion from research, maintaining nutrient adequacy is critical for minimizing the risk of infection and disease development, either through their roles in the normal function of the immune system or through the promotion of metabolic health.…”