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

Autores

  • Thabata Koester WEBER Universidade Estadual Paulista
  • Vânia Aparecida LEANDRO-MERHI Pontifícia Universidade Católica de Campinas
  • Isabela BERNASCONI Pontifícia Universidade Católica de Campinas
  • Maria Rita Marques de OLIVEIRA Universidade Estadual Paulista

Palavras-chave:

Coronavirus infection, Nutritional status, Nutrition therapy

Resumo

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.

Referências

Organização Pan-Americana da Saúde. Folha informativa COVID-19: escritório da OPAS e da OMS no Brasil. Brasília: Organização; 2020 [citado 19 set. 2020]. Disponível em: https://www.paho.org/pt/covid19

Ministério da Saúde (Brasil). Painel Coronavírus, informe virtual publicado em 19 de setembro de 2020. Brasília: Ministério; 2020 [citado 19 set. 2020]. Disponível em: https://covid.saude.gov.br/

Cavalcante JR, Cardoso Santos AC, Bremm JM, Lobo AP, Macário EM, Oliveira WK, França GVA. COVID-19 no Brasil: evolução da epidemia até a semana epidemiológica 20 de 2020. Epidemiol Serv Saúde. 2020;29(4):e2020376. https://doi.org/10.5123/S1679-49742020000400010

Joannidis JPA, Axfors C, Contopoulos-Ioannidis DG. Population-level COVID-19 mortality risk for non-elderly individuals overall and for non-elderly individuals without underlying diseases in pandemic epicenters. Environ Res. 2020;188:109890. https://doi.org/10.1016/j.envres.2020.109890

Li J, Xu G, Yu H, Peng X, Luo Y, Cao C. Clinical characteristics and outcomes of 74 patients with severe or critical COVID-19. Am J Med Sci. 2020;360(3):229-35. https://doi.org/10.1016/j.amjms.2020.05.040

Hozhabri H, Sparascio FP, Sohrabi H, Mousavifar L, Roy R, Scribano, et al. The global emergency of novel coronavirus (SARS-CoV-2): an update of the current status and forecasting. Int J Environ Res Public Health. 2020;17(16):5648. https://doi.org/10.3390/ijerph17165648

Martindale R, Patel JJ, Taylor B, Warren M, McClave SA. Nutrition therapy in the patient with COVID-19 disease requiring ICU care. Aspen. 2020. https://doi.org/10.1002/jpen.1930

Barazzoni R, Bischoff SC, Breda J, Wickramasinghe K, Krznaric Z, Nitzan D, et al. Endorsed by the ESPEN council. ESPEN expert statements and practical guidance for nutritional management of individuals with SARS-CoV-2 infection. Clin Nutr 2020;39:1631-8. https://doi.org/10.1016/j.clnu.2020.03.022

Chapple LS, Fetterplace K, Asrani V, Burrell A, Cheng AC, Collins P, et al. Nutrition management for critically and acutely unwell hospitalised patients with coronavirus disease 2019 (COVID-19) in Australia and New Zealand. Aust Crit Care. 2020;33(5):399-406. https://doi.org/10.1016/j.aucc.2020.06.002

Campos LF, Barreto PA, Ceniccola GD, Gonçalves RC, Matos LBN, Zambelli CMSF, et al. Parecer BRASPEN/AMIB para o enfrentamento do COVID-19 em pacientes hospitalizados. Braspen J. 2020 [cited 2020 Sep 19];35(1):3-5. https://www.cfn.org.br/wp-content/uploads/2020/03/Parecer-BRASPEN-COVID-19.pdf.pdf

Conselho Federal de Nutrição (Brasil). Recomendações do Conselho Federal de Nutrição: boas práticas para a atuação do nutricionista e do técnico em nutrição e dietética durante a pandemia do novo coronavírus (COVID-19). 2020. 3a. ed. Brasília: Conselho Federal de Nutricionistas; 2020.

Arkin N, Krishnan K, Chang MG, Bittner EA. Nutrition in critically ill patients with COVID-19: challenges and special considerations. Clin Nutr. 2020;39(7):2327-8.

Romano L, Bilotta F, Dauri M, Macheda S, Pujia A, De Santis GL, et al. Short report: medical nutrition therapy for critically ill patients with COVID-19. Eur Rev Med Pharmacol Sci. 2020;24:4035-9.

González-Salazar LE, Guevara-Cruz M, Hernández-Gómez G, Zúñiga AES. Nutritional management of the critically ill inpatient with COVID-19: a narrative review. Nutr Hosp. 2020;34(3):622-30. https://doi.org/10.20960/nh.03180

Patel JJ, Martindale RG, McClave SA. Relevant nutrition therapy in COVID-19 and the constraints on its delivery by a unique disease process. Nutr Clin Pract. 2020;35(5):792-9.

Rosenthal MD, Brakenridge S, Rosenthal CM, Moore FA. Nutritional support in the setting of persistent inflammation, immunosuppression, and catabolism syndrome (PICS). Curr Surg Rep. 2016;4:32. https://doi.org/10.1007/s40137-016-0152-3

Stachowska E, Folwarski M, Jamioł-Milc D, Maciejewska D, Skonieczna-Zydecka K. Protocol nutritional support in coronavirus 2019 disease. Medicina. 2020;56:289. https://doi.org/10.3390/medicina56060289

Thibault R, Seguin P, Tamion F, Pichard C, Singer P. Nutrition of the COVID-19 patient in the intensive care unit (ICU): a practical guidance. Crit Care. 2020;24:447. https://doi.org/10.1186/s13054-020-03159-z

Watteville A, Genton L, Barcelosc GK, Pugin J, Pichard C, Heidegger CP. Easy-to-prescribe nutrition support in the intensive care in the era of COVID-19. Clin Nutr Espen. 2020;(39):74-8. https://doi.org/10.1016/j.clnesp.2020.07.015

Li T, Zhang Y, Gong C, Wang J, Liu B, Shi L, et al. Prevalence of malnutrition and analysis of related factors in elderly patients with COVID-19 in Wuhan, China. Eur J Clin Nutr. 2020;22:1-5. https://doi.org/10.1038/s41430-020-0642-3

Papadimitriou-Olivgeris M, Gkikopoulos N, Wüst M, Ballif A, Simonin V, Maulini M, et al. Predictors of mortality of influenza virus infections in a swiss hospital during four influenza seasons: role of quick sequential organ failure assessment. Eur J Intern Med. 2020;74:86-91. https://doi.org/10.1016/j.ejim.2019.12.022

Johannessen A, Naman E, Ngowi BJ, Sandvik L, Matee MI, Aglen HE, et al. Predictors of mortality in HIVinfected patients starting antiretroviral therapy in a rural hospital in Tanzania. Bmc Infect Dis. 2008;8:52. https://doi.org/10.1186/1471-2334-8-52

Rothan HÁ, Byrareddy SN. The epidemiology and pathogenesis of coronavirus disease (COVID-19). Outbreak J Autoimmun. 2020;109:102433. https://doi.org/10.1016/j.jaut.2020.102433

Liu K, Chen Y, Lin R, Han K. Clinical features of COVID-19 in elderly patients: a comparison with young and middle-aged patients. J Infect. 2020;80(6):e14-8. https://doi.org/10.1016/j.jinf.2020.03.005

Arentz M, Yim E, Klaff L, Lokhandwala S, Riedo FX, Chong M, et al. Characteristics and outcomes of 21 Critically Ill patients with COVID-19 in Washington state. Jama. 2020;323(16):1612-4. https://doi.org/10. 1001/jama.2020.4326

Handu D, Moloney L, Rozga M, Cheng F. Malnutrition care during the COVID-19 pandemic: considerations for registered dietitian nutritionists evidence analysis center. J Acad Nutr Diet. 2020 [forthcoming]. https://doi.org/10.1016/j.jand.2020.05.012

Petrilli C, Jones SA, Yang J, Rajagopalan H, O’Donnel L, Chernyak Y, et al. Factors associated with hospitalization and critical illness among 4,103 patients with COVID-19 disease in New York City. Bmj. 2020;369. https://doi.org/10.1136/bmj.m1966

Caussy C, Wallet F, Laville M, Disse E. Obesity is associated with severe forms of COVID-19. Obesity. 2020. https://doi.org/10.1002/oby.22842

Laviano A, Koverech A, Zanetti M. Nutrition support in the time of SARS-CoV-2 (COVID-19). Nutrition. 2020;74:110834. https://doi.org/10.1016/j.nut.2020.110834

Piovacari SMF, Santos GFCG, Santana GA, Scacchetti T, Castro MG. Fluxo de assistência nutricional para pacientes admitidos com COVID-19 e SCOVID-19 em unidade hospitalar. Braspen J. 2020;35 (1):6-8.

Caccialanza R, Laviano A, Lobascio F, Bruno R, Ludovisi S, Corsico AG, et al. Early nutritional supplementation in non-critically ill patients hospitalized for the 2019 novel coronavirus disease (COVID-19): Rationale and feasibility of a shared pragmatic protocol. Nutrition. 2020;74:110835. https://doi.org/10.1016/j.nut.2020.110835

Tian Y, Rong L, Nian W, He Y. Review article: gastrointestinal features in COVID-19 and the possibility of faecal transmission. Aliment Pharmacol Ther. 2020;51(9):843-51. http://doi.org/10.1111/apt.15731

Lechien JR, Chiesa-Estomba CM, De Siati DR, Horoi M, Le Bom SD, Rodriguez A, et al. Olfactory and gustatory dysfunctions as a clinical presentation of mild-to-moderate forms of the coronavirus disease (COVID-19): a multicenter European study. Eur Arch Otorhinolaryngol. 2020;1-11. https://doi.org/10.1007/s00405-020-0 5965-1

Tulunay-Ugur OE, Eibling D. Geriatric dysphagia. Clin Geriatr Med. 2018;34(2):183-9. https://doi.org/10. 1016/j.cger.2018.01.007

Peterson SJ, Tsai AA, Scala CM, Sowa DC, Sheean PM, Braunschweig CL. Adequacy of oral intake in criticallyill patients 1 week after extubation. J Am Diet Assoc. 2010;110(3):427-33.

White JV, Guenter P, Jensen G, Malone A, Schofield M, Academy Malnutrition Work Group, et al. Consensus statement: Academy of Nutrition and Dietetics and American Society for Parenteral and Enteral Nutrition: characteristics recommended for the identification and documentation of adult malnutrition (undernutrition). J Parenter Enteral Nutr. 2012;36:275-83.

Correia MI, Waitzberg DL. The impact of malnutrition on morbidity, mortality, length of hospital stay, and costs evaluated through a multivariate model analysis. Clin Nutr. 2003;22:235-9.

Lim SL, Ong KC, Chan YH, Loke WC, Ferguson M, Daniels L. Malnutrition and its impact on cost of hospitalization, length of stay, readmission and 3-year mortality. Clin Nutr. 2012;31:345-50.

Alvarez-Hernandez J, Planas Vila M, León-Sanz M, Garcia LMA, Celaya PS, García LP, et al. Prevalence and costs of malnutrition in hospitalized patients; the PREDyCES Study. Nutr Hosp. 2012;27:1049-59.

José IB, Leandro-Merhi VA, Aquino JLB. Target, prescription and infusion of enteral nutritional therapy of critical patients in intensive care unit. Arq Gastroenterol. 2018;55(3):283-9. https://doi.org/10.1590/S0004-2803.201800000-72

Santana MMA, Vieira LL, Dias DAM, Braga CC, Costa RM. Inadequação calórica e proteica e fatores associados em pacientes graves. Rev Nutr. 2016;29(5):645-54.

Valizade Hasanloei MA, Vahabzadeh D, Shargh A, Atmani A, Alizadeh Osalou R. A prospective study of energy and protein intakes in critically ill patients. Clin Nutr. 2018;23:162-6.

Tsai J-R, Chang W-T, Sheu C-C, Wu Y-J, Sheu Y-H, Liu P-L, et al. Inadequate energy delivery during early critical illness correlates with increased risk of mortality in patients who survive at least seven days: a retrospective study. Clin Nutr. 2011;30(2):209e14. https://doi.org/10.1016/j.clnu.2010.09.003

Vallejo KP, Martínez CM, Adames AAM, Fuchs-Tarlovsky V, Nogales GCC, Paz RER, et al. Current clinical nutrition practices in critically ill patients in Latin America: a multinational observational study. Critical Care. 2017;21:227. http://doi.org/10.1186/s13054-017-1805-z

Siqueira-Paese MC, Dock-Nascimento DB, Aguilar-Nascimento JE. Critical energy deficit and mortality in critically ill patients. Nutr Hosp. 2016;33(3):522-7.

Lee Z-Y, Airini IN, Barakatun-Nisak MY. Relationship of energy and protein adequacy with 60-day mortality in mechanically ventilated critically ill patients: a prospective observational study. Clin Nutr. 2018;37:1264-70.

José IB, Leandro-Merhi VA, Aquino JLB, Mendonça JA. The diagnosis and NUTRIC score of critically ill patients in enteral nutrition are risk factors for the survival time in an intensive care unit? Nutr Hosp. 2019;36(5):1027-36. https://doi.org/10.20960/nh.02545

Chapple L-AS, Chapman MJ, Lange k, Deane AM, Heyland DK. Nutrition support practices in critically ill head-injured patients: a global perspective. Crit Care. 2016;20:6. https://doi.org/10.1186/s13054-015-1177-1

Assis MCS, Silveira CRM, Beghetto MG, Mello ED. Decreased calorie and protein intake is a risk factor for infection and prolonged length of stay in surgical patients: a prospective cohort study. Rev. Nutr. 2016;29(3):307-16.

Hsu P-H, Lee CH, Kuo L-K, Kung Y-C, Chen W-J , Tzeng M-S. Higher energy and protein intake from enteral nutrition may reduce hospital mortality in mechanically ventilated critically ill elderly patients. Inter J Gerontol. 2018;12(4):285-9. https://doi.org/10.1016/j.ijge.2018.03.001

Krznarić Ž, Bender DV, Laviano A, Cuerda C, Landi F, Monteiro R, et al. A simple remote nutritional screening tool and practical guidance for nutritional care in primary practice during the COVID-19 pandemic. Clin Nutr. 2020;10.1016/j.clnu.2020.05.006. doi:10.1016/j.clnu.2020.05.006

Elia M. The MUST report: nutritional screening of adults: a multidisciplinary responsibility. Maidenhead: British Association for Parenteral and Enteral Nutrition; 2003.

Stratton RJ, Hackston A, Longmore D, Dixon R, Price S, Stroud M, et al. Malnutrition in hospital outpatients and inpatients: prevalence, concurrent validity and ease of use of the “malnutrition universal screening tool” (‘MUST’) for adults. Br J Nutr. 2004:799-808. https://doi.org/10.1079/BJN20041258

Kondrup J, Allison SP, Elia M, Vellas B, Plauth M. ESPEN guidelines for nutrition screening 2002. Clin Nutr. 2003;22(4):415-21.

Kondrup J, Rasmussen HH, Hamberg O, Stanga Z, ESPEN working group. nutritional risk screening (NRS 2002): a new method based on a analysis of controlled clinical trials. Clin Nutr. 2003;22(3):321-36.

Heyland DK, Dhaliwal R, Jiang X, Day AG. Identifying critically ill patients who benefit the most from nutrition therapy: the development and initial validation of a novel risk assessment tool. Crit Care Med. 2011:15(6):R268.

McClave SA, Martindale RG, Vanek VW, Warren MM, Debbie R, Johnson DR, et al. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine (SCCM) and American Society of Parenteral and Enteral Nutrition (ASPEN). J Parenter Enteral Nutr. 2016;40(2):159-211. https://doi.org/10.1177/0148607115621863

Taylor BE, McClave SA, Martindale RG, Warren MM, Johnson DR, Braunschweig CRD, et al. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: society of critical care medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (ASPEN). Crit Care Med. 2016;44(2):390-438. https://doi: 10.1097/CCM.0000000000001525

Singer P, Blaser AR, Berger MM, Alhazzani W, Calder PC, Casaer MP, et al. ESPEN guideline on clinical nutrition in the intensive care unit. Clin Nutr. 2019;38(1):48-79. https://doi.org/10.1016/j.clnu.2018.08.037

Jayawardena R, Sooriyaarachchi P, Chourdakis M, Jeewandara C, Ranasinghe P. Enhancing immunity in viral infections, with special emphasis on COVID-119: a review. Diabetes Neta Syndr. 2020;14(4):367-82. https://doi.org/10.1016/j.dsx.2020.04.015

Gomes F, Schuetz P, Bounoure L, Austin P, Ballesteros-Pomar M, Cederholm T, et al. ESPEN guideline on nutritional support for polymorbid internal medicine patients. Clin Nutr. 2018;37:336-53. https://doi.org/10.1016/j.clnu.2017.06.025

Volkert D, Beck AM, Cederholm T, Cruz-Jentoft A, Goisser S, Hooper L, et al. ESPEN guideline on clinical nutrition and hydration in geriatrics. Clin Nutr. 2019;38(1):10-47. https://doi.org/10.1016/j.clnu.2018.05.024

Caussy C, Pattou F, Wallet F, et al. Prevalence of obesity among adult inpatients with COVID-19 in France [published online ahead of print. Lancet Diabetes Endocrinol. 2020;8(7):562-4. https://doi.org/10.1016/S22 13-8587(20)30160-1

Stefan N, Birkenfeld AL, Schulze MB, Ludwig DS. Obesity and impaired metabolic health in patients with COVID-19. Nat Rev Endocrinol. 2020;16:341-2. https://doi.org/10.1038/s41574-020-0364-6

Downloads

Publicado

17-08-2022

Como Citar

Koester WEBER, T. ., LEANDRO-MERHI, V. A. ., BERNASCONI, I. ., & Marques de OLIVEIRA, M. R. . (2022). Nutritional therapy in hospital care of in-patients with Covid-19: evidence, consensus and practice guidelines. Revista De Nutrição, 33, 1–14. Recuperado de https://periodicos.puc-campinas.edu.br/nutricao/article/view/6603

Edição

Seção

THEMATIC SECTION HUNGER, FOOD AND NUTRITION AND COVID-19