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Nutrition evaluation and management of critically ill patients with COVID‐19 during post–intensive care rehabilitation
Author(s) -
Hoyois Alice,
Ballarin Asuncion,
Thomas Justine,
Lheureux Olivier,
Preiser JeanCharles,
Coppens Emmanuel,
PerezBogerd Silvia,
Taton Olivier,
Farine Sylvie,
Van Ouytsel Pauline,
Arvanitakis Marianna
Publication year - 2021
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1002/jpen.2101
Subject(s) - medicine , mechanical ventilation , parenteral nutrition , intensive care unit , malnutrition , intensive care , body mass index , clinical nutrition , prospective cohort study , enteral administration , medical nutrition therapy , intensive care medicine
Abstract Background Among hospitalized patients with coronavirus disease 2019 (COVID‐19), up to 12% may require intensive care unit (ICU) management. The aim of this prospective cohort study is to assess nutrition status and outcome in patients with COVID‐19 following ICU discharge. Methods Patients requiring a minimum of 14 days’ stay in the ICU with mechanical ventilation were included. Nutrition status was assessed at inclusion (ICU discharge) and follow‐up (after 15, 30, and 60 days). All patients had standardized medical nutrition therapy with defined targets regarding energy (30 kcal/kg/d) and protein intake (1.5 g/kg/d). Results Fifteen patients were included (67% males); the median age was 60 (33–75) years old. Body mass index at ICU admission was 25.7 (IQR, 24–31) kg/m². After a median ICU stay of 33 (IQR, 26–39) days, malnutrition was present in all patients (11.3% median weight loss and/or low muscle mass based on handgrip strength measurement). Because of postintubation dysphagia in 60% of patients, enteral nutrition was administered (57% nasogastric tube; 43% percutaneous endoscopic gastrostomy). After 2 months, a significant improvement in muscle strength was observed (median handgrip strength, 64.7% [IQR, 51%–73%] of the predicted values for age vs 19% [IQR, 4.8%–28.4%] at ICU discharge [P < 0.0005]), as well as weight gain of 4.3 kg (IQR, 2.7–6.7 kg) (P < 0.0002). Conclusions Critically ill patients with COVID‐19 requiring ICU admission and mechanical ventilation have malnutrition and low muscle mass at ICU discharge. Nutrition parameters improve during rehabilitation with standardized medical nutrition therapy.