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Relevant Nutrition Therapy in COVID‐19 and the Constraints on Its Delivery by a Unique Disease Process
Author(s) -
Patel Jayshil J.,
Martindale Robert G.,
McClave Stephen A.
Publication year - 2020
Publication title -
nutrition in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.725
H-Index - 71
eISSN - 1941-2452
pISSN - 0884-5336
DOI - 10.1002/ncp.10566
Subject(s) - medicine , intensive care medicine , personal protective equipment , health care , infection control , medical nutrition therapy , psychological intervention , population , intensive care unit , intensive care , guideline , disease , covid-19 , nursing , environmental health , infectious disease (medical specialty) , pathology , economics , economic growth
Worldwide, as of July 2020, >13.2 million people have been infected by the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) virus. The spectrum of coronavirus disease 2019 (COVID‐19) ranges from mild illness to critical illness in 5% of cases. The population infected with SARS‐CoV‐2 requiring an intensive care unit admission often requires nutrition therapy as part of supportive care. Although the various societal guidelines for critical care nutrition meet most needs for the patient with COVID‐19, numerous factors, which impact the application of those guideline recommendations, need to be considered. Since the SARS‐CoV‐2 virus is highly contagious, several key principles should be considered when caring for all patients with COVID‐19 to ensure the safety of all healthcare personnel involved. Management strategies should cluster care, making all attempts to bundle patient care to limit exposure. Healthcare providers should be protected, and the spread of SARS‐CoV‐2 should be limited by minimizing procedures and other interventions that lead to aerosolization, avoiding droplet exposure through hand hygiene and use of personal protective equipment (PPE). PPE should be preserved by decreasing the number of individuals providing direct patient care and by limiting the number of patient interactions. Enteral nutrition (EN) is tolerated by the majority of patients with COVID‐19, but a relatively low threshold for conversion to parenteral nutrition should be maintained if increased exposure to the virus is required to continue EN. This article offers relevant and practical recommendations on how to optimize nutrition therapy in critically ill patients with COVID‐19.