Malnutrition and nutritional support in COVID-19: outcome of a rational nutritional support protocol

INTRODUCTION: COVID-19 is characterized by various clinical manifestations, mainly respiratory involvement Disease-related malnutrition is associated with impaired respiratory function and increased all-cause morbidity and mortality Patients with COVID-19 infection carry a high nutritional risk After designing a specific nutritional support protocol for this disease, we carried out a retrospective study on malnutrition and on the use of nutritional support in patients with COVID-19 METHODS: We performed a retrospective study to determine whether nutritional support positively affected hospital stay, clinical complications, and mortality in patients with COVID-19 We compared the results with those of standard nutritional management Our secondary objectives were to determine the prevalence of malnutrition in patients with COVID-19 and the value of nutritional support in the hospital where the study was performed RESULTS: At least 60% of patients with COVID-19 experience malnutrition (up to 78 66% presented at least 1 of the parameters studied) The specialized nutritional support protocol was indicated in only 21 patients (28%) and was started early in only 12 patients (16%) Hospital stay was significantly shorter in patients managed with the early protocol (5 09 days, 95% CI, 1 338–8 853, p<0 01) Similarly, in this group, respiratory distress was less severe and less frequent (41% vs 82 5%, p<0 007), and statistically significantly fewer complications were recorded (9/12 vs 91/63;p<0 001) CONCLUSIONS: COVID-19 is associated with high rates of disease-related malnutrition Early implementation of a specialized nutritional support plan can improve the prognosis of these patients by reducing hospital stay, the possibility of more severe respiratory distress, and complications in general Resumen INTRODUCCION: La COVID-19 se caracteriza por diversas manifestaciones clinicas, principalmente afectacion respiratoria La desnutricion relacionada con la enfermedad se asocia con deterioro de la funcion respiratoria y aumento de la morbilidad y la mortalidad globales Los pacientes con COVID-19 tienen un riesgo nutricional alto Tras disenar un protocolo de apoyo nutricional especifico para esta enfermedad, se emprendio un estudio retrospectivo sobre desnutricion y uso de soporte nutricional en pacientes con COVID-19 METODOS: Se realizo un estudio retrospectivo para determinar si el apoyo nutricional tenia efectos positivos en la estancia hospitalaria, las complicaciones clinicas y la mortalidad de pacientes con COVID-19 Se compararon los resultados con los del manejo nutricional habitual Los objetivos secundarios eran determinar la prevalencia de desnutricion en los pacientes con COVID-19 y la utilidad del apoyo nutricional en el hospital en el que se realizo el estudio RESULTADOS: Al menos el 60% de los pacientes con COVID-19 sufre desnutricion (hasta el 78,66% presentaba al menos uno de los parametros estudiados) El protocolo de apoyo nutricional especializado estaba indicado en solo 21 pacientes (28%) y se inicio de forma temprana en solo 12 pacientes (16%) La estancia hospitalaria fue significativamente menor en los pacientes sometidos al protocolo temprano (5,09 dias, IC al 95%, 1,338–8,853, p<0,01) Este grupo mostro asimismo un sufrimiento respiratorio menos intenso y frecuente (41% y 82,5% respectivamente, p<0,007), y un numero significativamente menor de complicaciones (9/12 frente a 91/63;p<0,001) CONCLUSIONES: La COVID-19 se asocia con tasas elevadas de desnutricion relacionada con la enfermedad La implantacion precoz de un plan de apoyo nutricional especializado puede mejorar el pronostico de estos pacientes al reducir la estancia hospitalaria, la posibilidad de sufrimiento respiratorio mas intenso y las complicaciones en general