Apr 27 ESPEN expert statements and practical guidance for nutritional management of individuals with SARS-CoV-2 infection
Rocco Barazzoni, Stephan C. Bischoff, Joao Breda, Kremlin Wickramasinghe, Zeljko Krznaric, Dorit Nitzan, Matthias Pirlich, Pierre Singer
ABSTRACT
The COVID-19 pandemic presents unprecedented challenges and threats to patients and healthcare systems around the world. Acute respiratory complications requiring intensive care unit (ICU) management are a major cause of morbidity and mortality in patients with COVID-19. It has been reported that the patients with the worst outcomes and the highest mortality include immunocompromised subjects, that is, elderly adults and polymorbid individuals and malnourished people in general.
ICU stay, polymorbidity and advanced age are commonly associated with a high risk of malnutrition, which represents per se a relevant risk factor for increased morbidity and mortality in chronic and acute diseases.
It is also important to note that prolonged periods in the ICU are required for stabilization of patients with COVID-19, and a prolonged stay in the ICU can directly worsen or cause malnutrition, with severe loss of skeletal muscle mass and function. which can lead to disability, poor quality of life, and additional morbidity. Therefore, prevention, diagnosis, and treatment of malnutrition should be routinely included in the treatment of patients with COVID-19.
In the current document, the European Society for Clinical Nutrition and Metabolism (ESPEN) aims to provide concise guidance for the nutritional management of patients with COVID-19 by proposing 10 practical recommendations. The practical orientation focuses on those patients in the ICU setting or in the presence of advanced age and polymorbidity, which are independently associated with malnutrition and its negative impact on patient survival.