Nutritional care protocol for patients with COVID-19 in Intensive Care Units: an experience report




COVID-19; Nutritional therapy; Nutritional support; Intensive care.


Recommendations to guide the nutritional care of critically ill patients affected by Coronavirus have been published in recent years. However, there are few reports on the establishment of the new routine of nutritional care and monitoring in the hospital setting. The objective of this article is to present the implementation of a protocol with care flow and nutritional routine of a nutrition service, for patients in the intensive care unit of a reference hospital for COVID-19. This is an experience report that presents the routines of the nutrition care service, which were organized for the care of patients during the pandemic of COVID-19, according to recommendations proposed by national and international entities. In the first stage of care, screening for nutritional risk and checking the level of care were performed to guide the frequency of nutritional monitoring. The calorie and protein needs were calculated according to individual nutritional diagnosis. For nutritional therapy use, the oral or enteral route was prioritized for feeding and procedures for special situations, such as prone position, were standardized. In the first 30 days of the hospital's operation, all nutritional assistance was provided non-presentially, with standardized protocols, which were later revised and adapted to be used in face-to-face care, but still without physical contact of nutritionists with patients. Thus, the production and review of institutional flows, adapting them to the scientific updates published during the pandemic, allowed for the qualification of the nutritional assistance provided in the reference hospital for COVID-19.


Allard, L., Ouedraogo, E., Molleville, J., Bihan, H., Giroux-Leprieur, B., Sutton, A., Baudry, C., Josse, C., Didier, M., Deutsch, D., Bouchaud, O., & Cosson, E. (2020). Malnutrition: Percentage and Association with Prognosis in Patients Hospitalized for Coronavirus Disease 2019. Nutrients, 12(12), 3679.

Barazzoni, R., Bischoff, S. C., Breda, J., Wickramasinghe, K., Krznaric, Z., Nitzan, D., Pirlich, M., Singer, P., & endorsed by the ESPEN Council (2020). ESPEN expert statements and practical guidance for nutritional management of individuals with SARS-CoV-2 infection. Clinical Nutrition (Edinburgh, Scotland), 39(6), 1631–1638.

BRASIL. Presidência da República. Lei 12.401, de 28 de abril de 2011. Da Assistência Terapêutica e da Incorporação de Tecnologia em Saúde. Brasília, DF: 2011. Disponível em: 2014/2011/lei/l12401.htm/. Acesso em: 20 ago. 2020.

Callender, L. A., Curran, M., Bates, S. M., Mairesse, M., Weigandt, J., & Betts, C. J. (2020). The impact of pre-existing comorbidities and therapeutic interventions on COVID-19. Frontiers in Immunology, 1991.

Campos, L. F., Barreto, P. A., Ceniccola, G. D., Gonçalves, R. C., Matos, L. B. N., Zambelli, C. M. S. F., & Castro, M. G. (2021). Revisão do parecer BRASPEN de terapia nutricional em pacientes hospitalizados com COVID-19. BRASPEN J, 36(1), 122–6.

Campos, L. F., Barreto, P. A., Ceniccola, G. D., Gonçalves, R. C., Matos, L. B. N., Zambelli, C. M. S. F., & Castro, M. G. (2020). Parecer BRASPEN/AMIB para o enfrentamento do COVID-19 em pacientes hospitalizados. BRASPEN J, 35(1), 3-5.

Castro, M. G., Ribeiro, P. C., Souza, I. D. O., Cunha, H. F. R., Silva, M. H. N., Rocha, E. E. M., ... & Toledo, D. O. (2018). Diretriz brasileira de terapia nutricional no paciente grave. BRASPEN J, 33(1), 2-36.

Conselho Federal de Nutricionistas (2020). Recomendações do CFN – Boas práticas para a atuação do nutricionista e do técnico em nutrição e dietética durante a pandemia do novo coronavírus (COVID-19).

Cunha, S. S., de Araújo Santiago, S. A., de Carvalho Guedine, C. R., de Pádua, C. S., & do Prado, P. R. Terapia nutricional em pacientes adultos com COVID-19: Revisão de escopo.

Dantas, C.C.S.& Silva, L.C.S. Protocolo de intervenção nutricional para pacientes com covid-19. Conselho Regional de Nutricionistas-6ª (CRN-6),2020.

Del Giorno, R., Quarenghi, M., Stefanelli, K., Capelli, S., Giagulli, A., Quarleri, L., ... & Gabutti, L. (2020). Nutritional risk screening and body composition in COVID‐19 patients hospitalized in an internal medicine ward. International Journal of General Medicine, 13, 1643. 9.

Elia, M., Normand, C., Laviano, A., & Norman, K. (2016). A systematic review of the cost and cost effectiveness of using standard oral nutritional supplements in the hospital setting. Clinical Nutrition. 35(2):370–80. Available from:

Formisano, E., Di Maio, P., Ivaldi, C., Sferrazzo, E., Arieta, L., Bongiovanni, S., ... & Demontis, S. (2021). Nutritional therapy for patients with coronavirus disease 2019 (COVID-19): Practical protocol from a single center highly affected by an outbreak of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Nutrition, 82, 111048.

Holdoway, A. (2020). Nutritional management of patients during and after COVID-19 illness. British Journal of Community Nursing, 25(Sup8), S6-S10.

Liu, H., Chen, S., Liu, M., Nie, H., & Lu, H. (2020). Comorbid chronic diseases are strongly correlated with disease severity among COVID-19 patients: a systematic review and meta-analysis. Aging and Disease, 11(3), 668.

Lobo, SMA, Rezende, E., Mendes, CL, Rea-Neto, Á., David, CM, Dias, FS, & Schettino, G. (2006). Consenso brasileiro de monitoramento e suporte hemodinâmico - Parte V: suporte hemodinâmico. Revista Brasileira de Terapia Intensiva, 18 (2), 161-176.

Martindale, R., Patel, J. J., Taylor, B., Arabi, Y. M., Warren, M., & McClave, S. A. (2020). Nutrition therapy in critically ill patients with coronavirus disease 2019. Journal of Parenteral and Enteral Nutrition, 44(7), 1174-1184.

McClave, S. A., Taylor, B. E., Martindale, R. G., Warren, M. M., Johnson, D. R., Braunschweig, C., & Compher, C. (2016). 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). JPEN. Journal of Parenteral and Enteral Nutrition, 40(2), 159-211.

Mendes, L., Cebola, M., Mendes, D., Marinho, A., & Guerreiro, A. S. (2020). Intervenção nutricional no doente com COVID-19. Saúde & Tecnologia, 23, 11-18.

Oliveira, E. M. D., Pereira, J. M., & Silva, D. D. O. (2020). Terapia nutricional em pacientes hospitalizados com COVID-19. Nutrição Clínica.

Piovacari, S. M. F., Santos, G. F. C. G., Santana, G. A., Scacchetti, T., & Castro, M. G. (2020). Fluxo de assistência nutricional para pacientes admitidos com COVID-19 e SCOVID-19 em unidade hospitalar. BRASPEN J, 35(1), 6-8.

Ramos, A., Joaquin, C., Ros, M., Martin, M., Cachero, M., Sospedra, M., ... & Puig-Domingo, M. (2021). Impact of COVID-19 on nutritional status during the first wave of the pandemic. Clinical Nutrition.

Silva, J. A. S. V., Hinrichsen, S. L., Brayner, K. A. C., Vilella, T. D. A. S., & Lemos, M. C. (2017). Glosas hospitalares e o uso de protocolos assistenciais: revisão integrativa da literatura. Revista de Administração em Saúde, 17(66).

Silverio, R., Gonçalves, D. C., Andrade, M. F., & Seelaender, M. (2021). Coronavirus disease 2019 (COVID-19) and nutritional status: the missing link?. Advances in Nutrition, 12(3), 682-692.

Singer, P., Blaser, A. R., Berger, M. M., Alhazzani, W., Calder, P. C., Casaer, M. P., & Bischoff, S. C. (2019). ESPEN guideline on clinical nutrition in the intensive care unit. Clinical Nutrition, 38(1), 48-79.



How to Cite

SANTOS, A. L. .; JESUS, C. A. de .; NEIVA, N. B. O. .; ALVES, T. C. H. S. .; CUNHA, C. de M. .; OLIVEIRA, L. . P. M. de .; CONCEIÇÃO-MACHADO, M. E. P. da . Nutritional care protocol for patients with COVID-19 in Intensive Care Units: an experience report. Research, Society and Development, [S. l.], v. 11, n. 9, p. e19811931517, 2022. DOI: 10.33448/rsd-v11i9.31517. Disponível em: Acesso em: 11 dec. 2023.



Health Sciences