Nutritional assistance during the COVID-19 pandemic in patients admitted to intensive care units

Authors

DOI:

https://doi.org/10.33448/rsd-v11i13.35624

Keywords:

Pandemic; COVID-19; Nutritional assessment; Intensive care unit; SARS-CoV-2.

Abstract

Nutritional care has undergone unexpected changes in the pandemic of COVID-19. The objective of this article is to describe the nutritional care of patients admitted to intensive care unit in the first fifteen months of this pandemic. This is a retrospective cohort of critically ill patients with COVID-19 admitted to a referral hospital between March/2020 to June/2021. Clinical (complaints, comorbidities, length of stay and evolution), nutritional (nutritional diagnosis and diet prescribed at admission) and patient's origin were evaluated. The Statistical Package for the Social Sciences was used for data analysis. Categorical variables were described by simple, absolute, and relative frequency, and quantitative variables by mean and standard deviation or median and interquartile range. We studied 643 patients with a mean (standard deviation) age of 63 (16) years, 374 (58.2%) were male. Hypertension was the most frequent comorbidity (61.1%), followed by diabetes mellitus (41.4%). Difficulty breathing (79.8%) and fever (48.7%) were the most frequent complaints. The median (interquartile range) hospital stay was 11 (6 - 18) days, and 570 (85.6%) patients died. Only 300 (46.7%) patients had nutritional diagnosis record, among them, 207 (69.0%) were diagnosed with overweight and 35 (11.7%) with malnutrition. There was a lack of nutritional assistance in critically ill patients with COVID-19 in the first 15 months of the pandemic. We suggest a nutritional assessment model that may contribute to better nutritional assistance in catastrophic situations, such as the one experienced in this pandemic.

References

Agarwal, E., Ferguson, M., Banks, M., Batterham, M., Bauer, J., Capra, S., & Isenring, E. (2013). Malnutrition and poor food intake are associated with prolonged hospital stay, frequent readmissions, and greater in-hospital mortality: results from the Nutrition Care Day Survey 2010. Clinical nutrition (Edinburgh, Scotland), 32(5), 737-745. https://doi.org/10.1016/j.clnu.2012.11.021.

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. Nutrição Clínica (Edinburgh, Scotland), 39(6), 1631-1638. https://doi.org/10.1016/j.clnu.2020.03.022.

Bastos, G.A.N., Azambuja, A. Z. de, Polanczyk, C. A., Gräf, D. D., Zorzo, I. W., Maccari, J. G., Haygert, L. S., Nasi, L. A., Gazzana, M. B., Bessel, M., Pitrez, P. M., Oliveira, R. P. de, & Scotta, M. C. (2020). Clinical characteristics and predictors of mechanical ventilation in patients with COVID-19 hospitalized in Southern Brazil. Características clínicas e preditores de ventilação mecânica em pacientes com COVID-19 hospitalizados no sul do país. Revista Brasileira de Terapia Intensiva, 32(4). https://doi.org/10.5935/0103-507X.20200082.

Brasil. Ministério da Saúde. COVID 19: painel Coronavírus (citado 22 de agosto de 2022). https://covid.saude.gov.br/.

Campos L.F., Barreto, P.A, Ceniccola, G. D., Gonçalves, R. C., de Matos, L. B. N., Zambelli, C. M. S. F., Castro, M. G. (2020). Parecer BRASPEN/AMIB para o enfrentamento da COVID-19 em pacientes hospitalizados. Braspen SBNPE Journal. 24.;35(1).

Chen, J., Qi, T., Liu, L., Ling, Y., Qian, Z., Li, T., Li, F., Xu, Q., Zhang, Y., Xu, S., Song, Z., Zeng, Y., Shen, Y., Shi, Y., Zhu, T., & Lu, H. (2020). Clinical progression of patients with COVID-19 in Shanghai, China. The Journal of Infection, 80(5), e1-e6. https://doi.org/10.1016/j.jinf.2020.03.004.

Corrêa, T. D., Midega, T. D., Timenetsky, K. T., Cordioli, R. L., Barbas, C., Silva Júnior, M., Bravim, B. A., Silva, B. C., Matos, G., Nawa, R. K., Carvalho, F., Queiroz, V., Rabello Filho, R., Piza, F., Pereira, A. J., Pesavento, M. L., Eid, R., Santos, B., Pardini, A., Teich, V. D., Ferraz, L. (2021). Clinical characteristics and outcomes of COVID-19 patients admitted to the intensive care unit during the first year of the pandemic in Brazil: a single center retrospective cohort study. Einstein (Sao Paulo, Brazil), 19, eAO6739. https://doi.org/10.31744/einstein_journal/2021AO6739.

Costa, D. R. D. da, Verissimo, L., Salvador, P. T. C. de O., & Rodrigues, C. C. F. M. (2022). Fatores estressores nos profissionais de enfermagem que atuam no combate ao COVID-19. Pesquisa, Sociedade e Desenvolvimento, 11(11), e322111133758. https://doi.org/10.33448/rsd-v11i11.33758.

Formisano, E., Di Maio, P., Ivaldi, C., Sferrazzo, E., Arieta, L., Bongiovanni, S., Panizzi, L., Valentino, E., Pasta, A., Giudice, M., & 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 (Burbank, Los Angeles County, Calif.), 82, 111048. https://doi.org/10.1016/j.nut.2020.111048.

Huang, C., Wang, Y., Li, X., Ren, L., Zhao, J., Hu, Y., Zhang, L., Fan, G., Xu, J., Gu, X., Cheng, Z., Yu, T., Xia, J., Wei, Y., Wu, W., Xie, X., Yin, W., Li, H., Liu, M., Xiao, Y., Cao, B. (2020). Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The Lancet (London, England), 395(10223), 497-506. https://doi.org/10.1016/S0140-6736(20)30183-5.

Kakeshita IS. Adaptação e validação de Escalas de Silhuetas para crianças e adultos brasileiros [Internet] [Doutorado em Psicobiologia]. [Ribeirão Preto]: Universidade de São Paulo; 2008 [citado 23 de agosto de 2022]. Disponível em: http://www.teses.usp.br/teses/disponiveis/59/59134/tde-25052008-170240/. doi:10.11606/T.59.2008.tde-25052008-170240.

Laviano, A., Koverech, A., & Zanetti, M. (2020). Nutrition support in the time of SARS-CoV-2 (COVID-19). Nutrition (Burbank, Los Angeles County, Calif.), 74, 110834. https://doi.org/10.1016/j.nut.2020.110834.

Lobo, S. M., & Mello, P. M. V. de C. (2021). Desafios da pandemia coronavírus para os intensivistas brasileiros: Presente e futuro. Revista Brasileira de Terapia Intensiva, 33(3). https://doi.org/10.5935/0103-507X.20210052.

Mendes, J. J., Mergulhão, P., Froes, F., Paiva, J. A., & Gouveia, J. (2020). Recommendations from the Sociedade Portuguesa de Cuidados Intensivos and Infection & Sepsis Group for intensive care approach to COVID-19. Revista Brasileira de Terapia Intensiva, 32(1). https://doi.org/10.5935/0103-507X.20200002.

Mentella, M. C., Scaldaferri, F., Gasbarrini, A., & Miggiano, G. (2021). The Role of Nutrition in the COVID-19 Pandemic. Nutrientes, 13(4), 1093. https://doi.org/10.3390/nu13041093.

Moock, M., & Mello, P. M. V. de C. (2020). Pandemia da COVID-19. Revista Brasileira de Terapia Intensiva, 32(1). https://doi.org/10.5935/0103-507X.20200001.

Perrotta, F., Corbi, G., Mazzeo, G., Boccia, M., Aronne, L., D'Agnano, V., Komici, K., Mazzarella, G., Parrella, R., & Bianco, A. (2020). COVID-19 and the elderly: insights into pathogenesis and clinical decision-making. Aging clinical and experimental research, 32(8), 1599-1608. https://doi.org/10.1007/s40520-020-01631-y.

Santos, L. P. M. dos, Souza, M. V. de C., Rosal, V. M. de S., Mendes, A. L. R., Andrade, I. L. X. C., Falcão, L. C. N., Carvalho, A. F. M. de, Melo, S. M., & Viana, D. dos S. F. (2022). “Infecting the mind”: Burnout in frontline healthcare professionals of COVID-19 in Brazil. Research, Society and Development, 11(11), e125111133401. https://doi.org/10.33448/rsd-v11i11.33401.

Singer, P., Blaser, A. R., Berger, M. M., Alhazzani, W., Calder, P. C., Casaer, M. P., Hiesmayr, M., Mayer, K., Montejo, J. C., Pichard, C., Preiser, J. C., van Zanten, A., Oczkowski, S., Szczeklik, W., & Bischoff, S. C. (2019). ESPEN guideline on clinical nutrition in the intensive care unit. Clinical nutrition (Edinburgh, Scotland), 38(1), 48-79. https://doi.org/10.1016/j.clnu.2018.08.037.

Simonnet, A., Chetboun, M., Poissy, J., Raverdy, V., Noulette, J., Duhamel, A., Labreuche, J., Mathieu, D., Pattou, F., Jourdain, M., & LICORN and the Lille COVID-19 and Obesity study group (2020). High Prevalence of Obesity in Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) Requiring Invasive Mechanical Ventilation. Obesity (Silver Spring, Md.), 28(7), 1195-1199. https://doi.org/10.1002/oby.22831.

Souza, N. J. R., Coelho, V. L., Lima, W. H. C. B, Pinheiro, J. D. (2022) . Complications in patients with COVID-19 in a cohort of intensive care hospitalists. Research, Society and Development, 11(11), e40111132451. https://doi.org/10.33448/rsd-v11i11.32451.

Teixeira, C., Rosa, R. G., Rodrigues Filho, E. M., & Fernandes, E. de O. (2020). The medical decision-making process in the time of the coronavirus pandemic. Revista Brasileira de Terapia Intensiva, 32(2). https://doi.org/10.5935/0103-507X.20200033.

Thibault, R., Coëffier, M., Joly, F., Bohé, J., Schneider, S. M., & Déchelotte, P (2021). How the Covid-19 epidemic is challenging our practice in clinical nutrition-feedback from the field. European Journal of Clinical Nutrition, 75(3), 407-416. https://doi.org/10.1038/s41430-020-00757-6.

Wells Mulherin, D., Walker, R., Holcombe, B., & Guenter, P. (2020). ASPEN Report on Nutrition Support Practice Processes With COVID-19: The First Response. Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition, 35(5), 783-791. https://doi.org/10.1002/ncp.10553.

World Health Organization. WHO COVID-19 dashboard. (citado em Agosto de 2022) World Health Organization.

Zabetakis, I., Lordan, R., Norton, C., & Tsoupras, A. (2020). COVID-19: The Inflammation Link and the Role of Nutrition in Potential Mitigation. Nutrients, 12(5), 1466. https://doi.org/10.3390/nu12051466.

Zhou, F., Yu, T., Du, R., Fan, G., Liu, Y., Liu, Z., Xiang, J., Wang, Y., Song, B., Gu, X., Guan, L., Wei, Y., Li, H., Wu, X., Xu, J., Tu, S., Zhang, Y., Chen, H., & Cao (2020). Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. The Lancet (London, England), 395(10229), 1054–1062. https://doi.org/10.1016/S0140-6736(20)30566-3.

Published

09/10/2022

How to Cite

GUIMARÃES, R. S.; CUNHA, C. de M.; SOUZA, V. S. .; ALVES, T. C. H. S. .; OLIVEIRA, A. D. de .; CONCEIÇÃO-MACHADO, M. E. P. da; OLIVEIRA, L. P. M. de .; DALTRO, C. Nutritional assistance during the COVID-19 pandemic in patients admitted to intensive care units . Research, Society and Development, [S. l.], v. 11, n. 13, p. e370111335624, 2022. DOI: 10.33448/rsd-v11i13.35624. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/35624. Acesso em: 27 dec. 2024.

Issue

Section

Health Sciences