Enteral nutritional support in patients hospitalized with COVID-19: results from the first wave in a public hospital

de Alencar, Eudoxia Sousa; dos Santos Muniz, Lia Sara; Holanda, Júlia Luisa Gomes; Oliveira, Breno Douglas Dantas; de Carvalho, Marcelo Costa Freire; Leitão, Alessandra Marjorye Maia; Cavalcante, Maria Isabel de Alencar; de Oliveira, Rayanne Cristina Pontes; da Silva, Carlos Antônio Bruno; Carioca, Antônio Augusto Ferreira

Background & aims Nutrition has become an important component in treating individuals during the COVID-19 pandemic, which is increasingly affecting the world population, and bringing with it a collapse in health services. Prolonged hospitalization, involving immobilization and catabolism, induces a decrease in body weight and muscle mass that may result in sarcopenia, a condition that impairs respiratory and cardiac function, worsening the prognosis. The present study aimed to analyze enteral nutritional support and the clinical evolution of patients admitted for COVID-19 in Brazil. Methods This was a retrospective study, carried out from March to May 2020, with patients admitted to a referral hospital in cardiology and pulmonology in Fortaleza-Ce/Brazil, 200 patients with COVID-19 were selected. Sociodemographic, clinical, and nutritional data were collected from electronic medical records, and associations between outcomes and use of prone body position with nutritional variables were analyzed by linear regression. The odds ratio and 95% confidence interval estimates for the death outcome were analyzed by logistic regression. Results Of the 112 patients who fed by the enteral route, the majority were male (n = 61, 54.5%), elderly (n = 88, 78.6%), with no current smoking habit (n = 81, 72.3%). The median hospital stay was 14 days, mostly in the intensive care units (median of 9 days). Prone body positioning impacted the nutritional therapy. In general, those patients who maintained a prone body position tested lower for kcal/kg of body weight, proteins/kg of body weight, percentage of diet adequacy, and total caloric value. In addition, patients who died had lower mean maximum kcal/kg body weight, protein/kg body weight, percentage of diet adequacy, and total caloric value compared to surviving patients. Conclusions There was an association between inadequacies in protein and energy supply with mortality was confirmed suggesting that nutritional support optimization be prescribed in such situations.