Nutritional evaluation and management of critically ill patients with COVID‐19 during post‐intensive care rehabilitation

Hoyois, Alice; Ballarin, Asuncion; Thomas, Justine; Lheureux, Olivier; Preiser, Jean‐Charles; Coppens, Emmanuel; Bogerd, Silvia Perez; Taton, Olivier; Farine, Sylvie; Van Ouytsel, Pauline; Arvanitakis, Marianna

BACKGROUND & AIMS: Among hospitalized patients with COVID‐19, up to 12% may require intensive care management (ICU). The aim of this prospective cohort study is to assess nutritional status and outcome in patients with COVID‐19 following ICU discharge. METHODS: All patients with COVID‐19 requiring a minimum of 14 days stay in the ICU with mechanical ventilation were included. Nutritional status was assessed at inclusion (ICU discharge) and follow‐up (after 15, 30 and 60 days). All patients had standardized medical nutrition therapy with defined targets regarding energy (30 kcal/kg/d) and protein intake (1,5g/kg/d). RESULTS: Fifteen patients were included (67% Males); median age was 60 (33 ‐75) years old. Body Mass index at ICU admission was 25,7 (IQR, 24 – 31) kg/m². After a median ICU stays of 33 (IQR, 26 – 39) days, malnutrition was present in all patients (11,3% median weight loss and/or low muscle mass based on hand grip strength measurement). Because of post‐intubation dysphagia in 60% of patients, enteral nutrition was administered (57% naso‐gastric tube; 43% percutaneous endoscopic gastrostomy). After 2‐month, a significant improvement in muscle strength was observed (median handgrip strength: 64,7%(IQR, 51 – 73) of the predicted values for age vs 19% (IQR, 4,8 – 28,4) at ICU discharge (p < 0,0005)), as well as weight gain of 4,3 kg (IQR, 2,7 – 6,7) (p< 0,0002). CONCLUSIONS: Critically ill patients with COVID‐19 requiring ICU admission and mechanical ventilation have malnutrition and low muscle mass at ICU discharge. Nutritional parameters improve during rehabilitation with standardized medical nutrition therapy. This article is protected by copyright. All rights reserved