Clinical Nutrition Research and the COVID-19 Pandemic: A Scoping Review of the ASPEN COVID-19 Nutrition Taskforce.

Mechanick, Jeffrey I; Carbone, Salvatore; Dickerson, Roland N; Hernandez, Beverly J D; Hurt, Ryan T; Irving, Sharon Y; Li, Ding-You; McCarthy, Mary S; Mogensen, Kris M; Gautier, Juan B Ochoa; Patel, Jayshil J; Prewitt, T Elaine; Rosenthal, Martin; Warren, Malissa; Winkler, Marion F; McKeever, Liam

The purpose of this scoping review by the American Society for Parenteral and Enteral Nutrition (ASPEN) COVID-19 Nutrition Taskforce was to examine nutrition research applicable to the COVID-19 pandemic. The rapid pace of emerging scientific information and need for expeditious translation into clinical nutritional care prompted this activity to discover research/knowledge gaps. This methodology adhered with recommendations from the Joanna Briggs Institute. There were 2301 citations imported, 439 articles fully abstracted, with 23 main topic areas identified across 24 article types, sourced across 61 countries and 51 specialties, in eight settings, and amongst 14 populations. Epidemiological/mechanistic relationships between nutrition and COVID-19 were reviewed, important topics catalogued, and results mapped to "Population, Intervention, Comparator, Outcome, and Time" (PICO-T) questions. The aggregated data was analyzed by clinical stage: pre-COVID-19, acute COVID-19, and chronic/post-COVID-19. Research gaps were discovered for all PICO-T questions. Important nutrition topics meriting urgent research included: food insecurity/societal infrastructure and transcultural factors (Pre-COVID-19); cardiometabolic-based chronic disease, pediatrics, nutrition support, and hospital infrastructure (Acute COVID-19); registered dietitian nutritionist counseling (Chronic/Post-COVID-19); and malnutrition and management (All Stages). The paucity of randomized, control trials (RCTs) was particularly glaring. Knowledge gaps were discovered for PICO-T questions on pediatrics, micronutrients, bariatric surgery, and transcultural factors (Pre-COVID-19); enteral nutrition, protein-energy requirements, and glycemic control with nutrition (Acute COVID-19); and home enteral and parenteral nutrition support (Chronic/Post-COVID-19). In conclusion, this ASPEN scoping review has identified multiple critical areas for urgent nutrition research, particularly using RCT design, to improve nutritional care for patients before, during, and after COVID-19. This article is protected by copyright. All rights reserved.