Hypermetabolism and COVID‐19

Yu, Pey‐Jen; Cassiere, Hugh; DeRosa, Sarah; Bocchieri, Karl; Yar, Shiraz; Hartman, Alan

BACKGROUND: Hypermetabolism has been described in stress states such as trauma, sepsis, ARDS, and severe burn injuries. We hypothesize that patients with COVID‐19 may develop a hypermetabolic state which may be a major contributing factor to the extraordinary ventilatory and oxygenation demands in patients with COVID‐19. METHOD: Resting energy expenditure (REE), carbon dioxide production (VCO2) and oxygen consumption (VO2) were measured by indirect calorimetry on seven critically ill patients with COVID‐19. RESULTS: The median measured REE was 4044 Kcal/day which was 235.7% ± 51.7% of predicted. The median VCO2 was 452 mL/min (range 295–582 mL/min) and the median VO2 was 585 mL/min (range 416–798 mL/min). CONCLUSION: Critically ill patients with COVID‐19 are in an extreme hypermetabolic state. This may explain the high failure rates for mechanical ventilation for these patients and highlights the potential need for increased nutritional requirements for such patients. This article is protected by copyright. All rights reserved