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• W3215542006 abstract "Rationale: NRS2002 and nutric scores are correlated with poor outcome of COVID-19 critically ill patients. The medical profile with long ICU and ward stay and the altered practical circumstances seen in a pandemic, complicate and challenge nutritional therapy. Although the medical community reacted quickly and nutritional protocols and guidance was foreseen (1), quality of care might be compromised by this healthcare disruption. We aimed to evaluate the adequacy of caloric and protein therapy of COVID-19 patients in the ICU and the following ward stay. Methods: COVID-19 patients with a length of stay of 7 days or more were prospectively followed up until hospital discharge, 8 weeks hospital stay or death. Caloric and protein intake, both intentional and non-intentional was collected and analyzed on a daily basis starting at ICU day 7. Intake was compared to needs, defined by the 2019 ESPEN guideline for clinical nutrition in the ICU: calories guided by indirect calorimetry and protein target defined by 1.3g/kgBW/day in ICU. In the ward the best suited ESPEN guideline (geriatrics, internal medicine) was used. Nutritional therapy adequacy was defined by the ratio intake/needs and expressed in %. Results: Eleven severely ill COVID-19 patients were included, 5 patients died in ICU and one in the ward (in accordance with their calculated mortality risk). Their hospital stay was a mean of 21 days (range 11-32). This represents 171 evaluation days. The mean measured Resting Energy Expenditure was 2079 kcal/day (28 kcal/kg/day) in ICU and 2115 kcal /day in the ward (26 kcal/kg/day). An overall daily intake of 1385 kcal and 70 g of protein was observed. The adequacy of the nutritional therapy was 70% of caloric target and 71% of protein target in the setting of ICU. The same patients, discharged from ICU, had a nutritional adequacy of 50% for calories and 44% for protein in the ward. Conclusion: Caloric targets guided by indirect calorimetry alter with time in a COVID-19 population. Providing adequate amounts of calories and proteins to ICU patients is challenging. The nutritional intake post ICU reveals to be even lower with less than half of recommended proteins being provided in a period of rehabilitation. This iatrogenic malnutrition of COVID-19 ICU survivors needs further investigation and improvement plans. References: 1:ESPEN expert statements and practical guidance for nutritional management of individuals with SARS-CoV-2 infection.Barazzoni R, Bischoff SC, Breda J, Wickramasinghe K, Krznaric Z, Nitzan D, Pirlich M, Singer P; endorsed by the ESPEN Council.Clin Nutr. 2020 Jun;39(6). Disclosure of Interest: J. Geers: None declared, J. Demol: None declared, C. Verhelst: None declared, J. Jonckheer: None declared, E. De Waele Grant / Research Support from: investigator-initiated grant funding related to this work from National Institutes of Health, Baxter, and Nutricia, Consultant for: honoraria or travel expenses for CME lectures on improving nutrition care from Baxter, Danone-Nutricia and Nestle." @default.
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• W3215542006 date "2021-12-01" @default.
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• W3215542006 title "Adequacy of nutritional therapy of covid-19 patients during their ICU and ward stay: better is worse" @default.
• W3215542006 doi "https://doi.org/10.1016/j.clnesp.2021.09.277" @default.
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