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Nutrition Therapy in the Intensive Care Unit during the COVID-19 Pandemic

Published in Clinical Nutrition, September 2021

 OPEN ACCESS  View online here

The COVID-19 pandemic has led to a global healthcare response so it is interesting to see a study which offers a global one-day prevalence study of nutritional therapy in patients in the ICU with and without COVID-19. In addition to nutrition therapy, patient physical activity and ICU administrative structures on that day were also assessed. 

On 27th January 2021, an international one-day point prevalence study was conducted, participants were recruited via invitations sent to local, national and international Critical Care networks. All registrations and questionnaires were completed via Google Forms, and basic hospital and ICU data was collected. On the survey date (21.01.21), data was collated for ICU patients with and without COVID-19, including details such as demographics, body mass index (BMI), route of feed (oral, enteral, parenteral) and estimated daily intakes of energy and protein. 

A total of 1229 patients (627 non-COVID and 602 COVID) were analysed from 135 worldwide ICU units, with the majority of patients from Asia (52.6%), Africa (28.4%) and Europe (15.3%). Enteral nutrition was more often used in COVID patients, regardless of the presence of mechanical ventilation, while parenteral nutrition was less frequent. The rate of energy delivery (≥20kcal/kg/day) and protein delivery (≥1.2g/kg/day) was significantly higher in the COVID group, with the same low level of activity reported in each group. Enteral nutrition was provided to most COVID patients. Thirty five percent of ICU units had a dedicated nutritionist / dietitian, which was significantly associated with appropriate energy delivery. 

While the authors highlight the limitations of this study design (such as selection bias, limits to data collection) this study does give an overview of nutrition support to COVID patients in the ICU on a worldwide level.