Domenico Azzolino. Geriatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico; Via Pace 9, 20122 Milan, Italy. Email:
J Nutr Health Aging. 2020;24(7):696-698. doi: 10.1007/s12603-020-1400-x.
The COVID-19 pandemic is posing an unprecedented challenge to healthcare systems worldwide. Older adults, which frequently present multiple chronic comorbidities, are more susceptible to COVID-19 and experience more likely negative outcomes, in terms of disease severity and mortality. However, chronological age per se may not entirely explain the dramatic scenario described among the frailest and oldest persons. Comorbidities and functional status may indeed play a relevant role. Patients at high risk of adverse clinical outcomes in COVID-19 infection are the same at risk of malnutrition, namely older adults and multimorbid individuals. In fact, COVID-19 can negatively impact on nutritional status, both in patients admitted to the hospital with the most severe manifestations of the infection, as well as in those who experience milder/asymptomatic forms of the disease. Despite being quite difficult in these emergency circumstances, nutritional status needs to be assessed in all COVID-19 patients upon admission and during hospital stay. Early nutritional support should be guaranteed in order to improve several malnutrition-related adverse outcomes. The evaluation of the nutritional status is today even more crucial than in normal times given the delicate status of older patients with COVID-19.
COVID-19 大流行给全球医疗系统带来了前所未有的挑战。老年人通常患有多种慢性合并症,更容易感染 COVID-19,并且在疾病严重程度和死亡率方面更有可能出现负面结果。然而,年龄本身可能并不能完全解释在最脆弱和最年长的人群中描述的戏剧性情况。合并症和功能状态确实可能发挥相关作用。在 COVID-19 感染中具有不良临床结果高风险的患者,同样有营养不良的风险,即老年人和多病共存的个体。事实上,COVID-19 会对营养状况产生负面影响,既影响那些因感染而出现最严重症状住院的患者,也影响那些患有轻度/无症状疾病的患者。尽管在这些紧急情况下相当困难,但在所有 COVID-19 患者入院时和住院期间都需要评估营养状况。为了改善与营养不良相关的不良结局,应尽早提供营养支持。考虑到 COVID-19 老年患者的脆弱状况,与平时相比,目前对营养状况的评估甚至更为关键。