Clinical Nutrition and Metabolism Unit and Center for Chronic Intestinal Failure, Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, Bologna, Italy; Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
Clinical Nutrition and Metabolism Unit and Center for Chronic Intestinal Failure, Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, Bologna, Italy; Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
Clin Nutr. 2021 Mar;40(3):1330-1337. doi: 10.1016/j.clnu.2020.08.021. Epub 2020 Aug 27.
The prevalence of malnutrition and the provided nutritional therapy were evaluated in all the patients with SARS-CoV-2 infection (COVID-19) hospitalized in a 3rd level hospital in Italy.
A one-day audit was carried out recording: age, measured or estimated body weight (BW) and height, body mass index (BMI, kg/m), 30-day weight loss (WL), comorbidities, serum albumin and C-reactive protein (CRP: nv < 0.5 mg/dL), hospital diet (HD) intake, oral nutritional supplements (ONS), enteral (EN) and parenteral nutrition (PN). Modified NRS-2002 tool and GLIM criteria were used for nutritional risk screening and for the diagnosis of malnutrition, respectively.
A total of 268 patients was evaluated; intermediate care units (IMCUs, 61%), sub-intensive care units (SICUs, 8%), intensive care units (ICUs, 17%) and rehabilitation units (RUs, 14%): BMI: <18.5, 9% (higher in RUs, p = 0.008) and ≥30, 13% (higher in ICUs, p = 0.012); WL ≥ 5%, 52% (higher in ICUs and RUs, p = 0.001); CRP >0.5: 78% (higher in ICUs and lower in RUs, p < 0.001); Nutritional risk and malnutrition were present in 77% (higher in ICUs and RUs, p < 0.001) and 50% (higher in ICUs, p = 0.0792) of the patients, respectively. HD intake ≤50%, 39% (higher in IMCUs and ICUs, p < 0.001); ONS, EN and PN were prescribed to 6%, 13% and 5%, respectively. Median energy and protein intake/kg BW were 25 kcal and 1.1 g (both lower in ICUs, p < 0.05) respectively.
Most of the patients were at nutritional risk, and one-half of them was malnourished. The frequency of nutritional risk, malnutrition, disease/inflammation burden and decrease intake of HD differed among the intensity of care settings, where the patients were managed according to the severity of the disease. The patient energy and protein intake were at the lowest limit or below the recommended amounts, indicating the need for actions to improve the nutritional care practice.
评估了在意大利一家三级医院住院的所有 SARS-CoV-2 感染（COVID-19）患者的营养不良发生率和提供的营养治疗情况。
进行了为期一天的审核，记录了：年龄、实测或估计体重（BW）和身高、体重指数（BMI，kg/m）、30 天体重下降（WL）、合并症、血清白蛋白和 C 反应蛋白（CRP：nv < 0.5mg/dL）、医院饮食（HD）摄入、口服营养补充剂（ONS）、肠内（EN）和肠外（PN）营养。分别使用改良 NRS-2002 工具和 GLIM 标准进行营养风险筛查和营养不良诊断。
共评估了 268 例患者；中级护理病房（IMCUs，61%）、亚重症监护病房（SICUs，8%）、重症监护病房（ICUs，17%）和康复病房（RUs，14%）：BMI：<18.5，9%（RUs 更高，p=0.008）和≥30，13%（ICUs 更高，p=0.012）；WL≥5%，52%（ICUs 和 RUs 更高，p=0.001）；CRP>0.5：78%（ICUs 和 RUs 更高，p<0.001）；营养风险和营养不良分别为 77%（ICUs 和 RUs 更高，p<0.001）和 50%（ICUs 更高，p=0.0792）。HD 摄入量≤50%，39%（IMCUs 和 ICUs 更高，p<0.001）；ONS、EN 和 PN 的处方率分别为 6%、13%和 5%。中位数能量和蛋白质摄入/kg BW 分别为 25 千卡和 1.1 克（均在 ICUs 中较低，p<0.05）。
大多数患者存在营养风险，其中一半存在营养不良。营养风险、营养不良、疾病/炎症负担和 HD 摄入量减少的频率在不同的护理强度设置中存在差异，这些患者是根据疾病的严重程度进行管理的。患者的能量和蛋白质摄入量处于最低限度或低于推荐量，表明需要采取行动改善营养护理实践。
