Graduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte59078-970, Brazil.
Graduate Program in Nutrition, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte59078-970, Brazil.
Br J Nutr. 2021 Aug 28;126(4):552-560. doi: 10.1017/S0007114520004420. Epub 2020 Nov 5.
Although increased weight, and particularly obesity, has been associated with a more severe clinical course of COVID-19 and risk of fatality, the course of the illness can lead to prolonged length of stay. Changes in nutritional status and weight loss during hospitalisation are largely reported in some populations, but still not explored in COVID-19 patients. Considering that patients with COVID-19 show an increased inflammatory response, other signs and symptoms, which can lead to weight and muscle loss, should be monitored. The aim of this article was to establish possible connections between COVID-19, prolonged hospitalisation and muscle wasting, as well as to propose nutritional recommendations for the prevention and treatment of cachexia, through a narrative review. Identification of risk and presence of malnutrition should be an early step in general assessment of all patients, with regard to more at-risk categories including older adults and individuals suffering from chronic and acute disease conditions, such as COVID-19. The deterioration of nutritional status, and consequently cachexia, increases the risk of mortality and needs to be treated with attention as other complications. There is, however, little hard evidence of nutritional approaches in assisting COVID-19 treatment or its management including cachexia.
尽管体重增加，特别是肥胖，与 COVID-19 更严重的临床病程和死亡风险相关，但疾病的病程可能导致住院时间延长。在某些人群中，大量报道了住院期间营养状况和体重减轻的变化，但 COVID-19 患者仍未得到探索。鉴于 COVID-19 患者表现出炎症反应增加，其他可能导致体重和肌肉减少的症状和体征也应得到监测。本文旨在通过叙述性综述，确定 COVID-19、住院时间延长和肌肉消耗之间的可能联系，并提出预防和治疗恶病质的营养建议。在对所有患者进行一般评估时，应及早识别风险和存在营养不良的情况，对于包括老年人和患有慢性和急性疾病（如 COVID-19）的个体等高危人群更是如此。营养状况的恶化，进而恶病质，会增加死亡风险，需要像对待其他并发症一样给予关注。然而，在 COVID-19 治疗或其管理（包括恶病质）中，营养方法的证据很少。
