新冠患者重症监护病房出院后的营养状况评估。
Nutritional status assessment in patients with Covid-19 after discharge from the intensive care unit.
机构信息
Department of Endocrinology and Metabolic Diseases, CHU Ibn Rochd, Casablanca, Morocco; Faculty of Medicine and Pharmacy, University Hassan II, Casablanca, Morocco.
Department of Endocrinology and Metabolic Diseases, CHU Ibn Rochd, Casablanca, Morocco; Faculty of Medicine and Pharmacy, University Hassan II, Casablanca, Morocco.
出版信息
Clin Nutr ESPEN. 2021 Feb;41:423-428. doi: 10.1016/j.clnesp.2020.09.214. Epub 2020 Oct 13.
INTRODUCTION
The nutritional diagnosis and early nutritional management of COVID-19 patients must be integrated into the overall therapeutic strategy. The aim of our study is to assess the nutritional status of patients with COVID-19 after a stay in intensive care, to describe the prevalence of undernutrition, to determine the factors influencing undernutrition and to describe the nutritional management.
TOOLS AND METHODS
This is a descriptive observational study of adult patients admitted to the endocrinology service for additional care after a stay in intensive care during the period from April 17, 2020 to May 26, 2020. The assessment tool used was the Mini Nutritional Assessment (MNA).
RESULTS
Our study included 41 patients; the average age of the patients was 55 years, 51.2% had a severe or critical form of COVID-19, 75.6% stayed in intensive care, 12.2% had a loss of autonomy. The average BMI was 25.2 kg/m (17-42 kg/m), 42.5% were overweight, 61% had weight loss, 26.2% had weight loss greater than 10%, 14.6% of our patients were undernourished, 65.9% were at risk of undernutrition, 19.5% had hypoalbuminemia, 17.1% had hypoprotidemia, 19.5% hypocalcemia, 34.1% anemia, 12.2% hypomagnesemia and 51.2% had a deficiency in vitamin D. A positive correlation was found between poor nutritional status and a longer stay in intensive care (>5 days) (p = 0.011) and lymphopenia (p = 0,02).
CONCLUSION
Despite a personalized diet, 14.6% of patients presented undernutrition. Particular attention should be paid to patients with a long stay in intensive care.
简介
必须将 COVID-19 患者的营养诊断和早期营养管理纳入整体治疗策略。我们研究的目的是评估重症监护后 COVID-19 患者的营养状况,描述营养不良的流行情况,确定影响营养不良的因素,并描述营养管理。
方法
这是一项对 2020 年 4 月 17 日至 5 月 26 日期间因重症监护后入住内分泌科进行额外护理的成年患者进行的描述性观察研究。使用的评估工具是迷你营养评估 (MNA)。
结果
我们的研究包括 41 名患者;患者的平均年龄为 55 岁,51.2%的患者患有严重或危重症 COVID-19,75.6%的患者入住重症监护病房,12.2%的患者失去了自主性。平均 BMI 为 25.2kg/m(17-42kg/m),42.5%超重,61%体重减轻,26.2%体重减轻超过 10%,14.6%的患者营养不良,65.9%有营养不良风险,19.5%低蛋白血症,17.1%低蛋白血症,19.5%低钙血症,34.1%贫血,12.2%低镁血症,51.2%维生素 D 缺乏症。营养状况差与重症监护时间延长 (>5 天)(p=0.011)和淋巴细胞减少(p=0.02)之间存在正相关。
结论
尽管进行了个性化饮食,但仍有 14.6%的患者出现营养不良。应特别注意在重症监护室停留时间较长的患者。
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