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从老龄化角度看 2019 冠状病毒病:关注营养状况和营养管理——一篇叙述性综述。

Coronavirus Disease 19 from the Perspective of Ageing with Focus on Nutritional Status and Nutrition Management-A Narrative Review.

机构信息

Faculty of Health Science, Kristianstad University, 291 88 Kristianstad, Sweden.

出版信息

Nutrients. 2021 Apr 14;13(4):1294. doi: 10.3390/nu13041294.

Abstract

The novel severe acute respiratory syndrome coronavirus (COVID-19) has hit older adults harder due to a combination of age-related immunological and metabolic alterations. The aim of this review was to analyze the COVID-19 literature with respect to nutritional status and nutrition management in older adults. No studies only on people aged 65+ years were found, and documentation on those 80+ was rare. Age was found to be strongly associated with worse outcomes, and with poor nutritional status. Prevalence of malnutrition was high among severely and critically ill patients. The studies found a need for nutrition screening and management, and for nutrition support as part of follow-up after a hospital stay. Most tested screening tools showed high sensitivity in identifying nutritional risk, but none were recognized as best for screening older adults with COVID-19. For diagnosing malnutrition, the Global Leadership Initiative on Malnutrition (GLIM) criteria are recommended but were not used in the studies found. Documentation of olfactory and gustatory dysfunction in relation to nutritional status is missing in older adults. Other COVID-19-associated factors with a possible impact on nutritional status are poor appetite and gastrointestinal symptoms. Vitamin D is the nutrient that has attracted the most interest. However, evidence for supplementation of COVID-19 patients is still limited and inconclusive.

摘要

新型严重急性呼吸综合征冠状病毒(COVID-19)对老年人的影响更为严重,这是由于与年龄相关的免疫和代谢改变的综合作用。本综述的目的是分析与老年人营养状况和营养管理相关的 COVID-19 文献。未发现仅针对 65 岁以上人群的研究,80 岁以上人群的相关记录也很少。年龄与较差的预后和较差的营养状况密切相关。严重和危重症患者营养不良的发生率很高。研究发现需要进行营养筛查和管理,并需要在住院后进行营养支持。大多数经过测试的筛查工具在识别营养风险方面具有较高的敏感性,但没有一种被认为是筛查 COVID-19 老年患者的最佳工具。对于营养不良的诊断,建议使用全球营养不良领导倡议(GLIM)标准,但在已发现的研究中并未使用。与营养状况相关的嗅觉和味觉功能障碍在老年人中的记录缺失。其他可能影响营养状况的 COVID-19 相关因素是食欲不佳和胃肠道症状。维生素 D 是最受关注的营养素。然而,COVID-19 患者补充维生素 D 的证据仍然有限且不确定。

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