Scarcella Marialaura, Scarpellini Emidio, Ascani Alessandra, Commissari Rita, Scorcella Claudia, Zanetti Michela, Parisi Amilcare, Monti Riccardo, Milic Natasa, Donati Abele, Luzza Francesco, De Robertis Edoardo, Abenavoli Ludovico
Anesthesia, Intensive Care and Nutritional Science, Azienda Ospedaliera "Santa Maria", Via Tristano di Joannuccio, 05100 Terni, Italy.
Clinical Nutrition and Internal Medicine Unit, "Madonna del Soccorso" General Hospital, Via Luciano Manara 7, 63074 San Benedetto del Tronto, Italy.
Nutrients. 2022 Jan 19;14(3):437. doi: 10.3390/nu14030437.
The novel SARS-CoV-2 virus has led to a severe pandemic, starting from early 2020. Intensive care (ICU) management of the COVID-19 disease is difficult with high morbidity and mortality. Early nutritional support, especially with whey protein, seems to be crucial in this medical case. Thus, we aimed to assess the effects of an adequate nutritional protocol rich in whey protein on nutritional and inflammatory status, extubating time, and mortality of critically ill COVID-19 patients (CICP).
A prospective single-center exploratory observational study was undertaken on 32 consecutive CICP admitted to the ICU of Santa Maria Hospital, Terni, Italy, and treated with whey protein-enriched formula. Patients' demographics, nutritional status, indexes of inflammation, daily pre-albumin serum levels, duration of mechanical ventilation, and mortality were recorded.
Thirty-two patients were enrolled. Ninety-five percent of them showed a gradual reduction in C-reactive protein (CRP) values and increase in pre-albumin levels after the whey protein-enriched formula. Prealbumin levels were not correlated with a better nutritional status but with a shorter extubating time and better survival.
An adequate administration of whey protein during COVID-19 patients' ICU stays can provide fast achievement of protein targets, reducing the duration of mechanical ventilation, and improving inflammatory status and ICU survival. Further prospective and large-scale, controlled studies are needed to confirm these results.
新型严重急性呼吸综合征冠状病毒2（SARS-CoV-2）自2020年初引发了一场严重的大流行。新型冠状病毒肺炎（COVID-19）疾病的重症监护（ICU）管理困难，发病率和死亡率很高。早期营养支持，尤其是使用乳清蛋白，在这种医疗情况下似乎至关重要。因此，我们旨在评估富含乳清蛋白的适当营养方案对危重症COVID-19患者（CICP）的营养和炎症状态、拔管时间及死亡率的影响。
对意大利特尔尼圣玛丽亚医院ICU收治的32例连续CICP患者进行了一项前瞻性单中心探索性观察研究，这些患者接受了富含乳清蛋白的配方治疗。记录患者的人口统计学资料、营养状况、炎症指标、每日血清前白蛋白水平、机械通气时间及死亡率。
共纳入32例患者。其中95%的患者在接受富含乳清蛋白的配方后，C反应蛋白（CRP）值逐渐降低，前白蛋白水平升高。前白蛋白水平与更好的营养状况无关，但与更短的拔管时间和更好的生存率相关。
在COVID-19患者的ICU住院期间适当给予乳清蛋白可快速实现蛋白质目标，缩短机械通气时间，改善炎症状态和ICU生存率。需要进一步进行前瞻性大规模对照研究来证实这些结果。
