Center for Geriatric Medicine, Heidelberg University, Rohrbacher Strasse 149, 69126 Heidelberg, Germany; Agaplesion Bethanien Hospital, Rohrbacher Strasse 149, 69126 Heidelberg, Germany.
Center for Geriatric Medicine, Heidelberg University, Rohrbacher Strasse 149, 69126 Heidelberg, Germany; Agaplesion Bethanien Hospital, Rohrbacher Strasse 149, 69126 Heidelberg, Germany.
Clin Geriatr Med. 2022 Aug;38(3):559-564. doi: 10.1016/j.cger.2022.04.001. Epub 2022 Apr 21.
Malnutrition has been one of the most common complications of older COVID-19 survivors. COVID-19 associated symptoms like loss of appetite as well as changes in taste and smell may trigger the deterioration of nutritional status, while other complications of the disease may contribute to it, like respiratory failure that necessitates admission to the ICU. Especially in nursing home residents reduced food intake may be related to preexisting and also to incident geriatric syndromes like delirium. Sarcopenia has also been highly prevalent in older COVID-19 survivors. It is caused and exacerbated by COVID-19-associated inflammatory processes, total or partial immobilization, and malnutrition. COVID-19 survivors may be at high risk of developing the vicious circle that results from the interaction of deteriorating nutritional status and declining functionality. Regular monitoring of nutritional and functional status is, therefore, indicated in all older COVID-19 survivors. If malnutrition and/or functional decline have been identified in this patient population, low-threshold provision of individualized nutritional and exercise interventions should be installed. In those that are most seriously affected by malnutrition and sarcopenia ambulatory or inpatient rehabilitation has to be considered. Geriatric rehabilitation programs should be specifically adapted to the needs of older patients with COVID-19.
营养不良是老年 COVID-19 幸存者最常见的并发症之一。COVID-19 相关症状，如食欲不振以及味觉和嗅觉改变，可能会导致营养状况恶化，而疾病的其他并发症也可能导致这种情况，例如需要入住 ICU 的呼吸衰竭。特别是在养老院居民中，减少食物摄入可能与预先存在的以及新发的老年综合征有关，如谵妄。肌少症在老年 COVID-19 幸存者中也非常普遍。它是由 COVID-19 相关的炎症过程、完全或部分固定以及营养不良引起和加重的。COVID-19 幸存者可能有很高的风险患上由营养状况恶化和功能下降相互作用引起的恶性循环。因此，所有老年 COVID-19 幸存者都需要定期监测营养和功能状况。如果在这些患者人群中发现存在营养不良和/或功能下降，应提供低门槛的个体化营养和运动干预。对于那些受营养不良和肌少症影响最严重的患者，应考虑进行门诊或住院康复治疗。老年康复计划应根据 COVID-19 老年患者的需求进行专门调整。
