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新型冠状病毒肺炎住院患者的胃肠道和感官表现、营养管理以及能量-蛋白质摄入。

Gastrointestinal and sensory manifestations, nutrition management, and energy-protein intake in hospitalized patients with COVID-19.

机构信息

Department of Gastroenterology, Laboratory of Nutrition and Surgery Metabolic of the Digestive Tract (LIM 35), School of Medicine (FMUSP), University of São Paulo, São Paulo, Brazil.

Nutrition Therapy Service, Sociedade Beneficente de Senhoras Hospital Sírio-Libanês de São Paulo, São Paulo, Brazil.

出版信息

Nutr Clin Pract. 2022 Oct;37(5):1152-1161. doi: 10.1002/ncp.10906.

Abstract

BACKGROUND

Gastrointestinal and sensory manifestations (GSMs) of coronavirus disease 2019 (COVID-19) may affect food intake, resulting in malnutrition and poor outcomes. We characterized the impact of GSMs and oral nutrition supplementation on energy-protein intake (EPI) and hospital discharge in adult patients with COVID-19.

METHODS

Patients from two hospitals were enrolled (n = 357). We recorded the presence and type of GSM at admission, estimated energy requirements (EER) and the EPI based on regular food intake (plate diagram sheets) during hospital stays. Patients not achieving 60% of their EER from food over 2 consecutive days received oral nutrition supplementation (ONS) with a high-energy-protein oral drink.

RESULTS

Most patients (63.6%) presented with GSMs at admission. Anorexia was the most common manifestation (44%). Patients with anorexia or more than one GSMs were more likely to not achieve 60% EER on the first day of follow-up and to require the ONS intervention (P ≤ 0.050). Prevalence of at least one GSM was higher in patients who did not achieve hospital discharge than in patients who achieved it (74.2% vs 54.6%, P = 0.038). The patients requiring ONS (26.9%) demonstrated good adherence to the intervention (79.3%), achieved their EER during 95.7% of the supplementation time, and presented with hospital discharge rates similar to patients not requiring ONS (92.2% vs 91.9%, respectively; P = 1.000).

CONCLUSIONS

GSM were prevalent in COVID-19 and it impaired EER attendance and patient recovery. ONS was well-tolerated, aided EER attendance, and potentially facilitated hospital discharge.

摘要

背景

2019 年冠状病毒病(COVID-19)的胃肠道和感官表现(GSM)可能会影响食物摄入,导致营养不良和不良结局。我们描述了 GSM 以及口服营养补充对成年 COVID-19 患者能量-蛋白质摄入(EPI)和出院的影响。

方法

从两家医院招募患者(n=357)。我们记录入院时 GSM 的存在和类型,根据住院期间的常规食物摄入量(餐盘图)估计能量需求(EER)和 EPI。如果患者连续两天通过食物摄入无法达到其 EER 的 60%,则给予高能量-蛋白质口服饮料的口服营养补充(ONS)。

结果

大多数患者(63.6%)入院时存在 GSM。食欲不振是最常见的表现(44%)。有食欲不振或多种 GSM 的患者更有可能在随访的第一天无法达到 60%的 EER,并且需要 ONS 干预(P≤0.050)。未达到出院标准的患者至少有一种 GSM 的发生率高于达到出院标准的患者(74.2%比 54.6%,P=0.038)。需要 ONS 的患者(26.9%)对干预措施的依从性良好(79.3%),在补充时间的 95.7%内达到其 EER,并且与不需要 ONS 的患者的出院率相似(分别为 92.2%比 91.9%,P=1.000)。

结论

GSM 在 COVID-19 中很常见,它会影响 EER 摄入和患者康复。ONS 耐受性良好,有助于 EER 摄入,并且可能促进出院。

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