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Early nutritional supplementation in non-critically ill patients hospitalized for the 2019 novel coronavirus disease (COVID-19): Rationale and feasibility of a shared pragmatic protocol
OBJECTIVES: Beginning in December 2019, the 2019 novel coronavirus disease (COVID-19) has caused a pneumonia epidemic that began in Wuhan, China, and is rapidly spreading throughout the whole world. Italy is the hardest hit country after China. Considering the deleterious consequences of malnutritio...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier Inc.
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7194616/ https://www.ncbi.nlm.nih.gov/pubmed/32280058 http://dx.doi.org/10.1016/j.nut.2020.110835 |
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author | Caccialanza, Riccardo Laviano, Alessandro Lobascio, Federica Montagna, Elisabetta Bruno, Raffaele Ludovisi, Serena Corsico, Angelo Guido Di Sabatino, Antonio Belliato, Mirko Calvi, Monica Iacona, Isabella Grugnetti, Giuseppina Bonadeo, Elisa Muzzi, Alba Cereda, Emanuele |
author_facet | Caccialanza, Riccardo Laviano, Alessandro Lobascio, Federica Montagna, Elisabetta Bruno, Raffaele Ludovisi, Serena Corsico, Angelo Guido Di Sabatino, Antonio Belliato, Mirko Calvi, Monica Iacona, Isabella Grugnetti, Giuseppina Bonadeo, Elisa Muzzi, Alba Cereda, Emanuele |
author_sort | Caccialanza, Riccardo |
collection | PubMed |
description | OBJECTIVES: Beginning in December 2019, the 2019 novel coronavirus disease (COVID-19) has caused a pneumonia epidemic that began in Wuhan, China, and is rapidly spreading throughout the whole world. Italy is the hardest hit country after China. Considering the deleterious consequences of malnutrition, which certainly can affect patients with COVID-19, the aim of this article is to present a pragmatic protocol for early nutritional supplementation of non-critically ill patients hospitalized for COVID-19 disease. It is based on the observation that most patients present at admission with severe inflammation and anorexia leading to a drastic reduction of food intake, and that a substantial percentage develops respiratory failure requiring non-invasive ventilation or even continuous positive airway pressure. METHODS: High-calorie dense diets in a variety of different consistencies with highly digestible foods and snacks are available for all patients. Oral supplementation of whey proteins as well as intravenous infusion of multivitamin, multimineral trace elements solutions are implemented at admission. In the presence of 25-hydroxyvitamin D deficit, cholecalciferol is promptly supplied. If nutritional risk is detected, two to three bottles of protein-calorie oral nutritional supplements (ONS) are provided. If <2 bottles/d of ONS are consumed for 2 consecutive days and/or respiratory conditions are worsening, supplemental/total parenteral nutrition is prescribed. CONCLUSION: We are aware that our straight approach may be debatable. However, to cope with the current emergency crisis, its aim is to promptly and pragmatically implement nutritional care in patients with COVID-19, which might be overlooked despite being potentially beneficial to clinical outcomes and effective in preventing the consequences of malnutrition in this patient population. |
format | Online Article Text |
id | pubmed-7194616 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Elsevier Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-71946162020-05-02 Early nutritional supplementation in non-critically ill patients hospitalized for the 2019 novel coronavirus disease (COVID-19): Rationale and feasibility of a shared pragmatic protocol Caccialanza, Riccardo Laviano, Alessandro Lobascio, Federica Montagna, Elisabetta Bruno, Raffaele Ludovisi, Serena Corsico, Angelo Guido Di Sabatino, Antonio Belliato, Mirko Calvi, Monica Iacona, Isabella Grugnetti, Giuseppina Bonadeo, Elisa Muzzi, Alba Cereda, Emanuele Nutrition Special Report OBJECTIVES: Beginning in December 2019, the 2019 novel coronavirus disease (COVID-19) has caused a pneumonia epidemic that began in Wuhan, China, and is rapidly spreading throughout the whole world. Italy is the hardest hit country after China. Considering the deleterious consequences of malnutrition, which certainly can affect patients with COVID-19, the aim of this article is to present a pragmatic protocol for early nutritional supplementation of non-critically ill patients hospitalized for COVID-19 disease. It is based on the observation that most patients present at admission with severe inflammation and anorexia leading to a drastic reduction of food intake, and that a substantial percentage develops respiratory failure requiring non-invasive ventilation or even continuous positive airway pressure. METHODS: High-calorie dense diets in a variety of different consistencies with highly digestible foods and snacks are available for all patients. Oral supplementation of whey proteins as well as intravenous infusion of multivitamin, multimineral trace elements solutions are implemented at admission. In the presence of 25-hydroxyvitamin D deficit, cholecalciferol is promptly supplied. If nutritional risk is detected, two to three bottles of protein-calorie oral nutritional supplements (ONS) are provided. If <2 bottles/d of ONS are consumed for 2 consecutive days and/or respiratory conditions are worsening, supplemental/total parenteral nutrition is prescribed. CONCLUSION: We are aware that our straight approach may be debatable. However, to cope with the current emergency crisis, its aim is to promptly and pragmatically implement nutritional care in patients with COVID-19, which might be overlooked despite being potentially beneficial to clinical outcomes and effective in preventing the consequences of malnutrition in this patient population. Elsevier Inc. 2020-06 2020-04-03 /pmc/articles/PMC7194616/ /pubmed/32280058 http://dx.doi.org/10.1016/j.nut.2020.110835 Text en © 2020 Elsevier Inc. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. |
spellingShingle | Special Report Caccialanza, Riccardo Laviano, Alessandro Lobascio, Federica Montagna, Elisabetta Bruno, Raffaele Ludovisi, Serena Corsico, Angelo Guido Di Sabatino, Antonio Belliato, Mirko Calvi, Monica Iacona, Isabella Grugnetti, Giuseppina Bonadeo, Elisa Muzzi, Alba Cereda, Emanuele Early nutritional supplementation in non-critically ill patients hospitalized for the 2019 novel coronavirus disease (COVID-19): Rationale and feasibility of a shared pragmatic protocol |
title | Early nutritional supplementation in non-critically ill patients hospitalized for the 2019 novel coronavirus disease (COVID-19): Rationale and feasibility of a shared pragmatic protocol |
title_full | Early nutritional supplementation in non-critically ill patients hospitalized for the 2019 novel coronavirus disease (COVID-19): Rationale and feasibility of a shared pragmatic protocol |
title_fullStr | Early nutritional supplementation in non-critically ill patients hospitalized for the 2019 novel coronavirus disease (COVID-19): Rationale and feasibility of a shared pragmatic protocol |
title_full_unstemmed | Early nutritional supplementation in non-critically ill patients hospitalized for the 2019 novel coronavirus disease (COVID-19): Rationale and feasibility of a shared pragmatic protocol |
title_short | Early nutritional supplementation in non-critically ill patients hospitalized for the 2019 novel coronavirus disease (COVID-19): Rationale and feasibility of a shared pragmatic protocol |
title_sort | early nutritional supplementation in non-critically ill patients hospitalized for the 2019 novel coronavirus disease (covid-19): rationale and feasibility of a shared pragmatic protocol |
topic | Special Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7194616/ https://www.ncbi.nlm.nih.gov/pubmed/32280058 http://dx.doi.org/10.1016/j.nut.2020.110835 |
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