It is not just about prescription. A Cohort study the impact of enteral nutrition on mortality of hospitalized patients with COVID-19.

Abstract

Abstract Background/Objectives: During COVID-19 pandemic, international societies released guidelines and recommendations for patients requiring nutritional support according with previous similar respiratory diseases. The aim of the study was to evaluate the nutritional support provided by enteral nutrition (EN) in patients with COVID-19 infection, identify if the recommendations from international societies were met and their impact on mortality rate. Subjects/Methods: A cohort study was conducted on adult patients with COVID-19 admitted to a tertiary hospital. Demographic, clinical, biochemical, and nutritional variables were obtained. A random-effect parametric survival-time model was performed to quantify the risk of death for each variable, the Hausman test was used to confirm the model. Results: 229 patients were enrolled; the delivered energy was > 80% of adequacy in the first two days, as suggested by international guidelines (11.7 ± 4.9 kcal/kg); however, an adequacy rate less than 60% was achieved on day 14 (25.4 ± 7.4 kcal/kg). The protein adequacy was > 75% on the first day of infusion (1.3 ± 0.3 g/kg); however, the infusion was < 50% (1.5 ± 0.4 g/kg) after being extubated. Age, sex, and nutritional risk were related to higher mortality in patients with EN, whereas, the infused energy and protein, the percentage of protein adequacy, arginine, and omega-3 were associated with lower mortality. Conclusion: Achieving at least 80% of the energy and protein requirements, as well as omega-3 and arginine supplementation are associated with lower mortality in COVID-19 patients. More studies are needed to confirm the role of these nutrients on the mortality rate.