Investigation and analysis of nutritional risk and dietary intake of patients with coronavirus disease 2019_West China Medical Journal

Authors：

CHENG Liangping ¹ , LI Xi ² , PAN Qun ³ , ZHU Hongfang ⁴ ,  RAO Zhiyong ⁵

1. Department of Critical Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. International Medical Center / Ward of General Practice, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
3. Department of Nutrition, Wuhan Wuchang Hospital, Wuhan, Hubei 430063, P. R. China;
4. Nursing Department, Wuhan Wuchang Hospital, Wuhan, Hubei 430063, P. R. China;
5. Department of Clinical Nutrition, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

RAO Zhiyong, Email: patchrao@126.com

Keywords：

Coronavirus disease 2019; Nutritional risk; Energy intake; Protein intake; Body weight; Body mass index

DOI：

10.7507/1002-0179.202005042

Video：

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Objective To explore and analyze the nutritional risk and dietary intake of patients with coronavirus disease 2019 (COVID-19), and provide data support for nutritional intervention.Methods COVID-19 inpatients were investigated in Wuhan Wuchang Hospital and the People’s Hospital of Wuhan University (East Area) from March 9th to 16th, 2020 by Nutrition Risk Screening 2002 (NRS 2002) scale and designed questionnaire. The energy and protein requirements were calculated according to the standard of 30 kcal/(kg·d) and 1.2 g/(kg·d). The nutritional risk, energy and protein intake, body weight and body mass index and their changes in the mild and severe patients were analyzed. The energy and protein intake of the two types of nutritional risk patients was analyzed.Results A total of 98 patients with COVID-19 completed the investigation, in whom 46 (46.94%) had nutritional risk, including 32 (39.02%) with mild type and 14 (87.50%) with severe type; and the difference was statistically significant (P<0.001). Compared with the usual condition, the body weight and body mass index of the two types of patients significantly decreased (P<0.01 or P<0.001); the energy and protein intake in mild type patients were significantly higher than those in the severe type patients (P<0.001); compared with the requirement, the protein intake in the two types of patients were significantly lower than the demand, while the energy and protein intake in the mild type patients were significantly lower than the requirement (P<0.05 or P<0.01). The proportion of energy and protein intakes in patients with nutritional risk was significantly higher than that in patients without nutritional risk (P<0.001 or P<0.01); the energy and protein intakes in patients without nutritional risk was significantly higher than that in patients with nutritional risk (P<0.001); the protein intakes in patients with nutritional risk was obviously insufficient (P<0.001); while the energy intake of the patients without nutritional risk was higher than the requirement (P<0.001).Conclusions COVID-19 patients has high incidence of nutritional risk which was higher in the severe patients compared with the mild patients. Higher incidence and lower intake of energy and protein are in the severe patients compared with those in the mild patients. Patients with nutritional risk has a higher proportion of energy and protein inadequate intake and lower intake compared with the patients without nutritional risk.

Citation： CHENG Liangping, LI Xi, PAN Qun, ZHU Hongfang, RAO Zhiyong. Investigation and analysis of nutritional risk and dietary intake of patients with coronavirus disease 2019. West China Medical Journal, 2021, 36(1): 24-29. doi: 10.7507/1002-0179.202005042 Copy

1.	Yang W, Cao Q, Qin L, et al. Clinical characteristics and imaging manifestations of the 2019 novel coronavirus disease (COVID-19): a multi-center study in Wenzhou city, Zhejiang, China. J Infect, 2020, 80(4): 388-393.
2.	Kondrup J, Allison SP, Elia M, et al. ESPEN guidelines for nutrition screening 2002. Clin Nutr, 2003, 22(4): 415-421.
3.	Li XY, Yu K, Yang Y, et al. Nutritional risk screening and clinical outcome assessment among patients with community-acquired infection: a multicenter study in Beijing teaching hospitals. Nutrition, 2016, 32(10): 1057-1062.
4.	Chen R, Xing L, You C. Nutritional risk screening 2002 should be used in hospitalized patients with chronic obstructive pulmonary disease with respiratory failure to determine prognosis: a validation on a large Chinese cohort. Eur J Intern Med, 2016, 36: e16-e17.
5.	National Health Commission of the People's Republic of China. Diagnosis and treatment protocol for novel coronavirus pneumonia (trial version 7). Chin Med J (Engl), 2020, 133(9): 1087-1095.
6.	Singer P, Blaser AR, Berger MM, et al. ESPEN guideline on clinical nutrition in the intensive care unit. Clin Nutr, 2019, 38(1): 48-79.
7.	Barazzoni R, Bischoff SC, Krznaric Z, et al. ESPEN expert statements and practical guidance for nutritional management of individuals with SARS-CoV-2 infection. Clin Nutr, 2020, 39(6): 1631-1638.
8.	张家瑛, 邵春海, 杨嘉红, 等. 新型冠状病毒肺炎危重症患者营养治疗专家建议. 中国临床医学, 2020, 27(2): 6-13.
9.	杨月欣, 王光亚, 潘兴昌. 中国食物成分表2009 第一册. 2版. 北京: 北京医科大学出版社, 2009.
10.	Wang D, Hu B, Hu C, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA, 2020, 323(11): 1061-1069.
11.	Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet, 2020, 395(10223): 497-506.
12.	Xiong Y, Liu Y, Cao L, et al. Transcriptomic characteristics of bronchoalveolar lavage fluid and peripheral blood mononuclear cells in COVID-19 patients. Emerg Microbes Infect, 2020, 9(1): 761-770.
13.	Sun P, Qie S, Liu Z, et al. Clinical characteristics of hospitalized patients with SARS-CoV-2 infection: a single arm meta-analysis. J Med Virol, 2020, 92(6): 612-617.
14.	Jensen GL, Bistrian B, Roubenoff R, et al. Malnutrition syndromes: a conundrum vs continuum. JPEN J Parenter Enteral Nutr, 2009, 33(6): 710-716.
15.	中国抗癌协会, 中国抗癌协会肿瘤营养与支持治疗专业委员会, 中国抗癌协会癌症康复与姑息治疗专业委员会, 等. 口服营养补充指南. 肿瘤代谢与营养电子杂志, 2015, 2(4): 33-34.
16.	Philipson TJ, Snider JT, Lakdawalla DN, et al. Impact of oral nutritional supplementation on hospital outcomes. Am J Manag Care, 2013, 19(2): 121-128.
17.	Santos H, Araujo IS. Impact of protein intake and nutritional status on the clinical outcome of critically ill patients. Rev Bras Ter Intensiva, 2019, 31(2): 210-216.
18.	Elke G, Wang M, Weiler N, et al. Close to recommended caloric and protein intake by enteral nutrition is associated with better clinical outcome of critically ill septic patients: secondary analysis of a large international nutrition database. Crit Care, 2014, 18(1): R29.
19.	Mehta NM, Skillman H, Irving SY, et al. Guidelines for the provision and assessment of nutrition support therapy in the pediatric critically ill patient: society of critical care medicine and American society for parenteral and enteral nutrition. Pediatr Crit Care Med, 2017, 18(7): 675-715.
20.	Allingstrup MJ, Kondrup J, Perner A, et al. Indirect calorimetry in mechanically ventilated patients: a prospective, randomized, clinical validation of 2 devices against a Gold standard. JPENJ Parenter Enteral Nutr, 2017, 41(8): 1272-1277.
21.	Rao ZY, Wu XT, Wang MY, et al. Comparison between measured and predicted resting energy expenditure in mechanically ventilated patients with COPD. Asia Pac J Clin Nutr, 2012, 21(3): 338-346.
22.	Ramos FM, Rossato LT, Ramires BR, et al. Comparison of predictive equations of resting energy expenditure in older adults with chronic obstructive pulmonary disease. Rev Port Pneumol, 2017, 23(1): 40-42.

1. Yang W, Cao Q, Qin L, et al. Clinical characteristics and imaging manifestations of the 2019 novel coronavirus disease (COVID-19): a multi-center study in Wenzhou city, Zhejiang, China. J Infect, 2020, 80(4): 388-393.
2. Kondrup J, Allison SP, Elia M, et al. ESPEN guidelines for nutrition screening 2002. Clin Nutr, 2003, 22(4): 415-421.
3. Li XY, Yu K, Yang Y, et al. Nutritional risk screening and clinical outcome assessment among patients with community-acquired infection: a multicenter study in Beijing teaching hospitals. Nutrition, 2016, 32(10): 1057-1062.
4. Chen R, Xing L, You C. Nutritional risk screening 2002 should be used in hospitalized patients with chronic obstructive pulmonary disease with respiratory failure to determine prognosis: a validation on a large Chinese cohort. Eur J Intern Med, 2016, 36: e16-e17.
5. National Health Commission of the People's Republic of China. Diagnosis and treatment protocol for novel coronavirus pneumonia (trial version 7). Chin Med J (Engl), 2020, 133(9): 1087-1095.
6. Singer P, Blaser AR, Berger MM, et al. ESPEN guideline on clinical nutrition in the intensive care unit. Clin Nutr, 2019, 38(1): 48-79.
7. Barazzoni R, Bischoff SC, Krznaric Z, et al. ESPEN expert statements and practical guidance for nutritional management of individuals with SARS-CoV-2 infection. Clin Nutr, 2020, 39(6): 1631-1638.
8. 张家瑛, 邵春海, 杨嘉红, 等. 新型冠状病毒肺炎危重症患者营养治疗专家建议. 中国临床医学, 2020, 27(2): 6-13.
9. 杨月欣, 王光亚, 潘兴昌. 中国食物成分表2009 第一册. 2版. 北京: 北京医科大学出版社, 2009.
10. Wang D, Hu B, Hu C, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA, 2020, 323(11): 1061-1069.
11. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet, 2020, 395(10223): 497-506.
12. Xiong Y, Liu Y, Cao L, et al. Transcriptomic characteristics of bronchoalveolar lavage fluid and peripheral blood mononuclear cells in COVID-19 patients. Emerg Microbes Infect, 2020, 9(1): 761-770.
13. Sun P, Qie S, Liu Z, et al. Clinical characteristics of hospitalized patients with SARS-CoV-2 infection: a single arm meta-analysis. J Med Virol, 2020, 92(6): 612-617.
14. Jensen GL, Bistrian B, Roubenoff R, et al. Malnutrition syndromes: a conundrum vs continuum. JPEN J Parenter Enteral Nutr, 2009, 33(6): 710-716.
15. 中国抗癌协会, 中国抗癌协会肿瘤营养与支持治疗专业委员会, 中国抗癌协会癌症康复与姑息治疗专业委员会, 等. 口服营养补充指南. 肿瘤代谢与营养电子杂志, 2015, 2(4): 33-34.
16. Philipson TJ, Snider JT, Lakdawalla DN, et al. Impact of oral nutritional supplementation on hospital outcomes. Am J Manag Care, 2013, 19(2): 121-128.
17. Santos H, Araujo IS. Impact of protein intake and nutritional status on the clinical outcome of critically ill patients. Rev Bras Ter Intensiva, 2019, 31(2): 210-216.
18. Elke G, Wang M, Weiler N, et al. Close to recommended caloric and protein intake by enteral nutrition is associated with better clinical outcome of critically ill septic patients: secondary analysis of a large international nutrition database. Crit Care, 2014, 18(1): R29.
19. Mehta NM, Skillman H, Irving SY, et al. Guidelines for the provision and assessment of nutrition support therapy in the pediatric critically ill patient: society of critical care medicine and American society for parenteral and enteral nutrition. Pediatr Crit Care Med, 2017, 18(7): 675-715.
20. Allingstrup MJ, Kondrup J, Perner A, et al. Indirect calorimetry in mechanically ventilated patients: a prospective, randomized, clinical validation of 2 devices against a Gold standard. JPENJ Parenter Enteral Nutr, 2017, 41(8): 1272-1277.
21. Rao ZY, Wu XT, Wang MY, et al. Comparison between measured and predicted resting energy expenditure in mechanically ventilated patients with COPD. Asia Pac J Clin Nutr, 2012, 21(3): 338-346.
22. Ramos FM, Rossato LT, Ramires BR, et al. Comparison of predictive equations of resting energy expenditure in older adults with chronic obstructive pulmonary disease. Rev Port Pneumol, 2017, 23(1): 40-42.

West China Medical Journal

Investigation and analysis of nutritional risk and dietary intake of patients with coronavirus disease 2019

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