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COVID-19 patients see nutrition as critical to recovery

Entereal nutritional support
Study results presented at the ESPEN congress found patients recovering from COVID-19 struggled with eating challenges and weight loss, and saw a need for nutritional support.

Nutritional support is critical to recovery from COVID-19, but resources for patients are not meeting their needs, according to new research from Nutricia. In the study, presented at the European Society for Clinical Nutrition and Metabolism (ESPEN) Congress, 453 European adults previously hospitalised with COVID-19 were surveyed by IPSOS about recovery of weight and physical function. Many patients reported symptoms that could impact their nutritional status, including change in taste/smell and dysphagia; nearly two-thirds of patients also reported clinically significant weight loss.

However, only half of patients received medical nutrition—whether oral supplements, parenteral feeding or tube feeding—in hospital. Further, 42% of patients received no nutritional support at discharge, the same number who received a referral to a dietitian or nutritional advice, with only 15% of patients receiving follow-up nutritional care with medical nutrition. And when recovering at home, 80% of continued to suffer eating challenges such as difficulty swallowing and lack of appetite.

These patients were also quite interested in information on nutritional support to help them regain strength, ability to conduct usual daily activities, and return to a normal eating pattern. More than half of those who did receive nutritional support after discharge considered it helped a lot/enormously with their recovery.

The findings were presented at the ESPEN Congress amongst other investigator-led research initiatives supported by Nutricia as part of its NutriCOVer program. This is an initiative by Nutricia to support independent research and contribute to real-world evidence and clinical guidance for the nutritional management of patients recovering from severe COVID-19 infection.

Dr Emanuele Cereda, physician at the Research Foundation IRCCS Policlinico San Matteo in Italy has conducted extensive research on nutrition and COVID-19 since the start of the pandemic. He shares his view on the survey findings: “Optimal nutrition care is key to support the disease journey and recovery and can help patients return to doing things that matter most to them. We are seeing many learnings from our experience with COVID-19, particularly the association between reduced energy intake and worse outcome. Collecting insights from patients complements clinical research and contributes to improving nutritional care for patients recovering from severe illness.“

There are multiple learnings that can be taken away from the study, according to Dr Patrick Kamphuis, senior medical affairs director at Nutricia, who noted, “At Nutricia we believe it’s really important to develop and pioneer medical nutrition solutions that are centered around people’s needs and really help address challenges they are experiencing.” As an example, he noted that patients with difficulty swallowing could benefit from pre-thickened oral nutritional supplements or texture-modified foods, while also being mindful of the importance of taste and flavour variations. Similarly, he added, low volume oral nutritional supplements can be useful for patients with low appetite to ensure they receive necessary nutrients in a smaller volume.

“Optimizing nutritional status with medical nutrition also includes improving status in micronutrients and correcting existing deficiencies in malnourished individuals,” Dr Kamphuis commented. “Ensuring sufficient energy and protein intake is essential to improve weight and in particular to regain muscle mass and strength. High-protein oral nutritional supplements can help people achieve their protein needs. Additionally, in patients with low muscle mass, our muscle-targeted medical nutrition containing whey, leucine and vitamin D have been shown to improve recovery outcomes of people including muscle strength and physical function.”

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