NUTRITION MAY 01

The role of nutrition in COVID-19 patients

3 supplemental considerations for clinicians

Studies dedicated to nutrition management in COVID-19 patients are few and far between at this point in the United States. There are, however, guidelines being set forth, from the European Society for Clinical Nutrition and Metabolism (ESPEN) among others, to provide concise expert statements and practical advice for nutrition, specifically as it pertains to those in the ICU setting or older age individuals.

Most of these recommendations focus on malnutrition and its negative impact on patient survival.1 Malnutrition is often connected with “undernutrition” or being underweight. But it can also be a state of being overweight, obese or having diet-related diseases, such as heart disease, stroke, diabetes and cancer2—all critical risk factors in patients with COVID-19.

A new study, published in the CDC’s Morbidity and Mortality Weekly Report, shows that about 90% of patients hospitalized due to COVID-19 have preexisting conditions—including hypertension (49.7%), obesity (48.3%), chronic lung disease (34.6%), diabetes mellitus (28.3%), and cardiovascular disease (27.8%).4

The studies specific to nutrition and COVID-19 may only just be emerging, and yet, if we look at other global health crises, such as the 2014–2016 Ebola virus outbreak in Western Africa, there is plenty of evidence suggesting that immediate supportive and nutritional care significantly reduce fatality rates.3 It is, therefore, not difficult to assume that this may also apply to the COVID-19 pandemic.

With that in mind, we’ve gathered some insight into nutritional management, centered around the critical lack of protein and the need for enteral support, geared to COVID-19 patients throughout their hospitalization.

Active TF- ENT444

Exclusively designed for enteral nutrition support.
Critically ill patients have higher protein needs. American Society of Parenteral & Enteral Nutrition recommends 1.2 – 2 grams of protein/kg actual body weight per day.5 Feeds can be slowly advanced to meet energy and protein goals to reduce risk of refeeding syndrome. Protein modulars can help meet nutrition requirements without providing large volumes of fluid. Active TF should be administered directly into the feeding tube during cluster care. Flush with 15mL before and after administration.

  • 11 grams of amino acid enhanced hydrolyzed protein in 45mL
  • Water-thin consistency reduces risk for tube occlusion
  • Ready to use, no mixing required—saving time

Gelatein 20 & Plus- ENT690, ENT691, ENT701, ENT703, ENT705

Protein supplement approved for people with dysphagia.
Patients with post mechanical ventilation have a high incident of swallowing challenges, which may strongly limit their oral nutrient intake. The amount of nutrition they consume will greatly impact their recovery. Gelatein 20 (sugar free) and Gelatein Plus contain 20 grams of hydrolyzed collagen and whey protein in each 4 oz. serving size. Both are International Dysphagia Diet Standardization Initiative (IDDSI) Level 4.

Banatrol Plus – ENT470

Formulated for those experiencing diarrhea and loose stools.
Between 5 – 50% of people testing positive for COVID-19 experience digestive symptoms such as diarrhea.6 In some cases diarrhea was the only symptom.7 Banatrol Plus treats the symptoms of diarrhea. Made of banana flakes and prebiotic, it works to solidify the stool without stopping gut motility and replenishes good bacteria in the gut. It may be used with C. diff, antibiotics, tube feeding, influenza and chronic diarrhea.

Key takeaway

As the crisis continues, more updates on nutritional management will come to light. In the meantime, one thing is clear, and that is delivering appropriate nutrition for very sick adults with COVID-19 remains an important consideration for optimizing patients’ outcomes, especially in light of the prevalence of preexisting health issues. For more information on patient nutrition and supplements, contact your rep or call 1 800 Medline.