Assessment of Adequacy of Nutritional Support in COVID-19 Patients Receiving Oxygen Therapy in Multi Isolation Centers in Khartoum State and its Relation to Outcomes
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Date
2022-07-18
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جامعة الشيخ عبدالله البدري
Abstract
Abstract: Background: 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. Nutrition support has become one of the 
important treatments for severe and critical patients. Objective: To assess the adequacy of nutritional support in COVID-19 patients 
receiving oxygen support. Methods: A multicenter prospective study enrolled 88 COVID-19 patients receiving oxygen support in 
Fedail Hospital, Albaraha Hospital, Aliaa Hospital, and Royal Care Hospital during the period from January to April 2021. Data 
regarding demographics, comorbidities, types of oxygen therapy, vital signs, laboratory investigations, methods of nutrition support, 
estimated calorie achievement, and outcomes were collected. Nutritional adequacy was assessed by using the Nutritional Risk 
Screening-2002 (NRS- 2002) test. Results: Among 88 patients, 50(56.8%) were males and 38(43.2%) were females; their mean age 
was 67±11 years. CPAP (n=28; 32%) and mechanical ventilation (n=27; 27%) were the main types of oxygen therapies. Estimated 
calories were achieved in only 36(40.9%) of patients and failure to the achievement of estimated calories was commonly due to
hypoxia (n=33; 37.5%) and poor appetite (n=23; 26.1%). About 66(75%) patients were adequately nourished, 16(18.2%) were at risk 
of malnutrition, and 6(6.8%) patients were malnourished. The mortality was significantly associated with malnutrition (P. value= 
0.000), and parental feeding modes (P. value= 0.000), and underweighted BMI (mean= 17.8 kg/m2; P. value= 0.000). Moreover, 
multi-organ failure was significantly correlated with risk of malnutrition (P.value= 0.000), NG feeding (P. value= 0.000) and 
overweighed BMI (mean= 28.8 kg/m2; P. value= 0.000). Additionally, mortality and multi-organ failure were significantly correlated 
with hypoalbuminemia among our study subjects (P. value= 0.001). Conclusion: The rates of malnutrition and risk of malnutrition 
were 6.8% and 18.2% among COVID-19 patients who received oxygen therapy, respectively. Inadequacy of nutritional support or 
failure in the achievement of estimated calories among our study subjects were commonly due to hypoxia and poor appetite. 
Mortality was significantly associated with malnutrition, parental feeding modes, and underweighted BMI. Furthermore, multi-organ 
failure was significantly correlated with the risk of malnutrition, NG feeding, and overweighed BMI. Both, mortality and multi-organ 
failure were correlated with hypoalbuminemia