Nutritional Therapy in Critically Ill Patients with COVID-19: A Narrative Review

Abstract

Introduction: Combating the pandemic caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), better known as Coronavirus Disease 2019 (COVID-19), in all countries of the world has been a challenge. Most patients can be treated in home isolation, however elderly patients and/or with associated comorbidities have been demonstrating more severe conditions of the disease, requiring hospitalization, or even nutritional therapy and mechanical ventilation. Objective: To review the current evidence to establish better nutritional recommendations for critically ill patients with COVID-19.Material and methods:This is a narrative review on nutritional therapy in critical patient with COVID-19. The scientific articles were searched in the databases U.S. National Library of Medicine (PubMed), as well as their respective terms in Portuguese and Spanish, and 40 articles were chosen, excluding the guidelines that were used to help better compose this article.Results: The main findings were that age and non-communicable diseases are considered risk factors for mortality, with systemic arterial hypertension and diabetes mellitus being the main ones. These patients need special care, as well as constant assessment of nutritional status, since malnourished and obese patients have shown a high association with mortality and the use of mechanical ventilation. Nutritional therapy in the affected patients can improve clinical outcome and should be considered as first-line treatment and be more valued in the hospital setting. Although there is no recommendation for supplementation of vitamin C and D and the mineral zinc, these may bring benefits to the immune system of these patients and help in a better prognosis of COVID-19, however more studies are still needed to substantiate the dosage.Conclusions: Further studies are needed, but it is important to bring these themes already exposed by some authors to stimulate discussions that might lead to improvements in the standardization of nutritional approaches.