Nutritional and metabolic profile of patients with critical COVID-19 in an intensive care unit

Abstract

Introduction: Malnutrition is associated with COVID-19 severity and mortality. 

Objective: To describe the nutritional and metabolic characteristics, and outcomes in patients with critical COVID-19. 

Methods: Observational retrospective study of patients with critical COVID-19 treated with mechanical ventilation (MV) in an intensive care unit in Peru. Patients ≥18 years old, with confirmed COVID-19, and moderate or severe respiratory distress syndrome criteria were included; patients with previous COVID-19 were excluded. Nutritional and metabolic assessment included: presence of obesity and diabetes mellitus; modified NUTRIC score; glucose, albumin and total bilirubin values; need for exogenous insulin; use of muscle relaxant, and prone ventilation. The variables were presented as absolute frequencies and percentages, measures of central tendency and dispersion; the variables between the survivors and the deceased were compared considering p <0.05 as significant. 

Results: 35 patients were included, with a mean age of 49.1±12.9 years, male sex predominated (71.4%). Obesity and diabetes mellitus were the most frequent comorbidities (51.4% and 22.9%, respectively), 11.4% had high nutritional risk. Mean blood glucose values were 146.60±46.98 mg/dL, albumin 3.26±0.38 mg/dL, and total bilirubin 0.58±0.22 mg/ dL. Dexamethasone was used in 91.4%, insulin therapy in 20%, muscle relaxant in 94.3%, and prone MV in 82.9%. 

Conclusions: Obesity, diabetes mellitus, hyperglycemia, and hypoalbuminemia were the most relevant characteristics in patients with critical COVID-19. The nutritional risk score and the frequency of patients at high nutritional risk, by the modified NUTRIC, were low.