Rationale: Severe SARS-CoV-2 pneumonia occurs in a small, yet significant number of patients and requires intensive care management with mechanical ventilation and other organ support. Patients with COVID-19 often require prolonged MV and ICU support, resulting in significant immobility, catabolic stress, and muscle wasting. As any other critically ill patient, managing nutrition is an integral part of disease management with a decisive component on the clinical evolution and a positive impact on the outcome.
The aims of this study were to assess the energy expenditure of critically ill patients with SARS-CoV-2 pneumonia requiring intubation versus non-COVID-19 critically ill patients.
Methods: Unicentric retrospective observational study of prospective collected conducted in a large tertiary university hospital. Data was gathered from 34 COVID-19 patients and 61 non-COVID-19 patients hospitalized in an Intensive Care Unit between January of 2020 and March of 2022. Data were obtained regarding resting energy expenditure (REE), energy expenditure per kilogram (EEKg) and respiratory exchange rate quotient (RER), by the method of indirect calorimetry. It was considered for every statistic test a significance of p < 0,05.
Results: The age (61.2 ± 12.65 years of COVID patients vs 58,18 ± 15,36 years for non-COVID, p=0,326), gender distribution (25 males [73,5%] COVID patients and 43 males [70,5%], p=0,753) and BMI (29.9 ± 5.92 for COVID and 28,3 ± 8,74 for non-COVID, p=0,350) were similar between groups.
The SOFA score at admission was similar (7,88 ± 2,04 for COVID patients and 8,51 ± 2,66 for non-COVID, p=0,237), but the SAPSII score was inferior in COVID patients (42,01 ± 8,32 vs 52,25 ± 14,32, p < 0,00)
A total of 193 measures were performed by indirect calorimetry, 70 COVID-19 patients and 123 in non-COVID-19 patients.
COVID-19 patients had energy requirements needs of 20,73 ± 4,87 Kcal/Kg/day, significantly inferior to the non-COVID-19 needs (23,24 ± 6,71 Kcal/Kg/day) (p = 0,002).
Conclusion: In this cohort with similar gender, age, BMI and SOFA distribution, but not in SAPS II score, COVID-19 patients had reduced energy requirements compared to non-COVID-19 patients.
Disclosure of Interest: None declared
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