Rationale: The COVID pandemic has resulted in a high number of intensive care (ICU) admissions, generally for respiratory distress. While research has focused on respiratory and infectious characteristics, little is known about their metabolic and nutritional status compared to other categories of patients. The aim was to compare COVID patients’ characteristics and metabolic response to long-stayer patients (LSP)
Methods: Prospective observational study in two consecutive cohorts admitted to the ICU: Only ventilated LSP and COVID-19 patients were included. Variables: demographic data, severity score (SAPS2), NRS score, C-reactive protein (CRP), prealbumin values on admission (adm) and D6-9 (delta calculated), nutritional management, length of stay and outcome. Nutritional recommendations were for both groups: energy goal 20 kcal/kg first week (then adapted following indirect calorimetry for LSP, no calorimetry for COVID), protein 1.2 g/kg, enteral nutrition privileged. The confined dieticians worked on computer basis. Statistics: median (interquartiles), percentage
Results: Altogether 52 of 55 LST and 74 of 104 COVID were mechanically ventilated. Characteristics in Table. Gender was evenly distributed (75% men). COVID patients were significantly older and heavier. Median NRS was 5 in both groups, 1-3 points coming from reduced eating in COVID. Mortality was higher in COVID. Admission prealbumin was significantly lower in COVID vs LST, unrelated to NRS score, and negatively correlated to CRP (r2=0.082). Prealbumin increased significantly more in COVID, but also in survivors of both groups where difference over time was 0.03 (0; 0.09) g/l (p<0.0001). Enteral nutrition initiated earlier in COVID. Energy & substrate data not yet available
| Long stay (n=52) | COVID (n=74) | P value | |
|---|---|---|---|
| Age (yrs) | 60 (51; 72) | 67 (57; 75) | 0.0014 |
| Weight | 77 (63; 90) | 85 (72; 98) | 0,0005 |
| BMI (kg/m2) | 25.1 (21.1; 31.5) | 27.8 (25.7; 33.1) | 0.0014 |
| SAPS2 score | 41 (33; 59) | 44 (36; 49) | 0.703 |
| Length ICU stay (d) | 26.6 (16.4; 27.8) | 13.7 (6.0; 20.3) | <0.0001 |
| Prealbumin Adm. g/L | 0.095 (0.07; 0.14) | 0.075 (0.06; 0.10) | 0.0333 |
| Delta prealbumin g/L | 0.025 (0.01; 0.06) | 0.15 (0.05; 0.29) | <0.0001 |
| Mortality | 19.2% | 32.4% | 0.1003 |
Conclusion: Mechanically ventilated COVID patients were older and heavier. Prealbumin values on admission were lower and reverted faster to normal values, which might be due to a more rapid clearance of inflammation and catabolism
Disclosure of Interest: None declared
P142