. Author manuscript; available in PMC: 2021 Sep 1.

Published in final edited form as: JPEN J Parenter Enteral Nutr. 2020 Nov 13;45(1):13–31. doi: 10.1002/jpen.2036

Table 3.

Nutrition Issues Related to the COVID-19 Pandemic.^a

Stage 1: Pre–COVID-19	Stage 2: Acute COVID-19	Stage 3: Chronic/post–COVID-19

Risk mitigation	Outpatient	Outpatient
Malnutrition	Nutrition risk assessment	Nutrition risk assessment
Cardiometabolic^b	Healthy eating and lifestyle	Healthy eating and lifestyle
Immunity/chronic disease	Micronutrient nutriture and support	Standard nutrition and nutrition support
Social determinants of health	Inpatient: non-ICU or ICU	Micronutrient nutriture and support
Lifestyle	Nutrition risk assessment	Nutrition and physical therapy
Transcultural dietary factors	Standard nutrition	Complication-specific nutrition^d
	Nutrition support	Infrastructure^c
	Nutrition, insulin, and glycemic control	Inpatient non-ICU or ICU
	Micronutrient nutriture and support	Nutrition risk assessment
	Infrastructure^c	Chronic critical illness metabolic support
	Standard nutrition and nutrition support
	Micronutrient nutriture and support
	Nutrition and physical therapy
	Complication-specific nutrition^d
	Infrastructure^c

COVID-19, coronavirus disease 2019; ICU, intensive care unit; SARS-CoV-2, severe acute respiratory syndrome coronavirus-2.

This 3-stage model is based on the presumed natural history of COVID-19 and applies to pediatric, adult, and geriatric populations, domestic (US) and global.

Cardiometabolic risk factors associated with increased severity of COVID-19 include: hypertension, obesity, diabetes, and cardiovascular disease.

Infrastructural changes needed to address shortages (eg, enteral pumps) and supply chain, redeployments, training, new programs, and adaptive protocols.

COVID-19 complications include encephalopathy, deconditioning, acute kidney injury and chronic kidney disease, hyperglycemia, hypercoagulable/prothrombotic state, cardiac injury, and pulmonary injury.