Reply - Letter to the editor: Impact of COVID-19 in nutritional and functional status of survivors admitted in intensive care units during the first outbreak. Preliminary results of the NUTRICOVID study

Dear Editor:

We acknowledge the comments of Gomes da Silva et al. to our article and would like to reply to their queries [1].

First, we would like to address that the aim of our study was to evaluate the long-term nutritional, functional recovery, and use of resources for ICU admitted COVID-19 survivors and not to evaluate the variables that could have influenced the in-hospital outcome, including survival.

Our article presented the study protocol with preliminary data of the patients included and at discharge [2]. As we mentioned, there were several limitations in this preliminary analysis. Firstly, many data were retrospectively collected through electronic medical records, that in some cases were not complete due to the overburden of work in the units during the pandemic crisis; this information includes, for instance, the initiation of medical nutritional therapy and the caloric and protein goals achieved by the patients during the hospital stay. Secondly, the sample size was not calculated to find correlations between variables or to compare subgroups; hence, no statistically significant conclusions can be drawn from the results obtained regarding, for example, the age of the patients. Finally, our data were collected at the first outbreak of the COVID-19 pandemic when there was a lack of resources, including ICU beds, to treat these patients. Even though we did not include this information in our article, the patients admitted to the ICU were those with confirmed SARS-CoV-2 infection, bilateral pneumonia and severe acute respiratory distress syndrome. At that time, the determination of SARS-CoV-2 viral load was not available for the stratification of patient severity but only employed in exceptional cases.

We want to mention that we have finalized the data collection and already analyzed the 1-yr outcomes, which we will send to publish in the coming weeks.