Obesity decreases energy and protein intake in hospitalized COVID-19 patients undergoing continuous positive airway pressure treatment

Abstract

Patients with SARS-CoV generally require noninvasive treatments including continuous positive airway pressure (CPAP), and appropriate nutritional therapy. Our hypothesis was that a higher body mass index (BMI) would result in greater respiratory difficulties during CPAP treatment and lead to a reduction in energy and protein intake. The study was conducted prospectively and retrospectively in a Brazilian public hospital. The sample comprised all patients (n = 70) hospitalized in COVID-19 wards and using the Elmo System (ELMO) helmet. To ensure proper nutritional support, the hospital established a standard ELMO diet and questionnaire for estimating dietary adherence. The median length of stay was 11 days (interquartile range, 9-20), and 84.3% of the patients received hospital discharge. The median duration of helmet use was 1.5 days (interquartile range, 1-4). From mid-upper arm circumference adequacy measurements, 35 patients (50%) were classified as being overweight or living with obesity and 36 adult patients (66.7%) were considered living with obesity based on their BMI. The prevalence of overweight elderly patients was 81.3%. The median energy and protein intake adequacy percentages were 65% and 72.5%, respectively. Patients with higher BMIs exhibited lower oxygen flows while wearing the ELMO helmet. Younger age and lower energy and protein intake characterized the obesity group. A correlation between oxygen therapy and food intake in COVID-19 patients undergoing CPAP treatment was observed. Patients with higher BMIs and/or mid-upper arm circumference adequacies were more susceptible to energy and protein intake declines, and patients with obesity presented the lowest intake values.

Keywords: COVID-19; CPAP (continuous positive airway pressure); Food intake; Nutrition assessment; Nutritional status; Obesity.