Does Route of Full Feeding Affect Outcome among Ventilated Critically Ill COVID-19 Patients: A Prospective Observational Study

Nutrients. 2021 Dec 29;14(1):153. doi: 10.3390/nu14010153.

Abstract

The outbreak of the new coronavirus strain SARS-CoV-2 (COVID-19) highlighted the need for appropriate feeding practices among critically ill patients admitted to the intensive care unit (ICU). This study aimed to describe feeding practices of intubated COVID-19 patients during their second week of hospitalization in the First Department of Critical Care Medicine, Evaggelismos General Hospital, and evaluate potential associations with all cause 30-day mortality, length of hospital stay, and duration of mechanical ventilation. We enrolled adult intubated COVID-19 patients admitted to the ICU between September 2020 and July 2021 and prospectively monitored until their hospital discharge. Of the 162 patients analyzed (52.8% men, 51.6% overweight/obese, mean age 63.2 ± 11.9 years), 27.2% of patients used parenteral nutrition, while the rest were fed enterally. By 30 days, 34.2% of the patients in the parenteral group had died compared to 32.7% of the patients in the enteral group (relative risk (RR) for the group receiving enteral nutrition = 0.97, 95% confidence interval = 0.88-1.06, p = 0.120). Those in the enteral group demonstrated a lower duration of hospital stay (RR = 0.91, 95% CI = 0.85-0.97, p = 0.036) as well as mechanical ventilation support (RR = 0.94, 95% CI = 0.89-0.99, p = 0.043). Enteral feeding during second week of ICU hospitalization may be associated with a shorter duration of hospitalization and stay in mechanical ventilation support among critically ill intubated patients with COVID-19.

Keywords: SARS-CoV-2 virus; critical illness; energy target; enteral nutrition; parenteral nutrition.

Publication types

  • Observational Study

MeSH terms

  • COVID-19 / mortality*
  • COVID-19 / therapy*
  • Critical Care / methods*
  • Critical Illness
  • Enteral Nutrition / methods
  • Enteral Nutrition / mortality
  • Enteral Nutrition / statistics & numerical data*
  • Female
  • Greece / epidemiology
  • Humans
  • Length of Stay / statistics & numerical data
  • Male
  • Middle Aged
  • Parenteral Nutrition / methods
  • Parenteral Nutrition / mortality
  • Parenteral Nutrition / statistics & numerical data*
  • Prospective Studies
  • Respiration, Artificial / methods
  • Respiration, Artificial / mortality*
  • SARS-CoV-2
  • Time Factors
  • Treatment Outcome