Impact of Immuno-Nutrition on the Nutritional Status, Inflammatory Response and Clinical Outcome of Clinic-Admitted Mild-Intensity-COVID-19 Patients: A Pilot, Perspective-Concluding Study

Martina Basilico; Marialaura Scarcella; Emanuele Rinninella; Nena Giostra; Stefano Marcelli; Carlo Rasetti; Jan Tack; Ludovico Abenavoli; Emidio Scarpellini

doi:10.3390/metabo13101070

Impact of Immuno-Nutrition on the Nutritional Status, Inflammatory Response and Clinical Outcome of Clinic-Admitted Mild-Intensity-COVID-19 Patients: A Pilot, Perspective-Concluding Study

Metabolites. 2023 Oct 12;13(10):1070. doi: 10.3390/metabo13101070.

Authors

Martina Basilico¹, Marialaura Scarcella², Emanuele Rinninella³, Nena Giostra¹, Stefano Marcelli⁴, Carlo Rasetti¹, Jan Tack⁵, Ludovico Abenavoli⁶, Emidio Scarpellini^{2

5}

Affiliations

¹ Clinical Nutrition Unit and Internal Medicine Unit, "Madonna del Soccorso" General Hospital, Via Luciano Manara 7, 63074 San Benedetto del Tronto, Italy.
² Anesthesia, Intensive Care and Nutritional Science-Azienda Ospedaliera "Santa Maria", Via Tristano di Joannuccio, 05100 Terni, Italy.
³ Department of Translational Medicine and Surgery, Clinical Nutrition Unit, Catholic University of Sacred Heart, Gemelli Foundation, 00168 Rome, Italy.
⁴ Nurse Teaching Programme Direction, Polytechnics University of Marche, 63036 Ascoli Piceno, Italy.
⁵ Translational Research in Gastrointestinal Disorders (T.A.R.G.I.D.), Gasthuisberg University Hospital, KULeuven, Herestraat 49, 3000 Leuven, Belgium.
⁶ Department of Health Sciences, University "Magna Graecia", 88100 Catanzaro, Italy.

Abstract

The SARS-CoV-2 pandemic has impacted our lives since early 2020. Both malnutrition and an overweight status significantly correlate with worse patient outcomes and mortality. Immuno-nutrition (IN) has shown promising results in the inflammatory bowel disease (IBD) clinical course and the extubation time and mortality of patients admitted to intensive care units (ICUs). Thus, we wanted to assess the impact of a standardized IN oral formula on COVID-19 patients admitted to our mild-intensity clinic in late 2021. We prospectively enrolled patients admitted to the Internal Medicine COVID-19 Unit of San Benedetto General Hospital. All patients had biochemical, anthropometric, HRCT chest scan, and nutritional assessments at the time of admission and, after oral immuno-nutrition formula administration, at 15 days of the interval follow up. We enrolled 52 consecutive patients (mean age of 60.9 ± 5.4 years, 17 F, and BMI of 23.5 Kg/m²). The main comorbidities were diabetes (20%, type 2: 90%), hyperuricemia (15%), hypertension (38%), chronic ischemic heart disease (12%), COPD (13%), anxiety (10%), and depression (8%). Upon informed consent, 14 patients (mean age of 67.9 ± 5.4 years, 7 F, and BMI of 26.7 Kg/m²) were accepted to be administered IN. A moderate to severe overweight status was present in 59% of the patients; MNA test (4.4 ± 0.7) and phase angle (PA) values, suggestive of malnutrition, were present in 13% of the patients. After 15 days of admission, we recorded three deaths (mean age of 68.9 ± 4.1 years, 3 F, and BMI of 27.5 Kg/m²). An overweight status significantly correlated with the exitus occurrence (r = 0.65). One death was reported among the IN-treated patients. IN administration was followed by a significant decrease in inflammatory markers with a tendency to be higher than those of non-treated patients. IN prevented the worsening of BMI and PA vs. non-treated patients. In this overweight COVID-19 population, immuno-nutrition prevented malnutrition development with a significant decrease in inflammatory markers.

Keywords: COVID-19; immuno-nutrition; inflammation; internal medicine; nutritional status; overweight.

Grants and funding

This research received no external funding.