ABSTRACT
Covid-19 infection is a potentially serious disease. Overweight, obesity, and diabetes are comorbidities frequently found in the severe form of the disease. Appropriate nutritional management of the patient is an integral part of care. We will discuss the renutrition of a 76-year-old, obese (BMI = 35kg/m2), malnourished patient, according to the 2021 Haute Autorité de santé criteria, with Covid-19 infection, admitted to the intensive care unit at the Bordeaux University Hospital for an acute respiratory distress syndrome. Adaptation of nutritional intakes was achieved by clinical and biological monitoring. A refeeding syndrome was treated on the first day of hospitalization in the intensive care unit. After thiamine supplementation and when kalemia and phosphatemia have been normalized, renutrition was started. Parenteral nutrition as a complement to oral nutrition was used. Parenteral nutrition was well tolerated; recommended caloric and protein intakes were achieved by the fourth day of hospitalization. The clinical evolution was favorable. In conclusion, patients with Covid-19 infection should be considered malnourished when admitted to the intensive care unit. Macro and micronutrient intakes adapted to metabolically stressed patients are essential. Biological monitoring including monitoring of ionogram, phosphate, uremia, creatinine, liver function tests and blood glucose is essential in the nutritional management of patients with serious Covid-19 infection.
Subject(s)
COVID-19 , Malnutrition , Aged , Biomarkers , COVID-19/complications , COVID-19/diagnosis , Humans , Malnutrition/diagnosis , Malnutrition/etiology , Malnutrition/therapy , Nutritional Status , SARS-CoV-2ABSTRACT
This article examines the (de)legitimation of a global governance institution (GGI) in the throes of a full-blown legitimacy crisis: the World Health Organization (WHO) during the coronavirus pandemic. Substantively, it fleshes out systematically the discursive (de)legitimating practices of six (types of) actors: the Trump administration, US allies, US quality press, global health-scientific community, the WHO, and the Chinese government. To that end, it synthesizes elements from the rich literature on legitimacy and elaborates a conceptual apparatus bolstered by operational sources of legitimacy. Empirically, it is grounded in a qualitative content analysis of a purpose-built data corpus of 458 texts that contain justifications for (de)legitimation. In so doing, this study not only presents a holistic and yet granular view of discursive (de)legitimation by some pivotal actors surrounding the WHO and its pandemic response, but offers general insights on legitimacy and (de)legitimation of GGIs during times of crisis. [ FROM AUTHOR] Copyright of International Studies Review is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
ABSTRACT
Soon after the pandemic, numerous publications described cases of neurological disorders associated with the SARS-CoV-2 infection. The range of neurological symptoms is becoming increasingly more extensive as the pandemic progresses. However, it is not yet well established whether the manifestations are due to direct viral damage to the nervous system or indirect consequences of the infection. This review presents an inventory of the biochemical markers studied in the context of neurological disorders related to SARS-CoV-2. By reflecting various physiopathological mechanisms, these biomarkers allow both a better understanding of the pathophysiology of Covid-19 and a contribution to the diagnosis of neurologic troubles; they could participate in the prognostic evaluation of patients.