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How the Covid-19 epidemic is challenging our practice in clinical nutrition-feedback from the field.
Thibault, Ronan; Coëffier, Moïse; Joly, Francisca; Bohé, Julien; Schneider, Stéphane M; Déchelotte, Pierre.
  • Thibault R; Unité de Nutrition, INRAE, INSERM, Nutrition Métabolismes et Cancer, NuMeCan, CHU Rennes, Univ Rennes, Rennes, France. ronan.thibault@chu-rennes.fr.
  • Coëffier M; Département de Nutrition-CIC1404, CHU Rouen, UNIROUEN, Inserm UMR, Normandie Univ, 1073, Rouen, France.
  • Joly F; Gastroentérologie, MICI, et Assistance Nutritive, AP-HP, Université de Paris, Inserm UMR 1149, F-92110, Clichy, France.
  • Bohé J; Service d'anesthésie-Réanimation-Médecine intensive, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre Bénite, France.
  • Schneider SM; Gastroentérologie et Nutrition, CHU Nice, Université Côte d'Azur, Nice, France.
  • Déchelotte P; Département de Nutrition-CIC1404, CHU Rouen, UNIROUEN, Inserm UMR, Normandie Univ, 1073, Rouen, France.
Eur J Clin Nutr ; 75(3): 407-416, 2021 03.
Article in English | MEDLINE | ID: covidwho-772967
ABSTRACT
The viral epidemic caused by the new Coronavirus SARS-CoV-2 is responsible for the new Coronavirus disease-2019 (Covid-19). Fifteen percent of the Covid-19 patients will require hospital stay, and 10% of them will need urgent respiratory and hemodynamic support in the intensive care unit (ICU). Covid-19 is an infectious disease characterized by inflammatory syndrome, itself leading to reduced food intake and increased muscle catabolism. Therefore Covid-19 patients are at high risk of being malnourished, making the prevention of malnutrition and the nutritional management key aspects of care. Urgent, brutal and massive arrivals of patients needing urgent respiratory care and artificial ventilation lead to the necessity to reorganize hospital care, wards and staff. In that context, nutritional screening and care may not be considered a priority. Moreover, at the start of the epidemic, due to mask and other protecting material shortage, the risk of healthcare givers contamination have led to not using enteral nutrition, although indicated, because nasogastric tube insertion is an aerosol-generating procedure. Clinical nutrition practice based on the international guidelines should therefore adapt and the use of degraded procedures could unfortunately be the only way. Based on the experience from the first weeks of the epidemic in France, we emphasize ten challenges for clinical nutrition practice. The objective is to bring objective answers to the most frequently met issues to help the clinical nutrition caregivers to promote nutritional care in the hospitalized Covid-19 patient. We propose a flow chart for optimizing the nutrition management of the Covid-19 patients in the non-ICU wards.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Nutritional Support / Critical Care / Malnutrition / COVID-19 Type of study: Diagnostic study / Observational study / Prognostic study Topics: Long Covid Limits: Humans Country/Region as subject: Europa Language: English Journal: Eur J Clin Nutr Journal subject: Nutritional Sciences Year: 2021 Document Type: Article Affiliation country: S41430-020-00757-6

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Nutritional Support / Critical Care / Malnutrition / COVID-19 Type of study: Diagnostic study / Observational study / Prognostic study Topics: Long Covid Limits: Humans Country/Region as subject: Europa Language: English Journal: Eur J Clin Nutr Journal subject: Nutritional Sciences Year: 2021 Document Type: Article Affiliation country: S41430-020-00757-6