Nutritional inpatient care in geriatric population during covid-19 outbrake: some basics forgotten in the rush?
Alvarez Schettini MI, Vazquez LA, Cruz F, Garcia Gomez MC, Ramos L, Gonzalez A, Ortega CH, Gordo T, Alonso A, Montalban C
First Published 2020Clinical Nutrition ESPEN (https://www.embase.com/search/results?subaction=viewrecord&id=L2008506184&from=export)
Rationale: Nutrition is often underestimated in the usual medical care in our hospitals and the impact of a suboptimal nutritional approach in this setting has been reported widely, especially in the elderly. Recently our hospital wards have been briskly and temporary overloaded by patients with COVID-19, most of them at older ages. We do not have much information about the nutritional approach during this unexpected situation. Aim: To describe basic aspects of nutritional care in inpatients of a tertiary hospital in Spain: diet prescription and use of nutritional support in patients admitted to internal medicine and pneumology inpatient units, specially focused in older population. Methods: A retrospective, cross sectional, descriptive study was performed. Medical records were analyzed to review nutritional care related aspects in all the SARS-CoV-2 PCR positive patients located at internal medicine and pneumology wards of a single hospital the last day of April 2020. Type of prescribed diet and nutritional support (oral supplements/tube feeding) were analyzed. Results: 27 patients were included (70.4% female) (median age 84; IQR 68-87), but data of patients over 75 (n=18; 66,6%) were finally analyzed. Among them, patients described as partially or totally dependent individuals regarding instrumental activities of daily living were 72.2%. Texture-modified (pureed) food was administered in 16 patients (88.9%). Oral nutritional supplements were prescribed in 4 patients (22.2%) and tube feeding formula in 1 (5.6%). Conclusion: Most inpatients with COVID-19 in general wards are over 75, with a high prevalence of disability. Most of them were nourished using texture-modified food, considered as a risk factor for undernutrition if not supplemented with oral/enteral nutritional support. Nutritional care in COVID-19 elderly patients is specially challenging moreover if they are isolated without caregivers in their rooms most of the time in order to avoid SARS-CoV-2 infection dissemination. A wider and/or more structured use of oral or enteral nutritional support could help to improve and ease the nutritional approach in this challenging health care situation. Disclosure of Interest: M. I. Alvarez Schettini: None declared, L. A. Vazquez Speakers Bureau of: Fresenius, F. Cruz: None declared, M. C. Garcia Gomez Speakers Bureau of: Fresenius, Nestle, L. Ramos: None declared, A. Gonzalez Speakers Bureau of: Nestle, Abbott, Nutavant, C. H. Ortega: None declared, T. Gordo: None declared, A. Alonso: None declared, C. Montalban Speakers Bureau of: Nestle