key: cord-0751953-xx36331o
authors: Poulia, K. A.; Karayiannis, D.; Almperti, A.; Pafili, Z.; Mastora, Z.
title: Nutritional risk and outcomes in intensive care unit patients with severe acute respiratory syndrome corona virus 2. – preliminary data
date: 2020-12-31
journal: Clinical Nutrition ESPEN
DOI: 10.1016/j.clnesp.2020.09.091
sha: 17213751b524a65c12d19bda38d0a6f0f2f1ff2c
doc_id: 751953
cord_uid: xx36331o

nan

(þ65, þ172). Wall thickness increase was inversely correlated with baseline thickness (rho -0.56, p<0.001). Patients with clinical response had a trend toward higher SB wall thickness increase (median þ133% [þ70, þ176] vs. þ90% [þ52, þ93], p¼0.061). All patients with 95% SB wall thickness increase (n¼18) had clinical response, while 8/13 (62%) patient with <95% SB thickness increase did (p¼0.008). Conclusion: TED induces a significant remnant small bowel wall thickness increase that can be depicted by imaging. The degree of such increase appears associated with clinical response. In the next future, imaging could become a predictor factor of efficacy for SBS pharmacological treatments. Rationale: As Severe Acute Respiratory Syndrome Coronavirus 2 disease (SARS-CoV-2/COVID-19) spread globally, intensive care units (ICUs) were called to face an extraordinary reality, where the need for treatment raised enormously. Patients with COVID-19 often experience significant nutritional obstacles, that could have a negative impact on their nutritional status. The aim of the present study was to investigate possible associations of nutritional risk with length of hospital stay (LoS) and clinical outcome in ICU patients with COVID-19. Methods: Data from patients with COVID-19 consequently admitted in the ICU of the biggest tertiary hospital in Greece were included in the study (Evaggelismos General Hospital, Athens). Geriatric nutrition risk index (GNRI) was calculated at baseline, at day 5-7 of the infection and before the exit of the hospital. Weight was measured in all patients on bed scales and height was measured or calculated by knee height. Albumin levels, creactive protein levels and data for their medical history were collected from the medical files. Nutritional support, intubation need and the LoS were reported, as well as weight loss and clinical outcome. Results: Data from forty-eight (48) patients (16 female) with median age 62 (IQR¼52) years were included in the analysis. Fifty percent of the patients had less than 2 co morbidities, 60.4% of them (n¼29) received enteral nutrition on admission and 34 (70.8%) were intubated during ICU stay. According to GNRI evaluation 38 (79%) patients were on low nutritional risk on admission, 9 (18.75%) on moderate risk and 1 (2%) on high risk. GNRI on admission was positively correlated with weight loss% (r¼0.569,p¼0.009) and negatively associated with the need of intubation an association that was enforced in the measurement of GNRI in the 5-7day (-0.424, p¼0.003 and r¼-0632,p¼<0,001 respectively). Length of stay was negatively correlated with BMI at discharge (r¼-0.551, p¼0.015) and also showed a marginal non significant association with BMI on admission (r-0.335, p¼0.065) Conclusion: Twenty per cent of patients were at moderate or high risk of malnutrition on admissionto the ICU. During hospitalization in the ICU for COVID-19, nutritional risk seems to increase and this increment is associated with the need of intubation. A low BMI seems to have a negative effect on LoS. Applying new cutoff calculated with the Youden index in this population of hospitalized elderly adults, the sensitivity and specificity for SARC-F was 52.4% and 76.5%. For MSRA were 75.7% and 65.1% for the 7-items version and 68.8% and 67.9% for the 5-items version. The combined use of SARC-F and MSRA 7-items improved the accuracy for sarcopenia diagnosis with a specificity and sensitivity of 97.7% and 63.6%, respectively. Conclusion: SARC-F and MSRA 7-items could be coadministered easily, quickly and economically in hospital wards, as a first line tool to identify sarcopenic subjects.

Assessing the Risk of Sarcopenia in the Elderly: The Mini Sarcopenia Risk Assessment (MSRA) Questionnaire

SARC-F: a simple questionnaire to rapidly diagnose sarcopenia

Disclosure of Interest: None declared Protein and amino acid metabolism / Carbohydrates and lipid metabolism O21 IMPAIRED INSULIN SENSITIVITY AND CARBOHYDRATE OXIDATION DURING BED REST IN HEALTHY PARTICIPANTS

Immobilisation reduces insulin-mediated whole body glucose disposal (GD) (1). The rate of decline of insulin stimulated GD and changes in carbohydrate (CHO) oxidation over the acute to chronic bed rest (BR) setting remain to be fully elucidated