key: cord-0870562-z2aang9y authors: Cintoni, Marco; Rinninella, Emanuele; Annetta, Maria Giuseppina; Mele, Maria Cristina title: Nutritional management in hospital setting during SARS-CoV-2 pandemic: a real-life experience date: 2020-04-06 journal: Eur J Clin Nutr DOI: 10.1038/s41430-020-0625-4 sha: 6af5dcb16646938876c3ea1187de5205d1daf7ef doc_id: 870562 cord_uid: z2aang9y nan The two sides of the same coin are the following: nutritional support to the COVID-19 patients and meals supply to the healthcare professionals in wards (Fig. 1) . In planning nutritional support for the patients, the following conditions were considered: • Since the median age of COVID-19 patients is 65 years old, their nutritional status may not be optimal. • Fever and respiratory distress represent two factors that increase the energy expenditure. • Isolation in small areas and bed resting induce a decrease in patients' muscle mass. • During HS, a decrease in total energy and protein intake is frequently reported, due to the scarce palatability of hospital meals. • Malnutrition is a frequent under-recognized and undertreated condition in hospital wards [4] , and this aspect may worsen during a pandemic. To meet the increased energy and protein requirements of the above-mentioned conditions, our institution started a personalized meal provision, combined with Oral Nutritional Supplements, to all oral-feedable COVID-19 patients, while those unable to eat are supported with high protein/low glucose Enteral and Parenteral Nutrition formulas, according to recent ESPEN guideline on clinical nutrition in the Intensive Care Unit [5] . Indeed, in the recent Chinese experience, nutritional support was considered a basic treatment and part of the multidisciplinary management for symptomatic SARS-CoV-2 affected patients [6, 7] . On the other side, the staff of the COVID-19 departments involved in the assistance, were provided with hot meals in disposable trays directly in the wards, with the addition of snacks and comfort food, since COVID-19 departments' shifts last 12 h and may result particularly heavy for personnel, deserving adequate nutritional support. This clinical choice has been made to avoid canteen meals, with a desirable reduction of SARS-CoV- Despite the absence of literature on nutritional support in a pandemic hospital setting, we want to advise all the clinical nutritionists to plan specific interventions in their hospital, directed both to avoid the potential spreading of SARS-CoV-2 through the canteen and to pay particular care to the nutritional status of the isolated and fragile COVID-19 patients. Conflict of interest The authors declare that they have no conflict of interest. Publisher's note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Fig. 1 The nutritional management of COVID-19 units at Gemelli Hospital. Both patients and healthcare professionals are provided with personalized nutritional support. The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak Situation Report-64 SITUATION IN NUMBERS total and new cases in last 24 h. 2020 Risk, prevalence, and impact of hospital malnutrition in a Tertiary Care Referral University Hospital: a crosssectional study ESPEN guideline on clinical nutrition in the intensive care unit Specialty Branch Chinese Medical Association Parenteral Enteral Nutrition Branch Medical Nutrition Therapy Experts Recommendation