Nutritional Support and Clinical Outcome of Severe and Critical Patients With COVID-19 Pneumonia.
Nutritional Support and Clinical Outcome of Severe and Critical Patients With COVID-19 Pneumonia.
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COVID-19 肺炎重症和危重症患者的营养支持和临床结果
DOI：
10.3389/fnut.2020.581679
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发表时间：
2020
影响因子：
5
通讯作者：
Du S
中科院分区：
文献类型：
--
作者：
Yue X;Li M;Wang Y;Zhang J;Wang X;Kan L;Zhang X;Du S
背景：2020年，一种新型冠状病毒在全球蔓延。超过40万人死于SARS-CoV-2肺炎，其中大多数是重症和危重症患者。迄今为止尚未证实有效的抗病毒治疗。营养支持已成为重症、危重患者的重要治疗手段之一。方法：回顾性分析实验室确诊的COVID-19重症患者26例，危重患者22例。记录重症、危重症患者的饮食及营养治疗情况。收集了重症和危重症患者的基线特征和临床结果。结果：重症患者平均热量摄入（19.3 kcal/kg/d）高于危重症患者（15.3 kcal/kg/d） （P = 0.04）。两组的蛋白质摄入量相似（分别为0.65和0.62 g/kg / d, P = 0.29）。重症与危重症患者的中位病毒脱落时间差异无统计学意义（P = 0.354）。结论：对SARS-CoV-2肺炎危重患者采取限制非蛋白质热量但保持蛋白质摄入的容许性不足喂养策略是可行的。危重患者的病毒脱落时间与标准喂养的重症患者相同。然而，由于样本量小，结论的证据并不充分。为了证明在SARS-CoV-2重症肺炎患者中允许低热量和充足蛋白质摄入的真正临床益处，需要进行大规模、实用的随机对照试验。
Background: In 2020, a novel coronavirus has spread throughout the world. More than four hundred thousand people have died of SARS-CoV-2 pneumonia, most of which were severe and critical patients. No effective antiviral treatment has been verified thus far. Nutrition support has become one of the important treatments for severe and critical patients. Methods: In this retrospective study, 26 severe patients and 22 critical patients with laboratory confirmed COVID-19 were enrolled. We recorded the diet and nutritional treatments in severe and critical patients. Baseline characteristics and clinical outcomes of severe and critical patients were also collected. Results: Average calorie intake of severe patients (19.3 kcal/kg/d) was higher than critical patients (15.3 kcal/kg/d) (P = 0.04). Protein intake was similar in the two groups (0.65 and 0.62 g/kg per day, respectively; P = 0.29). There was no significant difference in the median duration of viral shedding between the severe and critical patients (P = 0.354). Conclusions: A permissive underfeeding strategy that restricts non-protein calories but preserves protein intake is feasible for critical patients with SARS-CoV-2 pneumonia. Viral shedding duration of critical patients was the same as severe patients who received standard feeding. Nevertheless, evidence of the conclusion is not sufficient because of small sample size. To show the real clinical benefit of permissive low-calorie and adequate protein intake in critical SARS-CoV-2 pneumonia patients, a large and pragmatic randomized controlled trial is needed.
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作者：
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