ESPEN 2021 Late Breaking Abstracts

Topic: Critical care

Abstract Submission Identifier: ESPEN21-LB-1984

MALNUTRITION, SARCOPENIA AND DISABILITY IN CRITICAL COVID 19 PATIENTS

J. Alvarez^*, ¹, M. Bernal ², C. Serrano ³, B. LLorente ⁴, P. Villa ⁵, E. nevado ⁶

¹Endocrinology and Nutrition, Univesity Hospital Principe de Asturias, ²endocrinología y nutrición, University Hospital Principe de Asturias, ³intensive care unit, university Hospital Príncipe de Asturias, ⁴intensice care unit, university hospital Principe de Asturias, ⁵intensive care unit, university hospital Pirncipe de Asturias, ⁶intensive care unit, University Hospital Principe de Asturias, Alcala de Henares, Spain

Rationale: Sarcopenia and malnutrition cause functional impairment in sick individuals. Its prevention and treatment showed positive effects. Our aim were to define the nutritional and functional status of patients with SARS CoV-2 infection upon admission to the ICU and during their evolution

Methods: Observational, retrospective study, in conditions of usual clinical practice, of patients with critical SARS-CoV2 infection, admitted to the ICU between 09/03-30/09, 2020, and their evolution 3 and 6 months after discharge. Were analyzed demographics outcomes, clinical history, nutritional screening (MUST) and sarcopenia (SARC-f), Barthel index, nutritional therapy (NT), invasive mechanical ventilation (IMV), stays in ICU, hospital and mortality.

Results: 150 patients (94V, 56M), mean age 60 years (28-87). Obesity (56.7%) and overweight (31.3%). 46% have a MUST ≥2; 48% met GLIM criteria for malnutrition. This malnourished patients had a 15-day stay more in the ICU (25.78± 2.84 vs 9.9±10.054; p<0.027) and 26.5 more in hospitalization (49, 9±34.7 vs 23.3±13.4; p<0.015). Patients with weight loss ≥5% had 11.21 more days of IMV (p <0.004). 47.3% presented SARC-f ≥4 with prolonged stays in ICU (24.4±22.04 vs 13.2 ±10.3 days; p<0.016), and hospital (48.5±33.7 vs 25,7±13.2 days; p <0.005). Only 4% of the patients were independent at discharge from the ICU. At 6 months, 17 patients maintained some degree of dependence. Mortality was 33%. All patients received NT according to protocol, enteral nutrition exclusively (88%) or exclusive or complementary parenteral nutrition (29.3%) during their stay in the ICU. Statistical analysis was performed using SPSS 26.0.

Conclusion: Critical COVID patients have a high prevalence of obesity, malnutrition, sarcopenia and dependence. Malnutrition and sarcopenia affects more days of IMV and prolonged ICU and hospital stays. Screening for both entities is key upon admission to hospital.

References: 1. Thibault R, Seguin P, Tamion F, Pichard C, Singer P. Nutrition of the COVID-19 patient in the intensive care unit (ICU): a practical guidance. Crit Care. 2020 Jul 19;24(1):447.

Disclosure of Interest: None Declared

Keywords: malnutrition, obesity sarcopenic, sarcopenia screening