A study carried out on 80 patients hospitalized for Covid-19 during the first wave at the Toulouse University Hospital, highlighted the occurrence of rapid malnutrition. It would be linked to the inflammatory reaction of the virus.
Last spring, in the midst of the first wave of the pandemic, teams from the Toulouse University Hospital Center (CHU), in collaboration with the Institute for Metabolic and Infectious Diseases (Inserm, University Toulouse III-Paul-Sabatier) sought to measure the prevalence of undernutrition in hospitalized patients for Covid-19.
“At the time, we had little perspective on the effects of the disease in terms of undernutrition, but simply data that came from China and closer to home from the Grand Est region. We have therefore decided to conduct our own study to verify this phenomenon and adapt the management of Covid-19 patients, ”describes Antoine Rouget, intensive care physician at Rangueil hospital and lead author of the study (1).
Eighty patients, men and women, hospitalized for severe Sars COV2 pneumonia in intensive care, or likely to be admitted in case of worsening, were therefore included in the study for nearly two months.
37.5% of undernourished patients upon entering hospital
Each of these patients was weighed upon admission to hospital to make a diagnosis of undernutrition. “Among the sample, many patients were overweight or obese, so it was not easy to immediately measure their undernutrition”, describes Dr. Rouget. The doctors therefore relied on an internationally validated clinical diagnostic method which consists of measuring the BMI of patients, their recent weight loss (5% loss in one month), a reduction in food intake and an inflammatory infection. acute. “In these patients, in just seven days between the onset of Covid symptoms and hospitalization, weight loss reached 5%. An extremely rapid and high malnutrition. “
In addition, the study showed that in the sample, 46.2% of undernourished patients had reduced their diet by more than half over this same period, probably due to the symptoms associated with covid: 27.8% had mentioned loss of taste or appetite, 21.5% fatigue, and 20.3% loss of smell.
No more need for resuscitation
“We believe that there is no statistical relationship between the decrease in food intake and undernutrition since almost one in two patients no longer ate at home before being hospitalized”, concludes Antoine Rouget. On the other hand, it is the very important inflammatory nature of the virus which is undoubtedly the cause of this weight loss. “
Another lesson of the study, undernourished patients did not have more frequent recourse to resuscitation. “The results do not allow us to say that undernutrition is responsible for the excess mortality among this sample”, points out the doctor.
“On the other hand, this focus has enabled us to offer, since, nutritional care adapted and specific to Covid patients, to systematize recent weight loss research to then offer them an enriched diet. “
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