The research, conducted by IPSOS among 453 adult patients who were hospitalized with Covid-19 across the UK, Spain, Italy, France and Germany, was commissioned by Nutricia, part of food, beverage and nutrition company Danone. The findings reveal the need to better integrate nutrition into medical care to improve Covid patient recovery in hospital and after discharge.
Dr Emanuele Cereda, physician at the Research Foundation IRCCS Policlinico San Matteo in Italy has conducted extensive research on nutrition and Covid-19 since the start of the pandemic.
He said, “Optimal nutrition care is key to support the disease journey and recovery and can help patients return to doing things that matter most to them. We are seeing many learnings from our experience with Covid-19, particularly the association between reduced energy intake and worse outcome. Collecting insights from patients complements clinical research and contributes to improving nutritional care for patients recovering from severe illness.”
Two out of three patients surveyed experienced clinically-significant weight loss associated with a longer stay in hospital. This is consistent with clinical research conducted since the start of the pandemic showing a high prevalence of malnutrition in patients admitted to hospital with Covid-19. Also, patients reported symptoms like loss and change of smell and taste, diarrhea or difficulty swallowing, which can contribute to further worsening of nutritional issues.
Muscle loss is a key related issue and a common complication of critical illness, associated with functional disability and longer recovery. As a result of muscle loss, patients are weaker, recover more slowly and experience more difficulty with everyday tasks. This was confirmed by survey participants: 85% felt that they had lost muscle strength, and 42% felt much weaker than before their illness. The majority of patients surveyed reported more difficulties with daily activities including climbing the stairs (85% saying their ability to complete this was impacted), food shopping and getting out of bed (76% each) and preparing meals (67%).
For patients, regaining the strength they have lost is a key goal with 51% citing this as the top expectation from nutritional support. This is closely followed by 45% of people who want to regain the ability to perform usual daily activities. Addressing malnutrition, weight loss and muscle wasting with nutritional support contributes to people’s health outcomes after serious illness and helps them recover better, which is also why ESPEN issued recommendations to include nutritional support as an integral part of the management of Covid-19 patients.
Dr Cristina Cuerda, physician at the General University Hospital Gregorio Maranon in Spain and General Secretary of ESPEN, is leading a large-scale clinical trial on nutrition and COVID-19 in 16 hospitals in Madrid.
She said, “The clinical research conducted to date highlights that despite the high risk of malnutrition and muscle loss in patients hospitalized in intensive care units with COVID-19, the use of medical nutrition therapy remains inadequate after discharge. This aspect of patient care needs more attention to improve recovery of people who leave the hospital with significant physical impairments.”
The survey results reiterate the benefit of adequate care after discharge - 56% of patients who received nutritional support after leaving the hospital considered it helped a lot or enormously with their recovery.
Only half of the patients surveyed as part of the research presented at ESPEN received medical nutrition in hospital during their treatment. On discharge from the hospital, this number dropped to 15%, highlighting gaps in continuity of care after leaving the hospital.
Dr Patrick Kamphuis, senior medical affairs director at Nutricia, said, “In this research we are hearing directly from the patients themselves about their experience and expectations around nutrition during their COVID-19 illness. Their voices confirm what nutritional experts have been advising since early last year – nutrition is an underutilized area of care for this disease.”
The findings are being presented at the ESPEN Congress 2021 among other investigator-led research initiatives supported by Nutricia as part of its NutriCOVer program. This is an initiative by Nutricia to support independent research and contribute to real-world evidence and clinical guidance for the nutritional management of patients recovering from severe Covid-19.