By: Justin A. Bakhshai
COVID-19 poses an unprecedented global health risk – both to patients and healthcare systems, alike. Emerging data suggests that individuals with chronic health conditions such as cardiovascular disease, diabetes mellitus, and obesity are more likely to become critically ill from COVID-19.1 Patients presenting to the hospital with multiple co-morbidities are also more susceptible to malnutrition, making it especially important to prevent or treat malnutrition in the event of infection and/or severe disease.2
Upon hospital admission, patients should be immediately screened for malnutrition. Global Leadership Initiative on Malnutrition (GLIM) recently proposed a two-step approach for malnutrition diagnosis2:
Nutritional treatment should be applied during hospitalization via individualized nutritional plans; this is particularly important given pre-existing nutritional risk factors continue to apply and acute disease and hospitalization are likely to worsen the risk or condition of malnutrition. Adequate assessment of nutrient intake is recommended with treatment with oral nutrition supplements or with enteral nutrition if oral route is insufficient.2
The majority of patients hospitalized for severe COVID-19 receive mechanical ventilation (often prolonged), representing a critical risk factor for higher morbidity and mortality in this patient cohort. ICU stays, mechanical ventilation, polymorbidity and older age are all commonly associated with high risk for malnutrition, with prolonged ICU length-of-stay often resulting in severe loss of skeletal muscle mass and function which may lead to disability, poor quality-of-life and additional morbidity. Prevention, diagnosis and treatment of malnutrition, including parenteral nutrition, is therefore a critical component of COVID-19 management in the ICU setting.2
Given the importance of the prevention, diagnosis and treatment of malnutrition, the ESPEN recently issued guidance on the nutritional management of COVID-19 patients. This document adeptly outlines ten practical recommendations for nutrition management in the context of COVID-19.2
The recommendations are summarized, as follows:
The new ESPEN guidelines reinforce the critical importance of nutritional intervention for critically ill patients and presents a viable opportunity to tailor medical nutrition solutions, including parenteral nutrition.
At DSM, our commitment to quality extends broadly and is represented by our patient-centric approach to innovation. DSM teams are highly aware of – and sensitive to – the fact that the products we produce reach the most medically vulnerable population groups (i.e. patients with severe conditions and multiple co-morbidities, from infants to the elderly).
The stakeholder experience is at the core of our business approach; working with the patient in mind is how we internally guide our ways of working across all business functions, from quality, regulatory all the way to production and innovation. And as a purpose-led partner, DSM actively supports research related to COVID-19.
For a successful go-to-market, understanding and acceptance of the medical community is key. We support those who aspire to make a difference in the medical community with in-depth patient and consumer insights to discover opportunities to develop parenteral nutrition solutions.
Discover how, together, we can raise the profile of vital therapeutics supporting those who need it most. Contact us today.
31 July 2020
8 min read
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 National Center for Health Statistics, & Centers for Disease Control and Prevention. Evidence used to update the list of underlying medical conditions that increase a person’s risk of severe illness from COVID-19. Retrieved: https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/evidence-table.html.
 Barazzoni R, et al. ESPEN expert statements and practical guidance for nutritional management of individuals with SARS-CoV-2 infection. Clinical Nutrition. https://doi.org/10.1016/j.clnu.2020.03.022.