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JFSF Vol 7, No 2, June 2022, p.88-94

doi: 10.22540/JFSF-07-088

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Review Article

Nutritional management of individuals with SARS-CoV-2 infection during rehabilitation

Amalia Tsagari1, Grigoris Risvas2, Jannis V. Papathanasiou3,4, Yannis Dionyssiotis5

  1. Nutritional Department, KAT General Hospital, Athens, Greece
  2. Department of Dietetics, School of Health, Aegean College, Athens, Greece
  3. Department of Kinesiotherapy, Faculty of Public Health, Medical University of Sofia, Bulgaria
  4. Department of Medical Imaging, Allergology & Physiotherapy, Faculty of Dental Medicine, Medical University of Plovdiv, Bulgaria
  5. Spinal Cord Injury Rehabilitation Clinic, General University Hospital of Patras, Patras, Greece

Keywords: COVID-19, Nutrition, Rehabilitation

Abstract

The combination of poor dietary intake and increased healthcare needs predisposes COVID-19 patients to malnutrition and sarcopenia. The scope of this narrative review is tο present epidemiology and etiology of malnutrition and sarcopenia in COVID-19 patients, their consequences as well as the content and delivery mode of optimum nutritional services for malnourished/sarcopenic COVID-19 patients in the rehabilitation setting. This narrative review also summarizes nutritional recommendations, consensus statements and treatment pathways developed by scientific societies for COVID-19 patients. COVID-19 patients are prone to malnutrition and sarcopenia due to inactivity, comorbidities, cytokine response, nutritional deficiencies, anosmia, loss of taste, anorexia and treatment with dexamethasone. Thus, all COVID-19 patients, including those who are overweight or obese, should be regularly screened for malnutrition and sarcopenia at admission to the rehabilitation setting, using a validated tool to identify those with (or at risk of) malnutrition. As a consequence of malnutrition and sarcopenia, COVID-19 patients demonstrate diminished immune potential, lower respiratory function, swallowing dysfunction, and low resilience to metabolic stress. COVID-19 patients have increased energy (27-30 kcal/day) and protein needs (1-1.5 g/kg body weight/day). Personalized nutritional education and counseling, food fortification with energy dense and/or protein rich whole foods or with powdered supplements and use of high protein, energy dense oral nutritional supplements are recommended.