Guidelines for parenteral and enteral nutrition support treatment for hospitalized patients with COVID-19

Title: Guidelines for parenteral and enteral nutrition support treatment for hospitalized patients with COVID-19
Edition: Original
Classification: Rapid advice guideline
Field: Diagnosis and Treatment
Countries and regions: China
Guidelines users: Clinicians, dietitians, nurses and pharmacists
Evidence classification method: GRADE guidelines
Development unit: 四川省急危重症临床医学研究中心、四川省人民医院
Registration time: 2023-01-04
Registration number: PREPARE-2023CN006
Purpose of the guideline: COVID-19 is a serious threat to people's life and health, and there is no specific antiviral drug, symptomatic treatment is still the main clinical treatment method. COVID-19 is universally susceptible to all people, In addition to the main symptoms such as pharyngeal discomfort, cough and fever, the infected persons may also be accompanied by gastrointestinal symptoms such as nausea, diarrhea, hypotoleration, etc. In severe cases, the symptoms rapidly progress to acute respiratory distress syndrome, septic shock and multiple organ failure. Among them, the elderly infected patients, those with chronic underlying diseases and those with low immunity are more likely to progress to severe cases. Some patients will suffer from nutrient absorption dysfunction due to the above digestive tract symptoms, and may suffer from malnutrition due to the decrease or loss of taste and smell function leading to insufficient food intake. For severe patients, due to virus attack and secondary infection, the release of a large number of inflammatory factors triggers a cascade reaction of immune-endocrine-metabolism, resulting in serious metabolic dysfunction of patients and promoting the occurrence and development of malnutrition. Malnutrition leads to weakened immune function, which will further lead to the development of poor prognosis. Despite the continuous emergence of evidence-based medical evidence in the past three years, evidence-based and individualized intervention methods remain to be improved. This guideline has been formulated to better treat all kinds of hospitalized patients, especially those with severe infection, implement and promote optimization measures, improve treatment effects, and standardize nutritional treatment for those infected with COVID-19.