Early Versus Delayed Enteral Nutrition in Critically Ill Adults With COVID-19
Condition: Enteral Nutrition; COVID-19 Acute Respiratory Distress Syndrome
MeSH terms: COVID-19; Respiratory Distress Syndrome; Respiratory Distress Syndrome, Newborn; Acute Lung Injury
Study type: Observational

Summary: 
      The goal of this observational study is to determine the relationship between the nutritional
      profile of critically ill patients diagnosed with COVID-19 and disease severity, prognosis,
      and survival, to assess the ability to meet nutritional goals, EN complications, and reasons
      for discontinuation and postponement of feeding.

      The main questions aim to answer are the relationship between the duration of EN initiation
      and Prognostic Nutritional Index (PNI) score, neutrophil-lymphocyte ratio (NLR), oxygenation
      status, MV, ICU, and length of hospital stay, overall mortality, and whether nutritional
      goals were met, EN complications, and reasons for discontinuation and postponement.
    

Detailed description: 
      Nutritional support is a crucial component of managing critically ill patients. The
      prognostic impact of early enteral nutrition (EN) in critically ill COVID-19 patients is
      largely unknown. The study aimed to determine the relationship between the nutritional
      profile of critically ill patients diagnosed with COVID-19 and disease severity, prognosis,
      and survival, to assess the ability to meet nutritional goals, EN complications, and reasons
      for discontinuation and postponement of feeding. Methods: This retrospective study was
      conducted with adult intensive care unit (ICU) patients diagnosed with COVID-19 and receiving
      mechanical ventilation (MV) and EN. The demographic, clinical, biochemical, and nutritional
      data of the patients were obtained from the patient's files and the hospital database. The
      initiation time, route, method, product type, amount, and duration of feeding were recorded,
      and the daily intake of energy, protein, pulp, and water were calculated. The nutritional
      requirements of the patients were defined, and achievement of targets, EN complications, and
      reasons for discontinuation and postponement were recorded. Patients were divided into two
      groups: early EN (EEN) if the feeding was initiated within the first 48 hours after MV and
      late EN (LEN) if 48 hours or later. The research outcomes are to determine the relationship
      between the duration of EN initiation and Prognostic Nutritional Index (PNI) score,
      neutrophil-lymphocyte ratio (NLR), oxygenation status, MV, ICU, and length of hospital stay,
      overall mortality, and whether nutritional goals were met, EN complications, and reasons for
      discontinuation and postponement.
    

Observational model: Cohort
Time perspective: Retrospective
Sampling method: Non-Probability Sample
Study population: 
        This retrospective study was conducted in a 3rd line ICU. The study included adult patients
        diagnosed with COVID-19, aged 19 years and older, on MV, and receiving enteral tube
        nutrition.
      
Keywords: SARS-COV-2,COVID-19,intensive care unit,early enteral nutrition