Early Versus Delayed Enteral Nutrition in Critically Ill Adults With COVID-19

Study Overview
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Brief Summary
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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
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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.

Official Title
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The Role of Early Enteral Nutrition in Critical Patients With COVID-19: A Retrospective Study

Conditions
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Enteral Nutrition, COVID-19 Acute Respiratory Distress Syndrome

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patients diagnosed with COVID-19 aged 19 years and older on MV receiving only enteral tube nutrition Exclusion Criteria: patients with an inflammatory disease myocardial infarction, collapse, and circulatory shock within the last 6 months hemodynamic instability embolism and stroke presence of unspecified coma renal disease cancer with a mortality rate of more than 50% within 6 months allogeneic bone marrow transplantation within 5 years enteral nutrition was contraindicated patients with allergic reactions to the enteral formula patients who received antioxidant supplements during feeding patients who received tube feeding supplemented with immunonutrition agents patients whose data could not be accurately retrieved

Ages Eligible for Study
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Minimum Age: 19 Years
Maximum Age: 100 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Early Enteral Nutrition<br>Patients who received enteral nutrition within the first 48 hours following intubation were included in the Early Enteral Nutrition (EEN) group. | |
| Late Enteral Nutrition<br>Patients who received enteral nutrition 48 hours or later following intubation were included in the late Enteral Nutrition (LEN) group. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| mechanical ventilation (MV), intensive care unit (ICU), length of hospital stay and overall mortality. | The research outcomes are to determine the relationship between the duration of EN initiation and MV, ICU, and length of hospital stay, overall mortality. | through study completion, an average of 9 months | 
| Prognostic Nutritional Index (PNI) score, neutrophil-lymphocyte ratio (NLR), oxygenation status | 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 | From date of hospitalization and intubation until the date of extubation or date of death from any cause, whichever came first, assessed up to 9 months | 
| Whether Nutritional goals were met, EN complications, and reasons for discontinuation and postponement. | The research outcomes are to determine the relationship between the duration of EN initation and nutritional goals were met, EN complications, and reasons for discontinuation and postponement. | From date of intubation until the date of extubation or date of death from any cause, whichever came first, assessed up to 9 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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SARS-COV-2,COVID-19,intensive care unit,early enteral nutrition