• Login / Register
    View Item 
    •   Home
    • Faculty of Medicine, Dentistry and Life Sciences
    • Clinical Sciences and Nutrition
    • Clinical Sciences and Nutrition
    • View Item
    •   Home
    • Faculty of Medicine, Dentistry and Life Sciences
    • Clinical Sciences and Nutrition
    • Clinical Sciences and Nutrition
    • View Item
    JavaScript is disabled for your browser. Some features of this site may not work without it.

    Browse

    All of ChesterRepCommunitiesTitleAuthorsPublication DateSubmit DateSubjectsPublisherJournalThis CollectionTitleAuthorsPublication DateSubmit DateSubjectsPublisherJournalProfilesView

    My Account

    LoginRegister

    About

    AboutUniversity of Chester

    Statistics

    Display statistics

    Nutritional parameters and outcomes in patients admitted to intensive care with COVID-19: a retrospective single-centre service evaluation

    • CSV
    • RefMan
    • EndNote
    • BibTex
    • RefWorks
    Thumbnail
    Name:
    bmjnph-2021-000270.pdf
    Size:
    332.2Kb
    Format:
    PDF
    Download
    Authors
    Eden, Timothy
    McAuliffe, Shane
    Crocombe, Dominic
    Neville, Jonathan
    Ray, Sumantra
    Affiliation
    Imperial College Healthcare NHS Trust; St John's Innovation Centre, Cambridge; University of Chester; Ulster University; University of Cambridge; Imperial College London
    Publication Date
    2021-08-05
    Submitted date
    2021-03-13
    
    Metadata
    Show full item record
    Abstract
    Background: COVID-19 is an inflammatory syndrome caused by novel coronavirus SARS-CoV-2. Symptoms range from mild infection to severe acute respiratory distress syndrome (ARDS) requiring ventilation and intensive care. At the time of data collection, UK cases were around 300 000 with a fatality rate of 13% necessitating over 10 000 critical care admissions; now there have been over 4 million cases. Nutrition is important to immune function and influences metabolic risk factors such as obesity and glycaemic control, as well as recovery from acute illnesses. Poor nutritional status is associated with worse outcomes in ARDS and viral infections, yet limited research has assessed pre-morbid nutritional status and outcomes in patients critically unwell with COVID-19. Objectives: Investigate the effect of body mass index (BMI), glycaemic control and vitamin D status on outcomes in adult patients with COVID-19 admitted to an intensive care unit (ICU). Methods: Retrospective review of all patients admitted to a central London ICU between March and May 2020 with confirmed COVID-19. Electronic patient records data were analysed for patient demographics; comorbidities; admission BMI; and serum vitamin D, zinc, selenium and haemoglobin A1c (HbA1c) concentrations. Serum vitamin D and HbA1c were measured on admission, or within 1 month of admission to ICU. Primary outcome of interest was mortality. Secondary outcomes included time intubated, ICU stay duration and ICU-related morbidity. Results: Seventy-two patients; 54 (75%) men, mean age 57.1 (±9.8) years, were included. Overall, mortality was 24 (33%). No significant association with mortality was observed across BMI categories. In the survival arm admission, HbA1c (mmol/mol) was lower, 50.2 vs 60.8, but this was not statistically significant. Vitamin D status did not significantly associate with mortality (p=0.131). However, 32% of patients with low vitamin D (<25 IU/L) died, compared with 13% of patients with vitamin D levels >26 IU/L. Serum zinc and selenium, and vitamin B12 and folate levels were measured in 46% and 26% of patients, respectively. Discussion/conclusion: Increased adiposity and deranged glucose homeostasis may potentially increase risk of COVID-19 infection and severity, possibly relating to impaired lung and metabolic function, increased proinflammatory and prothrombotic mechanisms. Vitamin D deficiency may also associate with poorer outcomes and mortality, supporting a possible role of vitamin D in immune function specific to pulmonary inflammation and COVID-19 pathophysiology. There are plausible associations between raised BMI, glycaemic control, vitamin D status and poor prognosis, as seen in wider studies; however, in this service evaluation audit during the first wave of the pandemic in the UK, with a limited data set available for this analysis, the associations did not reach statistical significance. Further research is needed into specific nutritional markers influencing critical care admissions with COVID-19.
    Citation
    Eden, T., McAuliffe, S., Crocombe, D., Neville, J., & Ray, S. Nutritional parameters and outcomes in patients admitted to intensive care with COVID-19: A retrospective single-centre service evaluation. BMJ Nutrition, Prevention & Health, 4(2). https://doi.org/10.1136/bmjnph-2021-000270
    Publisher
    BMJ Publishing Group
    URI
    http://hdl.handle.net/10034/625606
    Type
    article
    Description
    From BMJ via Jisc Publications Router
    History: received 2021-03-13, accepted 2021-07-12, ppub 2021-08, epub 2021-08-05
    Publication status: Published
    Collections
    Clinical Sciences and Nutrition

    entitlement

     
    DSpace software (copyright © 2002 - 2023)  DuraSpace
    Quick Guide | Contact Us
    Open Repository is a service operated by 
    Atmire NV
     

    Export search results

    The export option will allow you to export the current search results of the entered query to a file. Different formats are available for download. To export the items, click on the button corresponding with the preferred download format.

    By default, clicking on the export buttons will result in a download of the allowed maximum amount of items.

    To select a subset of the search results, click "Selective Export" button and make a selection of the items you want to export. The amount of items that can be exported at once is similarly restricted as the full export.

    After making a selection, click one of the export format buttons. The amount of items that will be exported is indicated in the bubble next to export format.