Letter to the editor: Impact of COVID-19 in nutritional and functional status of survivors admitted in intensive care units during the first outbreak. Preliminary results of the NUTRICOVID study.

Dear Editor,

The study by CUERDA et al. (2021) evaluated the impact of COVID-19 on the nutritional and functional status of survivors admitted to intensive care units (ICU) during the first outbreak of the pandemic and piqued our interest. The research provides important information about the management and expected commitments of these individuals. The sample consisted of 176 patients of both sexes, with a mean age of 60.3 years [1].

Early nutritional management has been associated with a better evolution of the nutritional parameters of patients hospitalized for COVID-19 after discharge, especially in those transferred from the ICU (BEDOCK et al., 2021) [2]. Considering the importance of the moment of initiation of nutritional medical therapy (NMT) for these individuals, it would be valid for the authors to describe whether TMN was offered earlier or later, as it may contribute to a better recovery. Nutritional medical therapy offers benefits to the patient in the acute phase, providing energy and contributing to those who are critically ill, and if offered early, it contributes to the reduction of ICU length of stay, mortality and infection rate in patients with COVID-19.19 in serious condition [3].

In the description of the methods, CUERDA et al. (2021) did not specify the degree of severity of COVID-19 in the participating individuals. It has already been shown that clinical resolutions in hospitalized patients may be influenced by the SARS-COV2 viral load, and that its measurement and detection through RT-PCR are useful for risk stratification [4].

In addition, it was described in the methods that data were collected regarding the type of NMT (parenteral, enteral or oral nutritional supplement) and the time of administration of the diet. However, there was no questioning of additional information regarding the caloric and/or protein intake offered. Since, according to nutritional therapy guidelines, it is recommended to use a high-protein formula, which is considered one of the most important macronutrients to meet the nutritional needs of these individuals, benefiting their post-high recovery [3].

In their results regarding the functional state, CUERDA et al. (2021)reported that a high percentage of patients at risk of sarcopenia at discharge (86.3%) had moderate to total dependence, and the percentage of patients without risk was lower (34.8%). The presence of sarcopenia can lead to functional and physical deterioration, which may affect the hospital prognosis of those post-COVID-19 patients, in addition, the risk of sarcopenia and functional loss are greater in older patients [5]. When considering the importance that age can have on these disorders, it would be interesting for the authors to analyze the data by age group. In this way, comparisons would be possible, in the sense of knowing if the most dependent were the oldest.

It is worth mentioning that the present study brings important scientific and clinical contributions to the current moment, and since it is about preliminary results, it would be valid to observe the information mentioned above to increase the reliability of the data obtained.

Funding statement

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author contributions

KGS idealized the letter, writing of the manuscript. VONS, APSS, SLS and WMAB writing and revision of the manuscript. All authors read and approved the final version of the manuscript.

Conflict of interest

The authors declare that there is no conflicts of interest.