Covid is more serious if the patient is malnourished or obese. This is demonstrated by a review, published in ‘Nutrients’, conducted by researchers from the Gemelli Polyclinic – Catholic University of Rome, from which it emerges in particular that a state of malnutrition represents one of the crucial elements at the basis of a longer and more complicated course of the disease or of death from Covid-19. But what worries the experts is also and above all obesity which increases the risk of mortality from Covid and intubation by 6 times and also increases the risk of hospitalization by 2.6 times.
“For malnutrition – explains Maria Chiara Mentella, Uoc Clinical Nutrition of the Agostino Gemelli Irccs University Hospital Foundation, directed by Giacinto Abele Donato Miggiano, associate in dietetic and applied technical sciences and director of the Research and Training Center in Human Nutrition of the Catholic University – we mean an insufficient or unbalanced intake of macronutrients (carbohydrates, proteins, fats) and micronutrients (minerals and vitamins). You can be obese and malnourished if you suffer from a deficiency of one or more micronutrients; and this can result in lower resistance to infections and a greater severity of the disease in case of contagion “.
A good nutritional status – the researchers underline in a note – is fundamental for our immune defenses and therefore represents a key factor in the defense against viruses. The correct functioning of the immune system, according to the European food safety authority (Efsa), depends on an adequate level of 10 nutrients: vitamins D, C, A (including beta-carotene) and group B (especially B6, B12 and folate); as well as zinc, copper, iron and selenium. Half of the elderly are malnourished and this, as seen, represents a risk factor for hospitalization and mortality from Covid -19. At risk of malnutrition are in particular the elderly resident in the RSA, those who have paid the highest toll to Covid so far.
But what worries the experts is also and above all obesity. In fact, the review shows that obesity is a serious risk factor for Covid-19. “In particular – mentions Mentella – obesity increases the risk of mortality from Covid and intubation by 6 times; it also increases the risk of hospitalization by 2.6 times”. The distribution of fat in obese people is also important for the prognosis: visceral obesity (the ‘belly’) increases the risk of severe symptoms and having to resort to mechanical ventilation by two and a half times. Recent reports also suggest that the risk of severe forms and mortality increases up to 11 times in the presence of abundant fat deposits within the muscles.
“In the light of these premises – says Miggiano – it is therefore essential to have a correct nutritional care of all patients hospitalized for Covid-19, from the very first days of hospitalization. Their nutritional structure should be immediately evaluated, in order to then proceed with a adequate food prescription (also taking into account the fact that these subjects have an increased protein-caloric need for infection and fever). Feeding will be done by mouth, but in case of difficulty, feeding by tube should be used ( enteral feeding) or in some cases to that by drip (total parenteral nutrition) “.
Also important is a personalization of the prescription based on the patient’s characteristics, supplementing the diet with omega-3, vitamin D, vitamins of group B and C, if necessary. “Finally, it is necessary – continues Mentella – to carefully monitor patients with Covid-19 throughout the hospitalization, and thereafter, given that in 40% of cases they undergo weight loss (a problem that affects up to 66% of those who go to intensive care). Covid-19 can in fact interfere with proper nutrition due to breathing difficulties, loss of taste and smell, fever and severe fatigue complained by patients “, he explains.
“Clinical nutrition of patients with Covid-19 – concludes Miggiano – is in short one of the pillars of the treatment and prevention of Covid, as also underlined by the European Society for Clinical Nutrition and Metabolism (Epen). worsening of a state of malnutrition, adopting ad hoc nutrition protocols in the hospital. Clinical studies currently underway will provide further information on the role of amino acid, probiotic, omega-3 and vitamin D supplementation in patients with Covid-19 “.
“The nutritional status – comments Antonio Gasbarrini, professor of internal medicine at the Catholic University of the Sacred Heart, Rome campus, and director of the Department of Medical and Surgical Sciences of the Gemelli Irccs Polyclinic Foundation – has important repercussions in the prevention and treatment of many acute and chronic diseases. A correct diet is not only able to reduce the risk of certain diseases, from diabetes, obesity, through cardiovascular diseases, osteoporosis and some forms of cancer, but also represents a pillar of treatment. of a series of conditions and has an added value in reducing the infectious complications typical of the most fragile patients, as in the case of Covid-19 “, he concludes.