The National Clinical Programme in Gastroenterology and Hepatology
Guidance for Nutrition relating to COVID-19
Version 1.0 20th April 2020
It is important at this time that we continue to reinforce the importance of good nutritional care and the role it plays in defining both short- and long-term outcomes of our patients. Malnutrition and unintentional weight loss contribute to progressive decline in health and individuals are more at risk from negative outcomes. We also know that patients surviving acute complications through long ICU stays will face further worsening or further exacerbation of malnutrition and sarcopenia (1). This document from the National Clinical Programme in Gastroenterology and Hepatology was developed by the Nutrition subcommittee to offer some guidance on managing nutrition support during COVID-19 for vulnerable patients, those in ICU and patients with co-morbidities, which are independently associated with malnutrition and its negative impact on patient survival.
The biggest risk to these patients is related not only to the infection itself, but also the emergency reorganisation of hospitals and general practice services to deal with the pandemic. Routine nutrition services will be affected. Any reduction in the provision of nutritional care has the potential for negative impacts on morbidity and mortality. Under difficult times of high pressure, we therefore must aim at following recommendations for best-practice in nutritional care to improve our patient’s outcomes. At present there are no dedicated studies on nutrition management in COVID-19 infection. The following considerations can currently only be based on the best of knowledge and clinical experience.
Please refer to the IrSPEN and ESPEN web sites for the most up to date information for guidance in nutritional care and to continue to review updates on COVID-19. Please check the HSE Repository for Interim Clinical Guidance intended for the Clinical Community for the latest version of all clinical guidance https://hse.drsteevenslibrary.ie/Covid19V2. This guidance document has been endorsed by the Irish Society of Gastroenterology (ISG) and Irish Society for Clinical Nutrition and Metabolism (IrSPEN). For further information please contact Dr Cara Dunne at CarDunne@stjames.ie