RESUMO
Older people are a high-risk group for coronavirus disease 2019 (COVID-19) because of a range of factors, including age-related changes in anatomical pulmonary and muscle function, decreased immunity and increased inflammation. These factors partly explain why older people with COVID-19 experience more severe symptoms and higher mortality than younger adults and are more likely to require nutritional support. Furthermore, there is an association between suboptimal nutritional status and poorer recovery from COVID-19. Therefore, nutritional interventions are an important aspect of care for older people with COVID-19. All members of the multidisciplinary team, including dietitians and nurses, need to assess, treat and prevent nutritional deficiencies in older people with COVID-19. This literature review provides an overview of the evidence regarding the role of nutritional interventions in the treatment of, and recovery from, COVID-19 in older people.
RESUMO
OBJECTIVES: The association between malnutrition and poor patient outcome has been established for different medical fields. There is a general lack of data on the prevalence of malnutrition in urologic patients. An assessment of malnutrition is needed to raise awareness of this condition and to initiate nutrition therapy if needed. METHODS: The nutritional state of 897 patients was assessed prospectively using the Nutritional Risk Screening 2002 (NRS) at a urologic department. Recruitment started in January 2007 and closed in July 2007. Of the 897 patients, 751 were men (84%) and 146 (16%) were women. The median age was 66 years (range 18-98). Of the 897 patients, 441 presented with benign disease and 456 with malignant disease. RESULTS: A severe risk of malnutrition was diagnosed in 144 patients (16%; NRS score >or=3). The NRS score was 0, 1-2, and 3-5 in 45, 708, and 144 patients, respectively. Age and malignant disease were significant risk factors for malnutrition (P < .001). Also, the type of surgery was significantly associated with the risk of malnutrition (P < .001). Sex and body mass index had no significant influence. Of the patients with an NRS score of >or=3, 94% presented with >or=1 of the 3 risk factors: older age, open surgery, and/or malignant disease (P < .001). CONCLUSIONS: In the present study, 16% of urologic patients were at a severe risk of malnutrition according to the NRS 2002. Older age, type of procedure, and malignant disease proved to be significant factors for a greater risk of malnutrition. Adequate nutritional supportive therapy should be considered in these patients to optimize their clinical outcome.