It is not just about prescription. A cohort study of the impact of enteral nutrition on mortality of hospitalized patients with COVID-19.

Introduction: Introduction: during COVID-19 pandemic, international societies released guidelines and recommendations for patients requiring nutritional support according to previous similar respiratory diseases. Objectives: the aim of the study was to evaluate the nutritional support provided by enteral nutrition (EN) in patients with COVID-19 infection, identify if the recommendations from international societies were met and their impact on mortality rate. Methods: a cohort study was conducted on adult patients with COVID-19 admitted to a tertiary hospital. Demographic, clinical, biochemical, and nutritional variables were obtained. A random-effect parametric survival-time model was performed to quantify the risk of death for each variable, and the Hausman test was used to confirm the model. Results: two hundred and twenty-nine patients were enrolled. The delivered energy was > 80 % of adequacy in the first two days, as suggested by international guidelines (11.7 ± 4.9 kcal/kg); however, an adequacy rate less than 60 % was achieved on day 14 (25.4 ± 7.4 kcal/kg). The protein adequacy was > 75 % on the first days of infusion (1.3 ± 0.3 g/kg); however, the infusion was < 50 % (1.5 ± 0.4 g/kg) after being extubated. Age, sex, and nutritional risk were related to higher mortality in patients with EN, whereas the infused energy and protein, the percentage of protein adequacy, arginine, and n-3 PUFA were associated with lower mortality. Conclusion: achieving at least 80 % of the energy and protein requirements, as well as n-3 PUFA and arginine supplementation could be associated with lower mortality in COVID-19 patients. More studies are needed to confirm the role of these nutrients on the mortality rate.

Introducción: Introducción: durante la pandemia de COVID-19, las sociedades internacionales publicaron guías y recomendaciones para pacientes que requieren apoyo nutricional basándose en lo previamente recomendado en enfermedades respiratorias similares. Objetivos: evaluar el soporte nutricional con nutrición enteral (NE) en pacientes con COVID-19 e identificar el cumplimiento de las recomendaciones hechas por las sociedades internacionales y su impacto en la tasa de mortalidad. Métodos: estudio de cohorte en adultos con COVID-19 ingresados en un hospital de tercer nivel. Se registraron variables demográficas, clínicas, bioquímicas y nutricionales. Se realizó un modelo de supervivencia de efectos aleatorios para cuantificar el riesgo de muerte para cada variable y la prueba de Hausman para confirmar el modelo. Resultados: se incluyeron 229 pacientes. La energía administrada fue > 80 % de adecuación en los dos primeros días (11,7 ± 4,9 kcal/kg); sin embargo, fue < 60 % el día 14 (25,4 ± 7,4 kcal/kg). La adecuación de proteínas fue > 75 % en los primeros días de infusión (1,3 ± 0,3 g/kg), pero < 50 % (1,5 ± 0,4 g/kg) después de ser extubado. La edad, el sexo y el riesgo nutricional se relacionaron con mayor mortalidad, mientras que la energía y proteína infundidas, el porcentaje de adecuación proteica, la arginina y el contenido de ácidos grasos poliinsaturados (AGPI) n-3 se asociaron con menor mortalidad. Conclusión: aunque se necesitan más estudios para confirmarlo, alcanzar al menos el 80 % de los requerimientos energéticos y proteicos, así como la suplementación de fórmulas con AGPI n-3 y arginina, podría asociarse con menor mortalidad en pacientes con COVID-19.

Reduction of serum lipids by soy protein and soluble fiber is not associated with the ABCG5/G8, apolipoprotein E, and apolipoprotein A1 polymorphisms in a group of hyperlipidemic Mexican subjects.

Several studies have evaluated the effect of soy protein or soluble fiber on serum cholesterol in hypercholesterolemic subjects, with different results. We hypothesized that this response is associated with the presence of polymorphisms in genes encoding proteins involved in lipoprotein metabolism or reverse cholesterol transport. Thus, the aims of the present work were to study the effectiveness of a dietary portfolio consisting of a combination of soy protein and soluble fiber integrated in a low saturated fat (LSF) diet on blood lipids in a Mexican group with hyperlipidemia and to determine the association between responsiveness to the diet and the frequency of apolipoprotein (Apo) E and ApoA1 and ABCG5/8 polymorphisms. Forty-three hyperlipidemic subjects (20 men and 23 women) were given an LSF diet for 1 month, followed by an LSF diet that included 25 g of soy protein and 15 g of soluble fiber daily for 2 months. After the 3-month dietary intervention, serum total cholesterol (TC) significantly decreased by 20.6%, and serum triglycerides (TGs) decreased by 40.4%. Fifty-one percent of the subjects had a reduction more than 20% in serum TC, and 77% of the subjects had a reduction more than 20% in serum TG (hyperresponders). Approximately 14% of the hypercholesterolemic subjects had the ABCG8 (52 G/C) polymorphism, 65% had the ABCG5 (1950 C/G and G/G) polymorphism, 53.5% had the ApoA1 (-75 G/A and A/A) polymorphism, and 23.3% had the ApoE (3/4) polymorphism. Independently of genotype, the combination of cholesterol-lowering foods in an LSF diet significantly reduced serum TC and TG in Mexican hypercholesterolemic subjects.