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.

BACKGROUND & AIMS: COVID-19 patients present a high hospitalization rate with a high mortality risk for those requiring intensive care. When these patients have other comorbid conditions and older age, the risk for severe disease and poor outcomes after ICU admission are increased. The present work aims to describe the preliminary results of the ongoing NUTRICOVID study about the nutritional and functional status and the quality of life of adult COVID-19 survivors after ICU discharge, emphasizing the in-hospital and discharge situation of this population. METHODS: A multicenter, ambispective, observational cohort study was conducted in 16 public hospitals of the Community of Madrid with COVID-19 survivors who were admitted to the ICU during the first outbreak. Preliminary results of this study include data retrospectively collected. Malnutrition and sarcopenia were screened at discharge using MUST and SARC-F; the use of healthcare resources was measured as the length of hospital stay and requirement of respiratory support and tracheostomy during hospitalization; other study variables were the need for medical nutrition therapy (MNT); and patients' functional status (Barthel index) and health-related quality of life (EQ-5D-5L). RESULTS: A total of 176 patients were included in this preliminary analysis. Most patients were male and older than 60 years, who suffered an average (SD) weight loss of 16.6% (8.3%) during the hospital stay, with a median length of stay of 53 (27-89.5) days and a median ICU stay of 24.5 (11-43.5) days. At discharge, 83.5% and 86.9% of the patients were at risk of malnutrition and sarcopenia, respectively, but only 38% were prescribed MNT. In addition, more than 70% of patients had significant impairment of their mobility and to conduct their usual activities at hospital discharge. CONCLUSIONS: This preliminary analysis evidences the high nutritional and functional impairment of COVID-19 survivors at hospital discharge and highlights the need for guidelines and systematic protocols, together with appropriate rehabilitation programs, to optimize the nutritional management of these patients after discharge.

Impact of COVID-19 Lockdown on Glycemic Control in Adults with Type 1 Diabetes Mellitus.

AIM: To examine the impact of the lockdown caused by the COVID-19 pandemic on both the glycemic control and the daily habits of a group of patients with type 1 diabetes mellitus (T1DM) using flash continuous glucose monitoring devices (flash CGMs). METHODS: Retrospective analysis based on all the information gathered in virtual consultations from a cohort of 50 adult patients with T1DM with follow-up at our site. We compared their CGM metrics during lockdown with their own previous data before the pandemic occurred, as well as the potential psychological and therapeutic changes. RESULTS: We observed a reduction of average glucose values: 160.26 ± 22.55 mg/dL vs 150 ± 20.96 mg/dL, P = .0009; estimated glycosylated hemoglobin: 7.21 ± 0.78% vs 6.83 ± 0.71%, P = .0005; glucose management indicator 7.15 ± 0.57% vs 6.88 ± 0.49%; P = .0003, and glycemic variability: 40.74 ± 6.66 vs 36.43 ± 6.09 P < .0001. Time in range showed an improvement: 57.46 ± 11.85% vs a 65.76 ± 12.09%, P < .0001, without an increase in percentage of time in hypoglycemia. CONCLUSIONS: COVID-19 lockdown was associated with an improvement in glycemic control in patients with T1DM using CGMs.