The Effects of Oral Nutritional Support on the Ability of the COVID-19 Patients to Recover: A Prospective, Open, Multicenter, Comparative in Two Groups, Observational Study

Background. Nutritional insufficiency and decreased muscle mass of patients diagnosed with COVID-19 leads to prolonged respiratory support, stay in ICU and hospital, as well as reduced muscle strength and quality of life in the recovery period after a viral pneumonia caused by COVID-19. Aims: To study the effects of oral nutritional support on the physical health recovery of COVID-19 patients. Materials and methods. A prospective, open, multicenter, comparative observative study of two groups, observational study was initiated to evaluate the effects of oral nutritional support (ONS) by Nutridrink® 200 ml on the ability of COVID-19 patients to recover. The patients with these criteria were included in the study: aged 18–69; a confirmed COVID-19 infection; requires respiratory support; ability to consume more than 60% of food from the total required; presence of a signed consent form. One group received supplementary oral nutritional support (ONS) everyday for 28 days from the day of inclusion. The other group received standard diet. The primary endpoint was the evaluation of quality of life using the SF-36 questionnaire and the changes in the hand grip strength between the 3rd and 1st visits. Secondary endpoints of the study were length of stay in hospital and duration of respiratory support in the hospital. Results. 205 patients with a COVID-19 infection were included in the study. The final number of patients included in the study was 185 patients. Median age was 55 years old. The majority of patients were male — 57.84% (107 patients). Upon evaluation of the physical component of quality of life using the SF-36 questionnaire, we obtained a statistically significant difference between the control and study groups on the 4th visit — 44.28±5.45 and 46.58±6.76 respectively (p=0.012). Muscle strength was statistically different in the control (Δ4.01±1.15 daN) and study (Δ6.1±2.06 daN) groups (p <0.0001). The duration of respiratory support was significantly lower in the study group, 6.7±1.30 days as opposed to 8.14±1.52 days in the control group (p <0.0001). Also, in the group with oral nutritional support, there was a statistically significant decrease in the length of stay in hospital. In the control group, the average length of stay in hospital was 16.47±2.93 days, whereas in the study group it was 13.16±2.69 days (p <0.0001). Conclusion. Oral nutritional support given to oxygen dependent COVID-19 patients improves rehabilitation potential including preservation of muscle mass and function, reducing oxygen support requirements and length of stay in hospital.