The feeding problems of patients admitted to the hospital with COVID-19 are becoming more apparent. However, a large group of patients has never been hospitalized, and it is precisely this group that seems to experience persistent symptoms.
In the COVOED project, the Department of Dietetics of Amsterdam UMC investigated the nutritional problems and nutritional status. First in the hospital and now, in collaboration with the WUR, also in primary care. The results are described and commented in this scientific article in Journal of Human Nutrition and Dietetics. On this page you will find a summary, a fact sheet and a short video with the most important results.
Patient characteristics
246 patients were included;
- Mean age was 57 years (SD 16)
- The majority (61%) was female
- 57% of patients were not hospitalized during the period of COVID-19 infection
Nutritional status
- 67% of patients were overweight or obese.
- The majority of patients had experienced unintended weight loss; 26% lost 5 to 10 kg and 12% lost more than 10 kg. However, over a third of the patients had (re)gained weight in the month before the first consultation with the primary care dietitian.
- 44% of patients had an increased risk of sarcopenia at the first consultation with the dietitian.
Nutrition-related complaints
Almost all patients had one or more nutrition-related complaints. The most common nutrition-related complaints were decreased appetite, shortness of breath, altered taste, loss of flavor, and feeling full (see figure).
The nutrition-related complaints improved gradually after the first consultation with a dietitian, but persisted for months.
After four to six months, changed taste, loss of taste, and shortness of breath were still the most common nutrition-related complaints.
What was the care provided by the dietitian?
- Most patients (61%) were referred by their general practitioner.
- A physiotherapist was involved in 80% of patients.
- The median number of consultations was five consultations. More than a third of the patients had six to eight consultations with the dietitian.
- In 48% of patients, less than 3 hours had been claimed from the health insurance company; and in 48%, 3 to 7 hours had been claimed. In 4%, more than 7 hours had been claimed.
- Oral nutritional supplements were prescribed in almost half of the cases.
- Treatment goals were met in 75% of patients at the end of dietetic treatment.
Conclusions
- The majority of patients recovering from COVID-19 had unintentional weight loss due to the infection, but weight recovery was often evident at the first consultation.
- Nutrition-related complaints were common. Although these symptoms improved over time, in a large group of patients the symptoms persisted 4 to 6 months after the start of treatment by the primary dietitian.
- In about half of the cases, the possibility of extending dietetic care (up to a maximum of 7 hours) was used.
