郴州地区37例普通型新型冠状病毒肺炎成人患者营养状况分析及营养干预初探

A preliminary study on nutritional status and nutritional intervention of 37 adult patients with common-type Coronavirus Disease 2019 in Chenzhou

目的郴州地区37例普通型新型冠状病毒肺炎(COVID-19)成人确诊患者营养状况分析及营养干预初探。方法选择2020年1月23日至4月20日郴州市第二人民医院确诊为普通型COVID-19患者37例,设计营养食谱,由医院提供全天膳食,食物摄入不足者提供口服营养补充。收集患者人口学、流行病学资料及住院第1、5、10天营养相关指标,了解患者住院期间营养状况。结果37例普通型COVID-19患者中,第1天观察:31例(83.8%)营养风险筛查2002评分≥3分,32例(86.5%)食物摄入量减少,25例(67.6%)血糖≥6.1 mmol/L,15例(40.5%)C反应蛋白>8 mg/L,10例(27.0%)淋巴细胞总数<4×10^9/L,4例(10.8%)血红蛋白<110 g/L,5例(13.5%)白细胞介素6>7 pg/L。通过给予医院膳食及口服营养补充后,患者平均体重、体重指数在第5天较第1天有所下降(P<0.05),第10天体重及体重指数较第1天无差别(P>0.05);营养风险筛查2002评分第5、10天较第1天下降(P<0.05);食物摄入量减少患者第5天为23例(62.2%),第10天仅有4例(10.8%);血清白蛋白、血红蛋白在第10天较第1天上升(P<0.05);血糖、白细胞介素6在第5、10天较第1天下降(P<0.05);血钙、CD3^+CD4、淋巴细胞总数在第5、10天较第1天有所上升(P<0.05);C反应蛋白、中性粒细胞/淋巴细胞比率在第10天较第1天有所下降(P<0.05)。结论普通型COVID-19患者治疗过程中给予营养干预,可改善血清白蛋白、血钙、血红蛋白、血糖水平,减轻炎症反应。

Objective To analyze the nutritional status and explore the nutritional intervention of 37 adult patients with common-type Coronavirus Disease 2019(COVID-19)in chenzhou.Methods According to the principles of routine nutritional support for pneumonia patients and the"nutritional dietary guidelines for the prevention and treatment of COVID-19"issued by National Health Commission of the PRC,nutritional recipes were designed for 37 patients with common-type COVID-19 in the Second People's Hospital of Chenzhou from January 23 to April 20,2020.The patient's diet was provided by the hospital throughout the day,and oral nutritional supplements were provided for those with insufficient food intake.Demographic and epidemiological data of the patients and nutrition-related indicators on the 1st,5th and 10th day of hospitalization were collected to understand the nutritional status of the patients during hospitalization.Results On the first day,there were 31 patients(83.8%)with NRS 2002 score≥3 points,32 patients(86.5%)had a decrease in food intake,25 patients(67.6%)with blood glucose≥6.1 mmol/L,15 patients(40.5%)with C-reactive protein(CRP)>8 mg/L,10 patients(27.0%)with total lymphocyte count<4×10^9/L.4 patients(10.8%)with hemoglobin<110 g/L,5 patients(13.5%)with IL-6(Interleukin6)>7 pg/L.After giving the hospital diet and oral nutrition supplement,the average weight and BMI of the patients decreased on the 5th day compared with the 1st day(P<0.05),but recovered on the 10th day with no difference compared with the first day(P>0.05).NRS 2002 scores were lower on the 5th and 10th day than on the 1st day(P<0.05).There were 23 patients(62.2%)with reduced food intake on the 5th day and only 4 patients(10.8%)on the 10th day.Serum albumin and hemoglobin levels increased on the 10th day compared with the first day(P<0.05).The levels of blood glucose and interleukin-6(IL-6)were lower on the 5th and 10th day than on the 1st day(P<0.05).Compared with the first day,the level of blood calcium,the number of CD3^+CD4 and the total number of lymphocytes increased on the 5th and 10th day(P<0.05),CRP level and NLR(neutrophil/lymphocyte ratio)decreased on the 10th day(P<0.05).Conclusion Nutritional intervention in the treatment of common-type COVID-19 can improve serum albumin,blood calcium,hemoglobin and blood glucose levels,and reduce inflammatory response.