新型冠状病毒肺炎康复期患者营养筛查与评估及膳食摄入分析

Nutritional Screening and Assessment and Dietary Intake Analysis of COVID-19 Patients During Recovery Period

目的:对新型冠状病毒肺炎(COVID-19)康复期患者进行营养筛查与评估,并分析其膳食摄入情况。方法:选择2020年1月20日—2020年3月19日在武汉协和医院接受治疗的COVID-19患者进行追踪随访调查,应用营养风险筛查2002、营养不良通用筛查工具、主观全面评定,结合实验室检查和24 h膳食回顾调查进行营养状况评价。结果:43例COVID-19康复期患者,随访时间为出院后345.0(336.0,352.0)d,体重总体水平恢复到感染COVID-19前的体重。NRS2002显示,仅1名(2.3%)患者存在营养风险,MUST未筛查出有营养不良风险的患者,SGA也未发现轻中度营养不良或重度营养不良患者。高尿酸、高血糖和血脂异常检出率分别为39.5%、20.9%、20.9%,其中血脂异常率在轻型、普通型和重型患者分别为12.0%、18.2%、57.1%(P<0.05),此外,TG、TC、LDL-C存在不同程度的升高,在正常范围内的比例仅为60.5%、39.5%、46.5%。每日平均能量摄入为(1721.6±424.1)kcal,其中,蛋白质、脂肪和碳水化合物的摄入量分别为(60.4±20.7)、(56.8±17.2)、(246.3±74.7)g。值得注意的是,患者在饮食上存在蔬菜、水产品、奶制品、豆制品、坚果、杂粮和薯类摄入不足的情况。结论:COVID-19康复期患者的营养风险和营养不良发生率较低,但存在不同程度的代谢异常,且膳食摄入不平衡问题非常普遍,应予以重视。

Objective To conduct nutritional screening and assessment and dietary intake analysis of COVID-19 patients during recovery period.Method COVID-19 patients treated in Wuhan Union Hospital from January 20 to March 19 in 2020 were followed up.Nutritional status was evaluated by nutritional risk screening(NRS2002),malnutrition universal screening tool(MUST),subjective global assessment(SGA),combined with laboratory examination results and 24-hour dietary recall.Result Totally 43 convalescent patients with COVID-19 were followed up for 345.0(336.0,352.0)days after discharge.The overall level of body weight returned to the body weight before infection with COVID-19.NRS2002 showed that only 1(2.3%)patient was at nutritional risk,MUST was not identified as at risk of malnutrition,and SGA did not identify patients with mild to moderate or severe malnutrition.The rate of high uric acid,hyperglycemia and dyslipidemia were 39.5%,20.9%and 20.9%respectively.The rate of dyslipidemia in patients with light,normal and severe were 12.0%,18.2%and 57.1%respectively(P<0.05).In addition,TG,TC,LDL-C increased in differently degrees,and the proportion within the normal range of was only 60.5%,39.5%and 46.5%respectively.The average daily energy intake was(1721.6±424.1)kcal,of which protein intake,fat intake and carbohydrate intake were(60.4±20.7)g,(56.8±17.2)g and(246.3±74.7)g respectively.It was worth noting that the diet of the patients was generally deficient in vegetables,aquatic products,soy products,dairy products,nuts,coarse cereals and tubers.Conclusion The incidence of nutritional risk and malnutrition in patients with COVID-19 during recovery period was low,but there were different degrees of metabolic abnormalities,and unbalanced dietary intake was very common,which should be paid attention to.