Emerging data suggest that nutrition related symptoms manifest early in the viral process1 and are persistent post-discharge from ICU. Each of these symptoms has the potential to negatively impact oral intake and subsequent nutritional status before presentation to hospital / ICU. Symptoms include:
- Anosmia (with or without taste changes)
- Taste changes
- Loss of appetite
- Nausea and / or vomiting
To understand the need for nutritional rehabilitation post-ICU, it is important to consider the continuum of the patients’ illness. Given the above and the fact that presentation to ICU is around 7 days after the onset of symptoms, it is likely that the patients are presenting to ICU in an already nutritionally compromised state. This is further compounded by the clinical course during ICU which includes hyper-inflammation, the requirement for high levels of sedation, paralysis and proning. Each of these aspects impacts on nutritional status either directly by causing significant muscle wasting2 or indirectly by leading to feeding difficulties and interruptions precluding the delivery of adequate amounts of energy and protein.