Home medical nutrition during SARS-CoV-2 pandemic - A position paper

Clin Nutr ESPEN. 2020 Aug;38:196-200. doi: 10.1016/j.clnesp.2020.05.002. Epub 2020 May 11.

Abstract

Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of a worldwide rapidly spreading illness, Coronavirus Disease 2019 (COVID-19). Patients fed enterally and parenterally at home are exposed to the same risk of infection as the general population, but more prone to complications than others. Therefore the guidance for care-givers and care-takers of these patients is needed.

Methods: The literature search identified no relevant systematic reviews or studies on the subject. Therefore a panel of 21 experts from 13 home medical nutrition (HMN) centres in Poland was formed. Twenty-three key issues relevant to the management of SARS-CoV-2 infection or COVID-19 in the HMN settings were identified and discussed. Some statements diverge from the available nutrition, surgical or ICU guidelines, some are based on the best available experience. Each topic was discussed and assessed during two Delphi rounds subsequently. Statements were graded strong or weak based on the balance between benefit and harm, resource and cost implications, equity, and feasibility.

Results: the panel issued 23 statements, all of them were graded strong. Two scored 85.71% agreement, eleven 95.23%, and ten 100%. The topics were: infection control, enrolment to HMN, logistics and patient information.

Conclusions: the position paper present pragmatic statements for HMN to be implemented in places without existing protocols for SARS-CoV-2 pandemic. They represent the state of knowledge available at the moment and may change should new evidence occurs.

Keywords: COVID-19; HAN; HEN; Home enteral nutrition; Home medical nutritition; Home parenteral nutrition; SARS-CoV-2.

Publication types

  • Consensus Development Conference

MeSH terms

  • Betacoronavirus*
  • Caregivers / education
  • Clinical Laboratory Techniques
  • Consensus
  • Coronavirus Infections / complications*
  • Coronavirus Infections / diagnosis
  • Coronavirus Infections / prevention & control
  • Delivery of Health Care
  • Enteral Nutrition / methods*
  • Home Care Services*
  • Humans
  • Infectious Disease Transmission, Patient-to-Professional / prevention & control
  • Pandemics / prevention & control
  • Parenteral Nutrition / methods*
  • Patient Care Team
  • Patient Isolation
  • Patient-Centered Care / methods
  • Personal Protective Equipment
  • Pneumonia, Viral / complications*
  • Pneumonia, Viral / diagnosis
  • Pneumonia, Viral / prevention & control
  • Risk Factors

Supplementary concepts

  • COVID-19
  • COVID-19 diagnostic testing
  • severe acute respiratory syndrome coronavirus 2