Lessons Learned in Nutrition Therapy in Patients With Severe COVID-19

JPEN J Parenter Enteral Nutr. 2020 Nov;44(8):1369-1375. doi: 10.1002/jpen.2005. Epub 2020 Sep 24.


The coronavirus disease 2019 (COVID-19) pandemic has reached worldwide, and until a vaccine is found, it will continue to cause significant morbidity and mortality. The clinical presentation of COVID-19 ranges from that of being asymptomatic to developing a fatal illness characterized by multiple organ involvement. Approximately 20% of the patients will require hospitalization; one-quarter of hospitalized patients will develop severe COVID-19 requiring admission to the intensive care unit, most frequently, with acute respiratory failure. An ongoing effort is being made to identify the patients that will develop severe COVID-19. Overall, patients present with 3 different phenotypes of nutrition risk: (1) the frail older patient, (2) the patient with severe ongoing chronic illness, and (3) the patient with severe and morbid obesity. These 3 phenotypes represent different nutrition risks and diverse nutrition interventions. This article explores the different potential approaches to nutrition intervention in patients with COVID-19, evaluating, in this process, the challenges faced in the implementation of guidelines written by different societies.

Keywords: COVID-19; hypocaloric; nutrition; obesity; protein.

MeSH terms

  • Aged
  • COVID-19 / therapy*
  • Chronic Disease
  • Coronavirus
  • Critical Care*
  • Critical Illness
  • Frail Elderly
  • Frailty*
  • Hospitalization
  • Humans
  • Intensive Care Units
  • Malnutrition / prevention & control
  • Nutrition Therapy*
  • Nutritional Status*
  • Nutritional Support*
  • Obesity*
  • Pandemics
  • Practice Guidelines as Topic
  • Risk Assessment
  • Severity of Illness Index