Abstract

MENDES, Tiago M; FERRO, Graça  and  IRVING, Susana. COVID-19 AND CLINICAL OUTCOME: A CASE HIGHLIGHTING THE VALUE OF INTEGRATED NUTRITIONAL INTERVENTION. Acta Port Nutr [online]. 2022, n.29, pp.6-9.  Epub May 11, 2022. ISSN 2183-5985.  https://doi.org/10.21011/apn.2022.2902.

An 81-year-old man, with confirmed COVID-19 pneumonia, was hospitalised due to hypoxemic respiratory failure and severe hypovolemic hypernatremia. During pre-hospital emergency care, the patient was successfully managed with adenosine, for supraventricular tachycardia. At the Emergency Department, he exhibited an altered mental status varying from comatose to agitated, if stimulated. Further investigations confirmed SARS-CoV-2 infection and COVID-19 pneumonia (chest X-ray) with hypoxemic respiratory failure. Biochemistry indicated acute kidney failure with severe hypovolemic hypernatremia. At the designated internal medicine COVID-19 ward, comfort measures were initiated, but the patient remained stable. Therefore, a nasogastric tube was placed to correct hydration status. At the same time, the patient was identified as at a higher nutritional risk, warranting a nutritional assessment by the COVID-19 team nutritionist, followed by the implementation of a tailored nutritional care plan. A timely integration, within the comprehensive clinical care, of a proactive and specialised nutrition intervention, duly implemented and monitored by the multidisciplinary team, elicited that the patient condition was progressively improved.

Regardless, all the current clinical challenges and constraints felt when caring for elderly COVID-19 patients, nutritional risk identification and monitoring, within a tight multidisciplinary articulation, remains essential and, as described here, might allow for a timely implementation of salvage hydration and nutritional measures, which will contribute towards a favourable clinical response. The patient made a full recovery and was discharged back to the nursing home, where he still resides, in good health and without further loss of function. This case highlights the utmost need to implement and integrate nutritional care throughout COVID-19 hospitalizations.

Keywords : care; COVID-19; Geriatric medicine; Multidisciplinary approach; Nutritional status; Nutritional support.

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