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Corona disease: Malnourished patients have poorer prognoses
It has been known for some time that older people and those with certain pre-existing conditions are among those most at risk from the novel coronavirus. However, according to new knowledge, people who eat incorrectly also have an increased risk of a severe COVID-19 course.
COVID-19 particularly endangers people who are prone to malnutrition and malnutrition due to old age and previous illnesses - or who develop or intensify them during intensive care, according to a current report by the University of Hohenheim. According to Prof. Dr. med. Stephan C. Bischoff from the University of Hohenheim in Stuttgart even own children.
It is not only old age and previous illnesses that increase the risk
The Institute for Work and Technology (IAT / Westphalian University of Applied Sciences) recently reported that certain pre-existing conditions, such as high blood pressure, diabetes, heart disease or strokes, could result in a particularly severe COVID-19 course.
The Robert Koch Institute (RKI) explains that the likelihood of severe illness increases with age.
As the University of Hohenheim now writes, in addition to people whose immune system has already been weakened by old age and previous illnesses, malnourished and malnourished people are particularly at risk of COVID-19 disease.
"A good nutritional status of the patient significantly reduces the likelihood of going through a severe course of the disease, developing permanent consequential damage or even dying," says Prof. Bischoff.
Malnutrition also in children
However, staying in an intensive care unit, which may become necessary due to the severe respiratory diseases, more often leads to malnutrition and malnutrition developing or aggravating due to the inflammatory processes in COVID-19 patients.
The new type of coronavirus (SARS-CoV-2) mainly affects the respiratory tract, but the disease can also be associated with nausea, vomiting and diarrhea, which also affects food intake and utilization.
According to the experts, the body subsequently degrades skeletal muscles, which in turn can lead to a decrease in the quality of life, additional illnesses or even a disability - and this long after the treatment in the intensive care unit.
In this context, Prof. Bischoff warns not only to think of older people: “Malnutrition, malnutrition and being overweight are also a very present phenomenon in our society, even among children. With these preloads, the risk of viral pneumonia and a life-threatening course of infection increases. "
Therefore, the nutritionist demands: "Prevention, diagnosis and treatment of undernourishment and malnutrition should be routinely an integral part of the treatment of every COVID-19 patient."
Make sure you have a healthy diet before you get sick
In addition, it is important that people at risk, especially in the run-up to a possible COVID-19 disease, pay more attention to their nutritional status.
"People with known malnutrition and malnutrition or who are at risk should ideally get support from experienced nutritionists or medical experts," recommends Prof. Bischoff.
These experts can also assess to what extent it is necessary to supplement the daily diet with vitamins and minerals in order to achieve an optimal defense against infection.
However, Prof. Bischoff cannot subscribe to the thesis that an overdose of vitamins represents special protection.
“It is important to prevent and treat micronutrient deficits. However, there is no evidence that in well-nourished, healthy individuals, the routine use of high doses of micronutrients can prevent COVID-19 infection or improve disease progression, ”said the expert.
Regular physical activity even in quarantine
Regular physical activity of patients who are quarantined due to suspected COVID 19 is just as important as nutrition.
"However, the 14-day quarantine at home promotes a sedentary or lying lifestyle, e.g. B. in front of the television or the computer. As a result, regular physical activity and thus energy consumption decrease, ”Prof. Bischoff warns.
The quarantine could therefore lead to a worsening of chronic diseases, weight gain, the reduction of skeletal muscles and a reduced immune response. This in turn also increases the risk of illness for non-infected people in quarantine.
Regular training at home with various simple and easy to implement exercises is already well suited to maintaining the fitness level. This could include strengthening exercises, balance training, stretching exercises or a combination.
Further recommendations on nutrients and treatments
As a member of an international team of authors, Prof. Bischoff has now published further recommendations and, above all, specific treatment suggestions for practicing doctors in a guideline.
The expert recommendation was initiated by the European Society for Clinical Nutrition and Metabolism (ESPEN) in cooperation with the World Health Organization (WHO).
The publication was published in the journal "Clinical Nutrition". (ad)
Author and source information
This text corresponds to the requirements of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
- University of Hohenheim: Corona disease: malnutrition and malnutrition are underestimated risk factors, (accessed: April 28, 2020), University of Hohenheim
- Robert Koch Institute (RKI): Risk assessment for COVID-19, (accessed: April 28, 2020), Robert Koch Institute (RKI)
- Barazzoni R, Bischoff SC, Breda J, Wickramasinghe K, Krznaric Z, Nitzan D, Pirlich M, Singer P, endorsed by the ESPEN Council: ESPEN expert statements and practical guidance for nutritional management of individuals with SARS-CoV-2 infection; in: Clinical Nutrition, (published: March 31, 2020), Clinical Nutrition