Nutrition of elderly persons during a new coronavirus infection
https://doi.org/10.21518/2079-701X-2022-16-15-144-151
Abstract
A new coronavirus infection (COVID-19) of a particularly severe course is more often observed in the elderly, this is largely due to age-related immunological and metabolic changes, as well as polymorbidity. In the literature, increasing evidence highlights how malnutrition negatively affects the immune system functionality, impairing protection from infections.
Individual vitamins and trace elements play an important role in supporting both innate and acquired immune defenses. Many chronic diseases such as diabetes and cardiovascular diseases in the elderly are often associated with a high risk of malnutrition and a poorer prognosis. The main causes of malnutrition are limited mobility, catabolic changes in skeletal muscles, as well as a decrease in food intake, which can be further aggravated in the elderly. In this article the role of nutrition of elderly patients in the period of a new coronavirus infection pandemic is analyzed. Nutrition is a determinant of the health status of older persons. Inadequate nutrition contributes to the progression of many diseases, and also increases the risk of adverse outcomes, including coronavirus infection. Therefore, it is important to assess the nutritional status of patients infected with COVID‐19 at all stages of treatment. It is imperative to provide adequate nutrition, which will make up for the deficiency of micro- / macronutrients, primarily protein and energy necessary for the recovery of the body.
According to modern recommendations, the management program for elderly patients with COVID-19 should include measures aimed at screening, preventing and treatment of malnutrition.
About the Authors
S. A. Solgalova
Stavropol State Medical University
Russian Federation
Russian Federation
Svetlana A. Solgalova, Cand. Sci. (Med.), Associate Professor of the Department of Medical and Social Expertise, Rehabilitation with the course of Geriatrics
310, Mira St., Stavropol, 355017
S. G. Kechedzhieva
Stavropol State Medical University
Russian Federation
Russian Federation
Svetlana G. Kechedzhieva, Cand. Sci. (Med.), Associate Professor, Head of the Department of Medical and Social Expertise, Rehabilitation with the course of geriatrics
310, Mira St., Stavropol, 355017
References
1. Zhu J., Ji P., Pang J., Zhong Z., Li H., He C., Zhang J., Zhao C. Clinical characteristics of 3062 COVID-19 patients: A meta-analysis. J Med Virol. 2020;92(10):1902–1914. https://doi.org/10.1002/jmv.25884.
2. Yang X., Yu Y., Xu J., Shu H., Xia J., Liu H. et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med. 2020;8(5):475–481. https://doi.org/10.1016/S2213-2600(20)30079-5.
3. Porcheddu R., Serra C., Kelvin D., Kelvin N., Rubino S. Similarity in Case Fatality Rates (CFR) of COVID-19/SARSCOV-2 in Italy and China. J Infect Dev Ctries. 2020;14(2):125–128. https://doi.org/10.3855/jidc.12600.
4. Liu K., Chen Y., Lin R., Han K. Clinical features of COVID-19 in elderly patients: A comparison with young and middle-aged patients. J Infect. 2020:80:14–18. https://doi.org/10.1016/j.jinf.2020.03.005.
5. Hussain A., Mahawar K., Xia Z., Yang W., El-Hasani S. Obesity and mortality of COVID-19. Meta-analysis. Obes Res Clin Pract. 2020;14(4):295–300. https://doi.org/10.1016/j.orcp.2020.07.002.
6. Cederholm T., Barazzoni R., Austin P., Ballmer P., Biolo G., Bischoff S.C. et al. ESPEN guidelines on definitions and terminology of clinical nutrition. Clin Nutr. 2017;36(1):49–64. https://doi.org/10.1016/j.clnu.2016.09.004.
7. Agarwal E., Miller M., Yaxley A., Isenring E. Malnutrition in the elderly: a narrative review. Maturitas .2013;76(4):296–302. https://doi.org/ 10.1016/j.maturitas.2013.07.013.
8. Volkert D., Beck A.M., Cederholm T., Cruz-Jentoft A., Goisser S., Hooper L. et al. ESPEN guideline on clinical nutrition and hydration in geriatrics. Clin Nutr. 2019;(38):10–47. https://doi.org/10.1016/j.clnu.2018.05.024.
9. Pilgrim A.L., Baylis D., Jameson K.A., Cooper C., Sayer A.A., Robinson S.M., Roberts H.C. Measuring appetite with the simplified nutritional appetite questionnaire identifies hospitalised older people at risk of worse health outcomes. J Nutr Health Aging. 2016;20(1):3–7. https://doi.org/10.1007/s12603-015-0533-9.
10. Quarleri L., Cappello S., Turri A., Rondanelli M., Caccialanza R. Nutritional status in older persons according to healthcare setting: A systematic review and meta-analysis of prevalence data using MNA((R)). Clin Nutr. 2016;35(6):1282–1290. https://doi.org/10.1016/j.clnu.2016.03.008.
11. Tkacheva O.N., Runikhina N.K., Ostapenko V.S., Sharashkina N.V., Mkhitaryan E.A., Onuchina J.S. et al. Prevalence of geriatric syndromes among people aged 65 years and older at four community clinics in Moscow. Clin Interv Aging. 2018;(13):251–259. https://doi.org/10.2147/CIA.S153389.
12. Gomes F., Schuetz P., Bounoure L., Austin P., Ballesteros-Pomar M., Cederholm T. et al. ESPEN guideline on nutritional support for polymorbid internal medicine patients. Clin Nutr. 2018;37(1):336–353. https://doi.org/10.1016/j.clnu.2017.06.025.
13. Recinella G., Marasco G., Serafini G., Maestri L., Bianchi G., Forti P., Zoli M. Prognostic role of nutritional status in elderly patients hospitalized for COVID-19: A monocentric study. Aging Clin Exp Res. 2020;32(12):2695– 2701. https://doi.org/10.1007/s40520-020-01727-5.
14. Pironi L., Sasdelli A.S., Ravaioli F., Baracco B., Battaiola C., Bocedi G. et al. Malnutrition and nutritional therapy in patients with SARS-CoV-2 disease. Clin Nutr. 2021;40(3):1330–1337. https://doi.org/10.1016/j.clnu.2020.08.021.
15. Li T., Zhang Y., Gong C., Wang J., Liu B., Shi L., Duan J. Prevalence of malnutrition and analysis of related factors in elderly patients with COVID-19 in Wuhan, China. Eur J Clin Nutr. 2020;74(6):871–875. https://doi.org/10.1038/s41430-020-0642-3.
16. Zhao X., Li Y., Ge Y., Shi Y., Lv P., Zhang J. et al. Evaluation of Nutrition Risk and Its Association With Mortality Risk in Severely and Critically Ill COVID-19 Patients. J Parenter Enter Nutr. 2020;45(1):32–42. https://doi.org/10.1002/jpen.1953.
17. Zhang P., He Z., Yu G., Peng D., Feng Y., Ling J. et al. The modified NUTRIC score can be used for nutritional risk assessment as well as prognosis prediction in critically ill COVID-19 patients. Clin Nutr. 2021;40(2):534–541. https://doi.org/10.1016/j.clnu.2020.05.051.
18. Li G., Zhou C.L., Ba Y.M., Wang Y.M., Song B., Cheng X.B. et al. Nutritional risk and therapy for severe and critical COVID-19 patients: A multicenter retrospective observational study. Clin Nutr. 2021;40(4):2154–2161. https://doi.org/10.1016/j.clnu.2020.09.040.
19. Di Filippo L., De Lorenzo R., D’Amico M., Sofia V., Roveri L., Mele R. et al. COVID-19 is associated with clinically significant weight loss and risk of malnutrition, independent of hospitalisation: A post-hoc analysis of a prospective cohort study. Clin Nutr. 2021;40(4):2420–2426. https://doi.org/10.1016/j.clnu.2020.10.043.
20. Brugliera L., Spina A., Castellazzi P., Cimino P., Arcuri P., Negro A. et al. Nutritional management of COVID-19 patients in a rehabilitation unit. Eur J Clin Nutr. 2020;74(6):860–863. https://doi.org/10.1038/s41430-020-0664-x.
21. Ткачева О.Н., Тутельян В.А., Шестопалов А.Е., Котовская Ю.В., Стародубова А.В., Погожева А.В. и др. Недостаточность питания (мальнутриция) у пациентов пожилого и старческого возраста. Клинические рекомендации. Российский журнал гериатрической медицины. 2021;(1):15–34. https://doi.org/10.37586/2686-8636-1-2021-15-34. Tkacheva O.N., Tutelyan V.A., Shestopalov A.E., Kotovskaya Yu.V., Starodubova A.V., Pogozheva А.V. et al. Nutritional insufficiency (malnutrition) in older adults. Clinical recommendations. Russian Journal of Geriatric Medicine. 2021;(1):15–34. (In Russ.) https://doi.org/10.37586/2686-8636-1-2021-15-34.
22. Barazzoni R., Bischoff S.C., Breda J., Wickramasinghe K., Krznaric Z., Nitzan D. et al. ESPEN expert statements and practical guidance for nutritional management of individuals with SARS-CoV-2 infection. Clin Nutr. 2020;39(6):1631–1638. https://doi.org/10.1016/j.clnu.2020.03.022.
23. Cederholm T., Jensen G.L., Correia M.I.T.D., Gonzale M.C., Fukushima R., Higashiguchi T. et al. GLIM Core Leadership Committee, GLIM Working Group. GLIM criteria for the diagnosis of malnutrition - A consensus report from the global clinical nutrition community. Clinical Nutrition. 2019;38(1):1–9. https://doi.org/10.1016/j.clnu.2018.08.002.
24. Alix E., Berrut G., Bore M., Bouthier-Quintard F., Buia J.M., Chlala A. et al. Energy requirements in hospitalized elderly people. J Am Geriatr Soc. 2007;55(7):1085–1089. https://doi.org/10.1111/j.1532-5415.2007.01236.x.
25. Bauer J., Biolo G., Cederholm T., Cesari M., Cruz-Jentoft A.J., Morley J.E. et al. Evidence-based recommendations for optimal dietary protein intake in older people: a position paper from the PROT-AGE Study Group. J Am Med Dir Assoc. 2013;14(8):542–559. https://doi.org/10.1016/j.jamda.2013.05.021.
26. Гречко А.В., Евдокимов Е.А., Котенко О.Н., Крылов К. Ю., Крюков Е.В., Луфт В.М. и др. Нутритивная поддержка пациентов с коронавирусной инфекцией COVID-19. Клиническое питание и метаболизм. 2020;1(2):56–91. https://doi.org/10.17816/clinutr42278. Grechko A.V., Evdokimov E.A., Kotenko O.N., Krylov K.Yu., Kryukov E.V., Luft V.M. et al. Nutritional Support for Patients with COVID-19 Coronavirus Infection. Clinical nutrition and metabolism. 2020;1(2):56–91. (In Russ.) https://doi.org/10.17816/clinutr42278.
27. Тутельян В.А., Никитюк Д.Б., Аксенов И.В., Батурин А.К., Бессонов В.В. Воробьева В.М. и др. Нормы физиологических потребностей в энергии и пищевых веществах для различных групп населения Российской Федерации. М.: Федеральная служба по надзору в сфере защиты прав потребителей и благополучия человека; 2021. 72 с. Режим доступа: https://www.rospotrebnadzor.ru/documents/details.php?ELEMENT_ID=18979. Tutelyan V.A., Nikityuk D.B., Aksenov I.V., Baturin A.K., Bessonov V.V., Vorobeva V.M. et al. Norms of physiological needs for energy and food substances for various population groups of the Russian Federation. Moscow: Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing; 2021. 72 p. (In Russ.) Available at: https://www.rospotrebnadzor.ru/documents/details.php?ELEMENT_ID=18979.
28. Gomes F., Schuetz P., Bounoure L., Austin P., Ballesteros-Pomar M., Cederholm T., Fletcher J. et al. ESPEN guideline on nutritional support for polymorbid internal medicine patients. Clin Nutr. 2018;(37):336–353. https://doi.org/10.1016/j.clnu.2017.06.025.
29. Авдеев С.Н., Адамян Л.В., Алексеева Е.И., Багненко С.Ф., Баранов А.А., Баранова Н.Н. и др. Временные методические рекомендации «Профилактика, диагностика и лечение новой коронавирусной инфекции (COVID-19)». Версия 14 (27.12.2021). Режим доступа: https://xn--80aesfpebagmfblc0a.xn--p1ai/ai/doc/1213/attach/vmr_COVID-19_V14_27-12-2021.pdf. Avdeev S.N., Adamyan L.V., Alekseeva E.I., Bagnenko S.F., Baranov A.A., Baranova N.N. et al. Temporary methodological recommendations “Prevention, Diagnosis and Treatment of a New Coronavirus Infection (COVID-19).” Version 14 (27.12.2021). (In Russ.) Available at: https://xn--80aesfpebagmfblc0a.xn--p1ai/ai/doc/1213/attach/vmr_COVID-19_V14_27-12-2021.pdf.
30. Тутельян В.А., Никитин М.В. (ред.). Санаторно-курортное лечение пациентов, перенесших COVID-19. Методические рекомендации. М.; 2021. 40 с. Режим доступа: https://www.nmicrk.ru/upload/patsients/covid19/mr_san-kur_lechenie_pats_COVID-19.pdf. Tutelyan V.A., Nikitin M.V. Spa treatment of patients who have undergone COVID-19. Methodological recommendations. Moscow; 2021. 40 p. (In Russ.) Available at: https://www.nmicrk.ru/upload/patsients/covid19/mr_san-kur_lechenie_pats_COVID-19.pdf.
31. Бубнова М.Г., Шляхто Е.В., Аронов Д.М., Белевский А.С., Герасименко М.Ю., Глезер М.Г. и др. Новая коронавирусная инфекционная болезнь COVID-19: особенности комплексной кардиологической и респираторной реабилитации. Российский кардиологический журнал. 2021;26(5):4487. https://doi.org/10.15829/1560-4071-2021-4487. Bubnova M.G., Shliakhto E.V., Aronov D.M., Belevskii A.S., Gerasimenko M.Yu, Glezer M.G. et al. Coronavirus disease 2019: features of comprehensive cardiac and pulmonary rehabilitation. Russian Journal of Cardiology. 2021;26(5):4487. (In Russ.) https://doi.org/10.15829/1560-4071-2021-4487.
32. Ткачева О.Н., Котовская Ю.В., Алексанян Л.А., Мильто А.С., Наумов А.В., Стражеско И.Д. и др. Новая коронавирусная инфекция SARS-CoV-2 у пациентов пожилого и старческого возраста: особенности профилактики, диагностики и лечения. Согласованная позиция экспертов Российской ассоциации геронтологов и гериатров. Кардиоваскулярная терапия и профилактика. 2020;19(3):2601. https://doi.org/10.15829/1728-8800-2020-2601. Tkacheva O.N., Kotovskaya Yu.V., Aleksanyan L.A., Milto A.S., Naumov A.V., Strazhesko I.D. et al. Novel coronavirus infection SARS-CoV-2 in elderly and senile patients: prevention, diagnosis and treatment. Expert Position Paper of the Russian Association of Gerontology and Geriatrics. Cardiovascular Therapy and Prevention. 2020;19(3):2601. (In Russ.) https://doi.org/10.15829/1728-8800-2020-2601.
33. Дедов И.И., Мельниченко Г.А. Дефицит витамина D у взрослых: диагностика, лечение и профилактика. Клинические рекомендации. М.; 2015. 75 с. Режим доступа: https://minzdrav.gov-murman.ru/documents/poryadki-okazaniya-meditsinskoy-pomoshchi/D%2019042014.pdf. Dedov I.I., Melnichenko G.A. Vitamin D deficiency in adults: diagnosis, treatment and prevention. Clinical guidelines. Moscow; 2015. 75 р. (In Russ.) Available at: https://minzdrav.gov-murman.ru/documents/poryadkiokazaniya-meditsinskoy-pomoshchi/D%2019042014.pdf.
34. Chew H.S.J., Lopez V. Global impact of COVID-19 on weight and weightrelated behaviors in the adult population: a scoping review. Int J Environ Res Publ Health. 2021;18(4):1876. https://doi.org/10.3390/ijerph18041876.
35. Sepulveda-Loyola W., Rodriguez-Sanchez I., Perez-Rodriguez P., Ganz F., Torralba R., Oliveira D.V. et al. Impact of social isolation due to COVID-19 on health in older people: mental and physical effects and recommendations. J Nutr Health Aging. 2020;24(9):938–947. https://doi.org/10.1007/s12603-020-1469-2.
36. Hanifi R., Lambert V., Alkandari J.R., Khan S., Bull F., Oja P. et al. Global recommendations on physical activity for health. Geneva: World Health Organization; 2010. 58 p. Available at: https://minzdrav.gov.ru/system/attachments/attaches/000/016/375/original/9789244599976_rus.pdf?1389768711.
37. Chen P., Mao L., Nassis G.P., Harmer P., Ainsworth B.E., Li F. Coronavirus disease (COVID2019): The need to maintain regular physical activity while taking precautions. J Sport Health Sci. 2020;9(2):103–104. https://doi.org/10.1016/j.jshs.2020.02.001.
38. Mathus-Vliegen E.M., Basdevant A., Finer N., Hainer V., Hauner H., Micic D. et al. Prevalence, pathophysiology, health consequences and treatment options of obesity in the elderly: a guideline. Obes Facts. 2012;5(3):460–483. https://doi.org/10.1159/000341193.
39. Volkert D., Beck A.M., Cederholm T., Cruz-Jentoft A., Goisser S., Hooper L. et al. ESPEN guideline on clinical nutrition and hydration in geriatrics. Clin Nutr. 2019;38(1):10–47. https://doi.org/10.1016/j.clnu.2018.05.024.
40. Тутельян В.А., Никитюк Д.Б., Батурин А.К., Вараева Ю.Р., Воробьева B.М., Гмошинская М.В. и др. Методические рекомендации МР 2.3.0171-20 «Специализированный рацион питания для детей и взрослых, находящихся в режиме самоизоляции или карантина в домашних условиях в связи с COVID-19» (утв. Главным государственным санитарным врачом РФ 10.04.2020). Режим доступа: https://www.garant.ru/products/ipo/prime/doc/73866661. Tutelyan V.A., Nikityuk D.B., Baturin A.K., Varaeva Yu.R., Vorobeva B.M., Gmoshinskaya M.V. et al. Methodological recommendations MR 2.3.0171-20 “Specialized Diet for Children and Adults in the Mode of Self-isolation or Quarantine at Home in connection with COVID-19” (Resolution of the Chief State Sanitary Doctor of the Russian Federation 10.04.2020). (In Russ.) Available at: https://www.garant.ru/products/ipo/prime/doc/73866661/.
41. Zabetakis I., Lordan R., Norton С., Tsoupras A. COVID-19: The Inflammation Link and the Role of Nutrition in Potential Mitigation. Nutrients. 2020;19;12(5):1466. https://doi.org/10.3390/nu12051466.
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Solgalova SA, Kechedzhieva SG. Nutrition of elderly persons during a new coronavirus infection. Meditsinskiy sovet = Medical Council. 2022;(15):144-151. (In Russ.) https://doi.org/10.21518/2079-701X-2022-16-15-144-151
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