The importance of nutritional status in COVID-19 management
Against the background of the current COVID-19 pandemic, the European Society for Clinical Nutrition and Metabolism (ESPEN) emphasizes in an expert statement the importance of nutritional status in high-risk groups, but also in people without pre-existing medical conditions. [1] The nutritional status of a person is closely related to the strength of the immune system and thus the ability of the body to fight infections. Elderly persons and people with pre-existing health conditions generally have a weaker immune system and often a relatively poor nutritional status. At the same time, they fall into the high-risk group for severe courses of a COVID-19 infection. Therefore, according to ESPEN, the analysis and assessment of nutritional status is particularly important in these patients.
However, this should also be taken into account for people without pre-existing conditions, as a stay in the intensive care unit – as may be necessary for a COVID-19 infection – can lead to malnutrition, with severe loss of skeletal muscle mass and function. This in turn can result in a poorer quality of life, disabilities and morbidity after discharge from the intensive care unit. This shows the importance of routine prevention, diagnosis, and treatment of malnutrition in the management of COVID-19.
Obesity and COVID-19
According to the ESPEN statement, obesity patients also belong to the high-risk group for critical COVID-19 infection courses, as overweight increases the severity of the disease. It is therefore necessary to thoroughly evaluate and address the nutritional status of obesity patients.
The World Obesity Federation also draws attention to the fact that obesity or obesity-related diseases increase the risk of severe COVID-19 progression. [2] In addition, the current pandemic could lead to a further increase in global obesity numbers: [3] treatment options for obesity patients (such as exercise programs, dietary advice and bariatric operations) have been severely curtailed. Furthermore, the lockdown restrictions have led to many people doing less exercise and consuming more processed foods with a longer shelf life or convenience foods. “During the current COVID-19 situation, there is a lack of support for obesity patients, such as advisory services for nutrition and exercise,” says Dr. Birgit Schilling-Massmann, general practitioner and head of a specialist practice for nutritional medicine in the Münster region. “As soon as we start easing the lockdown measures, these programs will need to be reinforced and provided with both political and financial support in order to reduce obesity rates and to relieve the health system in the long term.”
[1] Clinical Nutrition Journal. ESPEN expert statements and practical guidance for nutritional management of individuals with SARS-CoV-2 infection. https: //www.clinicalnutritionjournal.com/article/S0261-5614(20)30140-0/fulltext#sec2.1. Last access: 04/30/20
[2] World Obesity Federation. Coronavirus (COVID-19) & Obesity. https://www.worldobesity.org/news/statement-coronavirus-covid-19-obesity. Last access: 04/30/20
[3] World Obesity Federation. Obesity and COVID-19: Policy statement. https://www.worldobesity.org/news/obesity-and-covid-19-policy-statement. Last access: 04/27/20
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