Terapia Nutricional en Pacientes Críticamente Enfermos con COVID-19: Revisión Narrativa
DOI:
https://doi.org/10.14306/renhyd.25.S2.1073Palabras clave:
Terapia nutricional, Estado nutricional, COVID-19, SARS-CoV-2Resumen
Introducción: La lucha contra la pandemia causada por el Síndrome Respiratorio Agudo Severo Coronavirus 2 (SARS-CoV-2), más conocido como Enfermedad por Coronavirus 2019 (COVID-19), en todos los países del mundo ha sido un desafío. La mayoría de los pacientes pueden ser tratados en aislamiento domiciliario, sin embargo, los pacientes de edad avanzada y/o con comorbilidades asociadas han demostrado condiciones más severas de la enfermedad, que requieren hospitalización, o incluso terapia nutricional y ventilación mecánica. Objetivo: Revisar la evidencia actual para establecer mejores recomendaciones nutricionales para pacientes críticamente enfermos con COVID-19.
Material y métodos: Esta es una revisión narrativa sobre la terapia nutricional en pacientes críticos con COVID-19. Los artículos científicos fueron buscados en las bases de datos U.S. National Library of Medicine (PubMed), así como sus respectivos términos en portugués y inglés, y se eligieron 40 artículos, excluyendo las pautas que se utilizaron para ayudar a redactar mejor este artículo.
Resultados: Los principales hallazgos fueron: La edad y las enfermedades no transmisibles se consideran factores de riesgo de mortalidad, siendo las principales hipertensión arterial sistémica y diabetes mellitus. Estos pacientes necesitan cuidados especiales, así como una evaluación constante del estado nutricional, ya que los pacientes desnutridos y com obesidad han mostrado una alta asociación con la mortalidad y el uso de ventilación mecánica. La terapia nutricional en los pacientes afectados puede mejorar el resultado clínico y debe considerarse como un tratamiento de primera línea y ser más valorado en el entorno hospitalario. Aunque no hay ninguna recomendación para la suplementación de la vitamina C y D y del zinc mineral, éstos pueden traer ventajas al sistema inmune de estos pacientes y ayudar en un mejor pronóstico de COVID-19. Sin embargo, son necesarios más estúdios para corroborar la correcta dosificación.
Conclusiones:Se necesitan más estudios, pero es importante llevar estos temas ya expuestos por algunos autores para estimular discusiones que puedan conducir a mejoras en la estandarización de los enfoques nutricionales.
Citas
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