NUTRITIONAL SUPPORT FOR PATIENTS WITH POST-COVID SYNDROME

Palladina O. L., Palladin M. O.

LITERATURE REVIEWS

Scentific article

An important place in the pathogenesis of coronavirus disease is metabolic stress, characterized by a violation of all types of metabolism, excessive mobilization of energy substrates involved in the processes of glycogenolysis, lipolysis, proteolysis, gluconeogenesis. This leads to the development of insulin resistance, hypoglycemia and a negative nitrogen balance. In the patient’s body there is an increase in energy needs and energy substrates against the background of tissue tolerance to these substrates. Therefore, to increase the effectiveness of rehabilitation, it is very important to assess the nutritional status and provide nutritional support to the patient at all stages of treatment of coronavirus disease. Nutritional support of the patient must include the correction of existing metabolic disorders, meeting the body’s needs for energy, macronutrients and micronutrients, maintenance of active protein mass, support of all organs and systems of the body, especially the immune system. The patient’s nutritional status should be determined using a special MUST scale, and the MNA scale should be used in geriatric patients with senile asthenia, sarcopenia, and eating disorders. The need for energy and essential nutrients, in particular protein, should be calculated individually for each patient with postcoid syndrome, taking into account gender, age, anthropometric parameters, level of physical activity and stage of medical rehabilitation. Patients with postcocious syndrome are often diagnosed with vitamin D deficiency. To prescribe a therapeutically effective dose, it is recommended to determine the level of 25-OH vitamin D and, depending on the result, individually select the dose, which can be increased from the standard dose of 2000 IU to 5000-10000 IU. Patients with postcocious syndrome are recommended additional appointment of B vitamins, which play an important role in energy metabolism, protein synthesis, glucose utilization, reduce the level of pro-inflammatory cytokines, strengthen cellular immunity. Be sure to include buckwheat, oatmeal, liver, yeast, nuts, and legumes in your diet. Additional use of dietary supplements containing thiamine, pyridoxine, riboflavin, folic acid, cyanocobalamin is recommended.

post-covid syndrome, COVID-19, nutrition, vitamin D.

1. Del Rio C, Collins LF, Malani P. Long-term Health Consequences of COVID-19 [Internet]. JAMA. 2020 Nov 3;324(17):1723-1724. Available from: https://jamanetwork.com/journals/jama/fullarticle/2771581. DOI: 10. 1001/jama.2020.19719.
2. Greenhalgh T, Knight M, A’Court C, Buxton M, Husain L. Management of post-acute covid-19 in primary care [Internet]. BMJ. 2020 Aug 11;370:m3026. Available from: https://www.bmj.com/content/370/bmj.m30 26.long. DOI: 10.1136/bmj.m3026.
3. World Health Organization. COVID-19 weekly epidemiological update [Internet]. WHO; 2021 [updated 2021 July 11]. Available from: https: //www.who.int/publications/m/item/weekly-epidemiological-update-on-covid-19---13-july-2021.
4. Moreno-Pérez O, Merino E, Leon-Ramirez JM, Andres M, Ramos JM, Arenas-Jiménez J, et al. Post-acute COVID-19 Syndrome. Incidence and risk factors: a Mediterranean cohort study. J. Infect. 2021;82(3):378-383. DOI: https://doi.org/10.1016/j.jinf.2021.01.004.
5. Halpin SJ, McIvor C, Whyatt G, Adams A, Harvey O, McLean L, et al. Postdischarge symptoms and rehabilitation needs in survivors of COVID-19 infection: a cross-sectional evaluation. J. Med. Virol. 2021;93(2):1013-1022. DOI: https://doi.org/10.1002/jmv.26368.
6. Carfì A, Bernabei R, Landi F, Gemelli Against COVID-19 Post-Acute Care Study Group. Persistent Symptoms in Patients After Acute COVID-19. JAMA. 2020;324:603-605. DOI: https://doi.org/10.1001/jama.2020.12603.
7. Carvalho-Schneider C, Laurent E, Lemaignen A, Beaufils E, Bourbao-Tournois C, Laribi S, et al. Follow-up of adults with non-critical COVID-19 two months after symptoms’ onset. Clin. Microbiol. Infect. 2021;27(2):258-263. DOI: https://doi.org/10.1016/j.cmi.2020.09.052.
8. Wang X, Xu H, Jiang H, Wang L, Lu C, Wei X, et al. Clinical features and outcomes of discharged coronavirus disease 2019 patients: a prospective cohort study. QJM Mon. J. Assoc. Physicians. 2020;113:657-665. DOI: https://doi.org/10.1093/qjmed/hcaa178.
9. Kurakh AV, Chubirko KI, Chopei IV, Bychko MV, Debretseni KO, Hechko MM. Postkovidnyi syndrom: klinichni proiavy ta yich osoblyvosti. Zdobutky klinichnoi i eksperementalnoi medytsyny. 2021;1:6-11. DOI: https://doi.org/10.11603/1811-2471.2021.v.i1. [in Ukrainian].
10. Normatyvno-dyrektyvni dokumenty MOZ Ukrayiny [Internet]. Protokol nadannia reabilitatsiinoi dopomoho patsiientam z koronovirusnoiu khvoroboiu (COVID-19) ta rekonvalestsentam. 2021. Dostupno: https:// moz.gov.ua/uploads/6/30153-dn_771_20_04_2021_dod_1. [in Ukrainian].
11. National Institute for Health and Care Excellence. COVID-19 rapid guideline: managing the long-term effects of COVID-19. [Internet]. London: National Institute for Health and Care Excellence; 2020 Available from: https://www.ncbi.nlm.nih.gov/books/NBK567264/.
12. Tenforde MW, Kim SS, Lindsell CJ, Rose EB, Shapiro NI, Files DC, et al. Symptom duration and risk factors for delayed return to usual health among outpatients with COVID-19 in a multistate health care systems network. United States, March–June 2020. MMWR. 2020;69(30):993-998. DOI: http: //dx.doi.org/10.15585/mmwr.mm6930e1.
13. Calder PC. Nutrition, immunity and COVID-19. BMJ Nutr. Prev. Health. 2020;3(1):74-92. DOI: https://doi.org/10.1136/bmjnph-2020-000085.
14. Calder PC, Carr AC, Gombart AF, Eggersdorfer M, Reply to «Overstated Claims of Efficacy and Safety. Comment On: Optimal Nutritional Status for a Well-Functioning Immune System Is an Important Factor to Protect against Viral Infections. Nutrients 2020, 12, 1181». Nutrients. 2020;12(9):2696. DOI: https://doi.org/10.3390/nu12092696.
15. Im JH, Je YS, Baek J, Chung MH, Kwon HY, Lee JS. Nutritional status of patients with COVID-19. Int. J. Infect. Dis. 2020;100:390-393. DOI: https: //doi.org/10.1016/j.ijid.2020.08.018.
16. Barazzoni R, Bischoff SC, 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. DOI: https://doi.org/10.1016/j. clnu.2020.03.022.
17. Fernández-Quintela A, Milton-Laskibar I, Trepiana J, Gómez-Zorita S, Kajarabille N, Léniz A, et al. Key aspects in nutritional management of COVID-19 patients. J. Clin. Med. 2020;9(8):2589. DOI: https://doi.org/10. 3390/jcm9082589.
18. Laviano A, Koverech A, Zanetti M. Nutrition support in the time of SARS-CoV-2 (COVID-19). Nutrition. 2020;74:110834. DOI: https://doi. org/10. 1016/j.nut.2020.110834.
19. Grechko AV, Evdokimov EA, Kotenko ON, Krylov KYU, Kryukov EV, Luft VM, et al. Nutritivnaya podderzhka pacientov s koronavirusnoj infekciej COVID-19. Klinicheskoe pitanie i metabolizm. 2020;1(2):56-91. DOI: https://doi.org/10.36425/clinnutrit42278. [in Russiаn].
20. Aman F, Masood S. How Nutrition can help to fight against COVID-19 pandemic. Pak. J. Med. Sci. 2020;36:121-123. DOI: https://doi. org/10. 12669/pjms.36.COVID19-S4.2776.
21. Beigmohammadi MT, Bitarafan S, Hoseindokht A, et al. Impact of vitamins A, B, C, D, and E supplementation on improvement and mortality rate in ICU patients with coronavirus-19: a structured summary of a study protocol for a randomized controlled trial. Trials. 2020;21:614. DOI: https://doi. org/10.1186/s13063-020-04547-0.
22. Bae M, Kim H. Mini-Review on the Roles of Vitamin C, Vitamin D, and Selenium in the Immune System against COVID-19. Molecules. 2020;25(22):5346. DOI: https://doi.org/10.3390/molecules25225346.
23. Marchenkova LA, Makarova EV, Yurova OV. Rol’ mikronutrientov v kompleksnoj reabilitacii pacientov s novoj koronavirusnoj infekciej COVID-19. Voprosy pitaniya. 2021;90(2):40-49. DOI: https://doi.org/10.33029/0042 -8833-2021-90-2-40-49. [in Russiаn].
24. Jovic TH, Ali SR, Ibrahim N, Jessop ZM, Tarassoli SP, Dobbs TD, et al. Could Vitamins Help in the Fight Against COVID-19? Nutrients. 2020;12(9):2550. DOI: https://doi.org/10.3390/nu12092550.
25. Shakoor H, Feehan J, Al Dhaheri SA, Ali IH, Platat C, Ismail CL, et al. Immune boosting role of vitamins D, C, E, zinc, selenium and omega-3 fatty acids: could they help against COVID-19? Maturitas. 2021;143:1-9. DOI: https://doi.org/10.1016/j.maturitas.2020.08.003.

«Bulletin of problems biology and medicine» Issue 3 (161), 2021 year, 76-80 pages, index UDK 616.98:578.834.1-036.1

10.29254/2077-4214-2021-3-161-76-80