Explanation of expert recommendations on medical nutrition for patients with novel coronavirus pneumonia

摘要

COVID 19 is a global challenge. At present, the main approaches for COVID 19 infection are nutrition therapy, supportive care and symptoms control because specific treatment is still under research. To facilitate the recovery and improve response to treatment of those infected, the Chinese Society for Parenteral and Enteral Nutrition, CSPEN expert panel has developed the following nutrition recommendations. （1） Principal: Nutrition therapy is a basic treatment modality and should be one of the key elements of the overall treatment regimen for 2019-nCoV infections. The nutrition treatment should be based on individual nutrition status. （2）Method: The 5 step nutrition treatment guide should be followed. Meal plans+ nutrition education, oral nutrition supplement, enteral feeding, supplementary parenteral nutrition, total parental nutrition. （3）Energy: 20-30 kcal/kg/day depends on the severity and stage of disease. （4）Protein: Overall protein intake needs to be advocated. We would recommend 1-2 g/kg/day protein with increased branch chain amino acid ratio. （5）Fatty acids: medium- and long-chain fatty acids should be given priority. The omega 3/6 ratio and omega 9 fatty acids should be increased. （6）Non Protein Calorie: Nitrogen Ratio: carbohydrate/lipid should be 50-70/50-30; non-protein calorie/nitrogen 100-150/1. （7）Fluid: Keep in and out balanced. For the elderly and those with large area of lung consolidation, we recommend provide IV fluid with close monitor. （8）Micronutrients: provide routine supplementation of vitamins and minerals. （9） Immunonutrients: recommend on a case by case basis. （10）Monitor: monitor adverse reaction closely, evaluate progress, adjust treatment plans on individual bases. This paper gives detail explanation for above Expert Recommendations.