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Gastrointestinal Manifestations of COVID‐19: Impact on Nutrition Practices

机译:Covid-19的胃肠道表现:对营养实践的影响

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Although Coronavirus disease 2019 (COVID‐19) is primarily a respiratory disease, growing evidence shows that it can affect the digestive system and present with gastrointestinal (GI) symptoms. Various nutrition societies have recently published their guidelines in context of the pandemic, and several points emphasize the impact of these GI manifestations on nutrition therapy. In patients with COVID‐19, the normal intestinal mucosa can be disrupted by the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) virus, and this could result in GI symptoms and a compromise in nutrient absorption. Optimization of oral diet is still recommended. However, given the GI effects of COVID‐19, a fraction of infected patients have poor appetite and would not be able to meet their nutrition goals with oral diet alone. For this at‐risk group, which includes those who are critically ill, enteral nutrition is the preferred route to promote gut integrity and immune function. In carrying this out, nutrition support practices have been revised in such ways to mitigate viral transmission and adapt to the pandemic. All measures in the GI and nutrition care of patients are clustered to limit exposure of healthcare workers. Among patients admitted to intensive care units, a significant barrier is GI intolerance, and it appears to be exacerbated by significant GI involvement specific to the SARS‐CoV‐2 infection. Nevertheless, several countermeasures can be used to ease side effects. At the end of the spectrum in which intolerance persists, the threshold for switching to parenteral nutrition may need to be lowered.
机译:虽然冠状病毒疾病2019(Covid-19)主要是呼吸系统疾病,但增长的证据表明它可以影响消化系统并存在胃肠道(GI)症状。各种营养社会最近在大流行的背景下发表了他们的指导方针,几点强调了这些GI表现对营养治疗的影响。在Covid-19患者中,正常肠粘膜可以被严重的急性呼吸综合征冠状病毒2(SARS-COV-2)病毒中断,这可能导致GI症状和营养吸收中的折衷。仍建议使用口服饮食的优化。然而,鉴于Covid-19的GI效应,一部分受感染的患者的食欲不佳,并不能单独与口服饮食满足他们的营养目标。对于这种危险的群体,包括那些危重病的人,肠内营养是促进肠道完整性和免疫功能的首选途径。在进行这一点时,营养支持实践已经以这种方式修订,以减轻病毒传播并适应大流行。 GI和患者营养照料的所有措施都被聚集到限制医疗工作者的暴露。在进入密集护理单位的患者中,显着的屏障是GI不耐受,并且似乎通过对SARS-COV-2感染的显着性GI受累而加剧。尽管如此,可以使用若干对策来缓解副作用。在不耐受持续存在的频谱结束时,可能需要降低切换到肠外营养的阈值。

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