Characteristics of inflammation and nutritional metabolism in patients with COVID‐19 pneumonia

Abstract

Objective: To clarify the characteristics of inflammation and nutritional metabolism in COVID‐19 pneumonia to inform therapeutic intervention measures.
Materials and Methods: Inflammation and nutritional metabolism data obtained from blood tests and indirect calorimetry were analyzed in 28 patients admitted to our emergency ICU with a diagnosis of COVID‐19 pneumonia.
Results: We identified 18 patients with moderate disease and 10 patients with severe disease. All patients with severe disease required intubation and four patients required vv‐ECMO management. Inflammation was significantly higher and lymphocyte counts were significantly lower in patients with severe disease（p = 0.005）. Furthermore, nutritional metabolism data showed significantly higher CONUT scores and PGC‐1α levels in the patients with severe disease（p = 0.03, 0.003, respectively）. In the five cases in which indirect calorimetry was performed, fatty acid oxidation tended to be lower and respiratory quotient higher than in normal pneumonia.
Conclusion: COVID‐19 pneumonia is associated with high inflammatory and immunoparalysis states and high nutritional risk, depending on the severity of the disease. Our findings suggest that there are specific changes in nutritional metabolism that should be considered in nutritional therapy.