Persistent hypermetabolism and longitudinal energy expenditure in critically ill patients with COVID-19

 

Persistent hypermetabolism and longitudinal energy expenditure in critically ill patients with COVID-19

 

by John Whittle, Jeroen Molinger, David MacLeod, Krista Haines and Paul E. Wischmeyer 

 

Critical Care volume 24, Article number: 581 (2020) Published: 28 September 2020

 

 COVID-19 infection results in respiratory failure requiring ICU care in a small, yet significant, number of patients [1]. The longitudinal metabolic phenotype and energy expenditure of this novel pandemic disease has yet to be described. As a marked and often prolonged, systemic inflammatory response (SIRS) has been suggested to be a hallmark of severe COVID-19 infection [1], we hypothesized a prolonged hypermetabolic state would evolve over ICU stay that would persist beyond the 7–10 day hypermetabolic phase described previously in other ICU conditions [2].

Further, understanding the energy expenditure of COVID-19 ICU patients is essential to help determine safe, optimal nutrition needs for the ICU provider [3], as both over-/underfeeding is associated with increased ICU mortality [3, 4]. Prediction of resting energy expenditure (pREE) using standardized formulas or bodyweight calculations often correlates poorly with measured REE (mREE) [3]. Thus, our aim was to assess longitudinal mREE via indirect calorimetry (IC) in intubated COVID-19 patients.