de Jesus, R.P., de Carvalho, J.F., de Oliveira, L.P.M., Cunha, C.M., Alves, T.C.H.S., Vieira, S.T.B., Figueiredo, V.M. and Bueno, Allain ORCID: https://orcid.org/0000-0002-9456-8558
(2022)
Metabolic and nutritional triggers associated with increased risk of liver complications in SARS-CoV-2.
World Journal of Hepatology, 27 (14(1)).
pp. 80-97.
ISSN 1948-5182 (online)
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Text (Open Access article)
WJH-14-80.pdf - Published Version Available under License Creative Commons Attribution Non-commercial. Download (1MB) | Preview |
Abstract
Obesity, diabetes, cardiovascular and respiratory diseases, cancer and smoking are risk factors for negative outcomes in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which can quickly induce severe respiratory failure in 5% of cases. Coronavirus disease-associated liver injury may occur during progression of SARS-CoV-2 in patients with or without pre-existing liver disease, and damage to the liver parenchyma can be caused by infection of hepatocytes. Cirrhosis patients may be particularly vulnerable to SARS-CoV-2 if suffering with cirrhosis-associated immune dysfunction. Furthermore, pharmacotherapies including macrolide or quinolone antibiotics and steroids can also induce liver damage. In this review we addressed nutritional status and nutritional interventions in severe SARS-CoV-2 liver patients. As guidelines for SARS-CoV-2 in intensive care (IC) specifically are not yet available, strategies for management of sepsis and SARS are suggested in SARS-CoV-2. Early enteral nutrition (EN) should be started soon after IC admission, preferably employing iso-osmolar polymeric formula with initial protein content at 0.8 g/kg per day progressively increasing up to 1.3 g/kg per day and enriched with fish oil at 0.1 g/kg per day to 0.2 g/kg per day. Monitoring is necessary to identify signs of intolerance, hemodynamic instability and metabolic disorders, and transition to parenteral nutrition should not be delayed when energy and protein targets cannot be met via EN. Nutrients including vitamins A, C, D, E, B6, B12, folic acid, zinc, selenium and ω-3 fatty acids have in isolation or in combination shown beneficial effects upon immune function and inflammation modulation. Cautious and monitored supplementation up to upper limits may be beneficial in management strategies for SARS-CoV-2 liver patients.
Item Type: | Article |
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Additional Information: | This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/ |
Uncontrolled Discrete Keywords: | COVID-19, SARS-CoV-2, Enteral nutrition, Parenteral nutrition, Hepatic failure |
Divisions: | College of Health, Life and Environmental Sciences > School of Science and the Environment |
Related URLs: | |
Copyright Info: | Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved. de Jesus RP, de Carvalho JF, de Oliveira LPM, Cunha CM, Alves TCHS, Vieira STB, Figueiredo VM, Bueno AA. Metabolic and nutritional triggers associated with |
Depositing User: | Allain Bueno |
Date Deposited: | 24 Jan 2022 10:29 |
Last Modified: | 31 Jan 2022 12:12 |
URI: | https://eprints.worc.ac.uk/id/eprint/11625 |
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