Addressing nutrition in the road map of recovery for those with long COVID-19

A former article (Holdoway, 2020) on the nutritional management of patients during and after COVID-19 illness highlighted the impact of the infection and associated symptoms on dietary intake. The article emphasised how community nurses could identify the risk of malnutrition when working remotely, but also support patients and carers to adjust diet to achieve optimum nutrition while facing the adverse effects of a pandemic, including dealing with the disease itself as well as its impact on daily life. Since that time, through international collaboration, our knowledge on the effects of COVID-19 has expanded rapidly. Data published worldwide have further illustrated the negative sequelae associated with a severe infection of COVID-19, including the impact on nutritional status and function, along with the emergence and recognition of long COVID.

Age and comorbidities have proved to be powerful predictors of hospitalisation, with oxygen impairment and inflammatory markers most strongly associated with critical illness (British Medical Journal, 2020). After age, a body mass index of 40 kg/m² was one of the strongest predictors of hospitalisation. Poor glycaemic control associated with diabetes and the disease itself were both found to be contributory factors underlying severity of COVID-19 and outcomes (Bornstein et al, 2020; Holman et al, 2020). Anabolic resistance arising from the inflammatory response associated with a COVID-19 infection also has a marked effect on muscle synthesis, resulting in rapid loss of muscle mass among thousands affected (Welch et al, 2020).