References
The frequency of nutrition impact symptoms and reduced oral intake among consecutive COVID-19 patients from an Australian health service

Abstract
COVID-19 symptoms range from severe respiratory failure to mild anorexia, cough and smell and taste alterations, adversely impacting nutritional intake. The aim of this paper was to establish malnutrition risk, Nutrition Impact Symptoms (NIS) and associations with reduced oral intake. A retrospective observational cohort of all people testing positive for COVID-19 was conducted. Malnutrition risk, nutritional status, weight, reduced oral intake and NIS on and during admission were collected. Dietetic consultation frequency and mode were captured. Some 80% (48/60) of participants reported at least one NIS, and 58% (25/60) reported two or more. Most frequent reported symptoms were cough (60%), sore throat (35%) and reduced appetite (28%). Significant associations existed between ≥2 NIS (p=0.006), reduced appetite (p=0.000) and reduced oral intake, with 20% requiring ongoing nutrition support and consultation. High NIS prevalence confirms systematised nutrition support pathways are indicated through incorporation into standard care across the healthcare continuum, including community care.
The global pandemic caused by the novel coronavirus, SARS-CoV-2 (COVID-19) (World Health Organization (WHO), 2022a) has posed unprecedented challenges for healthcare systems worldwide (Barazzoni et al, 2020). There is significant variance in the clinical sequelae associated with COVID-19, ranging from no to moderate (fever, cough, shortness of breath, muscle ache, confusion, sore throat, headache, pneumonia, diarrhoea, nausea and vomiting, loss of taste and smell) to severe symptoms (respiratory failure from COVID-19 pneumonia, requiring ventilation and intensive care). Moderate symptoms may adversely impact nutritional intake, resulting in loss of weight and muscle and malnutrition (Wierdsma et al, 2021), while severe symptoms may deteriorate to multi-organ failure (Australasian Society of Parenteral and Enteral Nutrition (AuSPEN), 2020; Barazzoni et al, 2020; Handu et al, 2021).
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