Hypermetabolism and Coronavirus Disease 2019

Background Hypermetabolism has been described in stress states such as trauma, sepsis, acute respiratory distress syndrome, and severe burn injuries. We hypothesize that patients with Coronavirus disease 2019 (COVID‐19) may develop a hypermetabolic state, which may be a major contributing factor to...

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Published in:JPEN. Journal of parenteral and enteral nutrition 2020-09, Vol.44 (7), p.1234-1236
Main Authors: Yu, Pey‐Jen, Cassiere, Hugh, DeRosa, Sarah, Bocchieri, Karl, Yar, Shiraz, Hartman, Alan
Format: Article
Language:English
Subjects:
Adult
Basal Metabolism
Brief Communication
calorimetry
Calorimetry, Indirect - methods
Carbon Dioxide - metabolism
COVID-19 - metabolism
COVID-19 - virology
Critical Illness
Energy Metabolism
Humans
nutrition assessment
Nutritional Requirements
Oxygen Consumption
pulmonary disease
Respiration, Artificial
Respiratory Distress Syndrome
Rest
SARS-CoV-2
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Summary:Background Hypermetabolism has been described in stress states such as trauma, sepsis, acute respiratory distress syndrome, and severe burn injuries. We hypothesize that patients with Coronavirus disease 2019 (COVID‐19) may develop a hypermetabolic state, which may be a major contributing factor to the extraordinary ventilatory and oxygenation demands in patients with COVID‐19. Method Resting energy expenditure (REE), carbon dioxide production (VCO2), and oxygen consumption (VO2) were measured by indirect calorimetry on 7 critically ill patients with COVID‐19. Results The median measured REE was 4044 kcal/d, which was 235.7% ± 51.7% of predicted. The median VCO2 was 452 mL/min (range, 295–582 mL/min), and the median VO2 was 585 mL/min (range, 416–798 mL/min). Conclusion Critically ill patients with COVID‐19 are in an extreme hypermetabolic state. This may explain the high failure rates for mechanical ventilation for these patients and highlights the potential need for increased nutrition requirements for such patients.
ISSN:0148-6071
1941-2444
DOI:10.1002/jpen.1948