SARS_CoV2 Critically ill patients, :Focus on Nutrition

Introduction An outbreak of novel coronavirus–infected (SARS-CoV-2) pneumonia in Wuhan City, China has caused a global health emergency . The number of patients is rapidly increasing out of China creating a pandemic. SARS-CoV-2 belongs to the new coronavirus of the genus β. The pneumonia that this coronavirus causes re- sembles severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). However, the genome of SARS-CoV-2 is significantly different from that of SARS-CoV and MERS-CoV , and thus, this virus may cause different clinical presentations,it appears to occur so rapidly and so invasively as to cause severe respiratory deficits quickly. The severity of the illness has been reported to be milder than SARS with a mortality rate ranging from 4.3 to 11%. . The longer incubation time and relatively mild symptoms at presentation may allow this disease to more easily spread from humans to humans due to little concern. Moreover Covid pneumonia is often associated with gastrointestinal disorders that compromise the patient's ability to adequately feed in the pre-icu stages. Sars cov2 desease has forced millions of patients to be treated in the ICU. Prompt screening for the early identification and isolation of the patients are of particular importance. AIM of the study In this abstract we want to highlight how an adequate nutritional strategy guarantees an equally adequate clinical response by reducing intubation times, hospitalization in ICU, infectious complications. Method We studied and treated 32 positive covid patients from 9/3 to 30/4/2020 applying the following nutritional strategies     - start of enteral nutrition within 24/48 hours aiming 50% of caloric intake, rumping up to 80-100% only After 48 Hours.     - protein target> = 1.3 g / kg targetting slowly     - Caloric target 20/25 kcal / kg     - Use of enteral mixtures in case free and rich in soluble fiber     - Monitoring of prealbumin     - Use of supports with whey proteins in case of failure to reach the set target Results We observed that at the entrance in ICU the prealbumin values ​​were always below the lower limits However, in 95% of Pz patients treated with our nutritional protocol, a gradual and rapid increase in prealbumin values ​​was noted. Most of the patients who achieved prealbumin values> 20 during the ICU hospitalization had shorter hospitalization times. The extubation time of patients treated experimentally with Tocilizumab and high prealbumin values ​​was found to be extremely low. All patients who died early showed prealbumin values ​​<10. Conclusion An adequate nutritional and protein intake guarantees the synthesis of protein carriers that facilitate the transport of the active ingredients of the drugs administered in therapy to the effector site, guarantee the synthesis of proteins suitable for immune defense, reduce the risk of sarcopenia facilitating respiratory weaning