EARLY ENTERAL NUTRITION AND MORTALITY IN CRITICALLY ILL PATIENTS WITH COVID-19

Background: Early enteral nutrition (EEN) has shown favorable clinical outcomes, such as lower risk of death, fewer frequency of infection and less healthcare costs. Different societies recommend the provision of enteral nutrition in the first 24 to 48 hours of admission to the Intensive Care Unit in patients with COVID-19. Methods: This was a retrospective cohort study in adult patients with severe COVID-19 and orotracheal intubation. Demographic and clinical characteristics and laboratory results were registered. Data was also collected on the use of drugs with nutritional relevance, such as vasopressors and steroids. EEN was defined as the provision of enteral feeding in the first 24-48 hours of invasive mechanical ventilation (IMV). Primary outcome was in-hospital all-cause mortality. Results: Four hundred four patients were included in the study. EEN was achieved in 74% of all patients. EEN significantly reduced the mortality in the bivariate model (RR 0.88, 95% CI 0.80 a 0.95) and in the multivariate model (adjusted OR 0.42, 95% CI 0.19 – 0.90). No differences in hospital length of stay and days on IMV in survivors were found. Conclusions: EEN reduces the risk of death in critically ill patients with COVID-19. Additional studies are necessary to further clarify the effects of early enteral feeding in patient outcomes.