Proper diet linked to better clinical outcomes in hospitalized COVID-19 patients

A full and varied diet is an important factor in the treatment of COVID-19. However, quarantine restrictions can make it difficult to purchase products, and it becomes more difficult to follow the recommendations. RUDN University doctors interviewed colleagues from 17 medical institutions in Vietnam and Indonesia to compare this effect in countries with different numbers of coronavirus cases. The results are published in Clinical Nutrition ESPEN journal.

During the pandemic, some production stopped, borders were closed, and many people lost their jobs. These problems have increased food shortages and weakened people's health. Previous studies have shown that children under five years of age and adults 18-78 years old who had a history of malnutrition on average suffered COVID-19 harder and stayed in the hospital longer than patients who ate a full meal. In addition, the food in the hospital may also be insufficiently balanced (for example, due to a supply disruption or lack of funding). RUDN University researchers, together with colleagues from Taipei Medical University (Taiwan), as well as Vietnam, Indonesia, and Russia, interviewed 51 doctors from hospitals in Vietnam and Indonesia to find out if they follow the recommendations for the nutrition of patients with coronavirus, and if not, to find out the main reasons.

We aimed to understand barriers to doctors' adherence to guidelines of medical nutritional therapy for hospitalized COVID-19 patients. This is especially important, given that there is currently no specific antiviral therapy for this infection. We also wanted to understand the practical challenges and concerns in providing medical nutritional therapy and the prognostic potential of adherence to nutritional guidelines on the clinical outcomes (indicated by the length of stay and mortality) of hospitalized COVID-19 patients."

Anatoly Skalny, DSc, Head of RUDN Department of medical elements studies

Researchers addressed 35 coronavirus hospitals in Indonesia, where the infection caused the death of more than 140 thousand people, and to 19 hospitals in Vietnam, which quickly and successfully coped with the pandemic. The test consisted of 36 questions: 12 of them tested the knowledge of medical staff about the recommended diet for patients, 22 concerned how doctors apply them in practice, and two questions clarified additional environmental factors that may affect the situation. 51 doctors from 11 Indonesian and 6 Vietnamese hospitals agreed to participate in the study.

It turned out that in 65% of cases, medical workers experienced stress when prescribing therapeutic nutrition to patients with coronavirus, in 49% they were unsure of their choice. Also, 45% of doctors lacked clear and understandable recommendations, and 33% complained about budget constraints. At the same time, according to whether doctors comply with dietary recommendations, RUDN University researchers were able to predict the clinical outcome of the disease in hospitalized patients. There were also differences between the doctors of the two countries. Thus, doctors of covid hospitals from Indonesia were more engaged in nutritional science at the university, but less often specialized in intensive care and resuscitation.

Our results indicated that the key barrier for doctors' guideline adherence was a lack of nutritional knowledge and not the lack of agreement. This is caused by the healthcare system and the peculiarities of medical education, and it is far from unique for these countries. We also found out that in Vietnam, which showed success in combating the pandemic, doctors followed the recommendations better than in Indonesia, which was ranked the world's fifth by the number of deaths. Perhaps this is due to stricter legislative control in healthcare in Vietnam", said Anatoly Skalny, DSc, Head of RUDN Department of medical elements studies.