lvrachЛечащий ВрачLechaschi Vrach1560-51752687-118110.51793/OS.2021.24.11.004lvrach-834Research ArticleИНФЕКЦИИ. ВАКЦИНОПРОФИЛАКТИКАINFECTIONS. VACCINE PROPHYLAXISНовая коронавирусная инфекция COVID-19: как нам накормить больного?New coronavirus infection COVID-19: how do we feed the sick?https://orcid.org/0000-0002-8121-4160ПасечникИ. Н.PasechnikI. N.

Пасечник Игорь Николаевич, д. м. н., профессор, заведующий кафедрой анестезиологии и реаниматологии

121359, Россия, Москва, ул. Маршала Тимошенко, 19, стр. 1А

121309, Россия, Москва, ул. Алябьева, 7/33

Igor N. Pasechnik, Dr. of Sci. (Med.), Professor, Head of department of Anesthesiology and Intensive Care

19 b. 1A Marshal Timoshenko str., Moscow, 121359, Russia

7/33 Alyabieva str., Moscow, 121309, Russia

pasigor@yandex.ruhttps://orcid.org/0000-0001-7973-8777ЩучкоА. А.SchuchkoA. A.

Щучко Анатолий Анатольевич, заведующий отделением анестезиологии и реанимации

121309, Россия, Москва, ул. Алябьева, 7/33

Anatoly A. Schuchko, Head of the Department of Anesthesiology andResuscitation

7/33 Alyabieva str., Moscow, 121309, Russia

anatolchic@gmail.comСазоновВ. В.SazonovV. V.

Сазонов Виктор Васильевич, заместитель главного врача по хирургии

121309, Россия, Москва, ул. Алябьева, 7/33

Viktor V. Sazonov, Deputy Chief Physician for Surgery

7/33 Alyabieva str., Moscow, 121309, Russia

sazonovvik@gmail.comhttps://orcid.org/0000-0001-5614-1898ИвановаТ. Б.IvanovaT. B.

Иванова Татьяна Борисовна, ассистент кафедры внутренних болезней стоматологического факультета

127473, Россия, Москва, ул. Делегатская, 20/1

Tatiana B. Ivanova, Assistant of the Department of Internal Diseases of the Faculty of Dentistry

20/1 Delegatskaya str., Moscow, 27473, Russia

tbiva@mail.ruФГБУ ДПО ЦГМА УДП РФ; ГБУЗ ГКБ № 51 ДЗМРоссияCentral State Medical Academy of the Administrative Department of the President of the Russian Federation; Citi Clinical Hospital No 51Russian FederationГБУЗ ГКБ № 51 ДЗМРоссияCiti Clinical Hospital No 51Russian FederationФГБОУ ВО МГМСУ им. А. И. Евдокимова Минздрава РоссииРоссияA. I. Yevdokimov Moscow State Medical and Dental UniversityRussian Federation2021181220211112328Copyright © Пасечник И.Н., Щучко А.А., Сазонов В.В., Иванова Т.Б., 20212021Пасечник И.Н., Щучко А.А., Сазонов В.В., Иванова Т.Б.Pasechnik I.N., Schuchko A.A., Sazonov V.V., Ivanova T.B.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.lvrach.ru/jour/article/view/834

Повышение качества оказания помощи больным новой коронавирусной инфекцией COVID-19 возможно только на основе мультидисциплинарного подхода. Оценка пищевого статуса и при необходимости его коррекция являются важной составляющей комплексных программ лечения и реабилитации таких больных. Значительное число пациентов с COVID-19 составляют люди пожилого и старческого возраста, у которых уже есть признаки нутритивной недостаточности. Нарушения питания и сопутствующая им саркопения – факторы риска неблагоприятного течения COVID-19. Прогрессирование саркопении при COVID-19 объясняют возникновением вирусного миозита, миопатией, спровоцированной цитокинами, и иммобилизацией. Уменьшение мышечной массы ассоциировано с плохим прогнозом заболевания и снижением качества жизни. Коррекция нарушений пищевого статуса больных COVID-19 должна проводиться на всех этапах лечения. Важность проблемы нутритивной поддержки отражена во множестве публикаций, посвященных лечению больных COVID-19. Необходимо заметить, что Европейское общество клинического питания и метаболизма (European Society for Clinical Nutrition and Metabolism, ESPEN) в кратчайшие сроки выпустило рекомендации по нутритивной поддержке больных новой коронавирусной инфекцией, что лишний раз подчеркивает актуальность проблемы. Это стало логичным продолжением рекомендаций по коррекции пищевого статуса больных, находящихся на лечении в отделении реанимации и интенсивной терапии. Аналогичные клинические рекомендации были разработаны в Великобритании, Бразилии и целом ряде других стран. Использование препаратов для перорального дополнительного питания в большинстве случаев позволяет обеспечить потребности пациентов в необходимых нутриентах, уменьшить выраженность саркопении и повысить эффективность реабилитационных мероприятий.

Improving the quality of care for patients with the new coronavirus infection COVID-19 is possible only on the basis of a multidisciplinary approach. Evaluation of nutritional status and, if necessary, its correction are an important component of comprehensive treatment and rehabilitation programs for such patients. A significant number of patients with COVID-19 are elderly and senile people who already have signs of nutritional deficiency. Eating disorders and accompanying sarcopenia are risk factors for the adverse course of COVID-19. The progression of sarcopenia in COVID-19 is explained by the occurrence of viral myositis, myopathy provoked by cytokines, and immobilization. Decreased muscle mass is associated with poor disease prognosis and reduced quality of life. Correction of nutritional disorders in patients with COVID-19 should be carried out at all stages of treatment. The importance of the problem of nutritional support is reflected in many publications devoted to the treatment of patients with COVID-19. It should be noted that the European Society for Clinical Nutrition and Metabolism (ESPEN) promptly issued recommendations on nutritional support for patients with new coronavirus infection, which once again emphasizes the urgency of the problem. This was a logical continuation of the recommendations for correcting the nutritional status of patients undergoing treatment in the intensive care unit. Similar clinical guidelines have been developed in the UK, Brazil and a number of other countries. The use of drugs for oral supplementary nutrition in most cases allows to meet the needs of patients for the necessary nutrients, to reduce the severity of sarcopenia and to increase the effectiveness of rehabilitation measures.

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The authors declare that there are no conflicts of interest present.