Nutritional Assessment of Critically Ill Children with COVID-19 Admitted to PICU
Ph.D Nahla A Mohamed, M.D Hanan F Mohammed
doi:10.22608/MJCU
Background: Nutrition has important role in the regulation of optimal immune functions, as it provides proper nutrients such as minerals, and vitamins, as well as macronutrients in adequate concentrations to immune system. however, nutritional deficiencies are associated with impaired immune response and have negative impact on human resistance to infection.
Aim of Study: Evaluation of the nutritional status of critically ill pediatric patients diagnosed with COVID-19 admitted to PICU and study correlation between nutritional deficiency and outcome.
Patients and Methods: This retrospective cohort study of hospitalized patients with COVID-19 enrolled at the pediatric intensive care unit of El-Galaa Teaching Hospital. All confirmed COVID-19 patients have been screened in the period between June 1 st , 2023 and may 31 th , 2024. The study reviewed the demographic data, anthropometric data, nutritional and medical history, laboratory investigation, duration of hospital stays and outcome of the hospitalized patients during the period of the study. Results: A total of 60 patients with COVID-19 aged 2 to 10 years were evaluated in this study. Non-survivors' patients with COVID-19 had significantly lower anthropometric measurements (Z score for weight, Z score for height and body mass index Z score) as compared to survivors. There was statistically decrease in folic acid, Vitamin D, Zinc, Selenium (38.3%, 23.3%, 65%, 36.7% respectively) in COVID-19 patients. While severe vitamin D deficiency was reported in 21.7% of patients. There was statistically significant decrease in folic acid, Vitamin D, Zinc, Selenium innon-survivors as compared with survivors'patients. Also, there was statistically significant increase in duration of hospital stay innon-survivors' patients.
Conclusion: Pediatric patients with COVID-19 may have nutritional deficiency in one or more micronutrients that may
Nutritional Assessment of Critically Ill Children with COVID-19 Admitted to PICU
References
Amodio, Buonsenso, Palma P, Susceptibility of SARS-CoV2 infection in children, Eur. J. Pediatr
Bergman, Lindh, Bjorkhem-Bergman L, Vitamin D and respiratory tract infections: A systematic review and meta-analysis of randomized controlled trials, PloS ONE
Bourke, Berkley, Immune Dysfunction as a Cause and Consequence of Malnutrition, Trends Immunol
Butler, Barrientos R, The impact of nutrition on COVID-19 susceptibility and long-term consequences, Brain Behav Immun
De, García, Moreno, Coronavirus infection: An immunologists' perspective, Scand. J. Immunol
Elmadfa, Meyer A, The Role of the Status of Selected Micronutrients in Shaping the Immune Function, Endocr. Metab. Immune Disord. Drug Targets
Farag, Hafez, Dwedar R, Bilal, Said et al., The use of folic acid as a prophylaxis against COVID-19 among healthcare workers, Microbes and Infectious Diseases
Fowler, Kim, Lepler, Malhotra R, Debesa et al., Intravenous vitamin C as adjunctive therapy for enterovirus/rhinovirus induced acute respiratory distress syndrome, World J. Crit Care Med
Ghanei, Baghani, Moravvej, Low serum levels of zinc and 25-hydroxy vitmain D as potential risk factors for COVID-19 susceptibility: A pilot case-con-trol study, Eur. J. Clin. Nutr,
doi:10.1038/s41430-022-01095-5.Gombart, Pierre, Maggini S, A Review of Micronutrients and the Immune System-Working in Harmony to Reduce the Risk of Infection, Nutrients
Gombart, Pierre, Maggini S, A review of micronutrients and the immune system-working in harmony to reduce the risk of infection, Nutrients,
doi:10.3390/nu12010236Guan, Ni Z, Hu, Clinical characteristics of coronavirus disease 2019 in China, New England Journal of Medicine
Hasan R, Rink, Haase H, Chelation of free Zn 2 + impairs chemotaxis, phagocytosis, oxidative burst, degranulation, and cytokine production by neutrophil granulocytes, Biol. Trace Elem Res
Hasan R, Rink, Haase H, Zinc signals in neutrophil granulocytes are required for the formation of neutrophil extracellular traps, Innate Immun
Hawkes, Kelley, Taylor P, The effects of dietary selenium on the immune system in healthy men, Biol. Trace Elem Res
Hecker, Mechanisms and consequences of oxidative stress in lung disease: Therapeutic implications for an aging populace, Am. J. Physiol. Lung Cell Mol. Physiol
Heller R, Sun, Hackler, Seelig, Seib-Ert et al., Prediction of survival odds in COVID-19 by zinc, age and selenoprotein P as composite biomarker, Redox Biol,
doi:10.1016/j.redox.2020.101764Ivory, Prieto, Spinks, Armah, Gold-Son et al., Selenium supplementation has beneficial and detrimental effects on immunity to influenza vaccine in older adults, Clin. Nutr,
doi:10.1016/j.clnu.2015.12.003Jothimani, Kailasam, Danielraj, Na-Llathambi, Ramachandran et al., COVID-19: Poor outcomes in patients with zinc deficiency, Int. J. Infect. Dis,
doi:10.1016/j.ijid.2020.09.014Karakaya, Ünal, Koç N, Evaluation of nutritional status in pediatric patients diagnosed with Covid-19 infection, Clinical Nutrition ESPEN
Kaushik, Subramani, Anang, Zinc salts block hepatitis E virus replication by inhibiting the activity of viral RNA-dependent RNA polymerase, J. Virol
Kiremidjian-Schumacher L, Roy, Wishe, Supplementation with selenium and human immune cell functions. II. Effect on cytotoxic lymphocytes and natural killer cells, Biol. Trace Elem Res
Kiremidjian-Schumacher, Wishe, Supplementation with selenium and human immune cell functions. I. Effect on lymphocyte proliferation and interleukin 2 receptor expression, Biol. Trace Elem Res
Maares, Haase H, Zinc and immunity: An essential interrelation, Arch. Biochem. Biophys
Maggini, Pierre, Calder P, Immune function and micronutrient requirements change over the life course, Nutrients,
doi:10.3390/nu10101531Maywald, Wessels, Rink, Zinc signals and immunity, Int. J. Mol. Sci
Meng, Zhao, Zhang H, HIPK1 Interference attenuates inflammation and oxidative stress of acute lung injury via autophagy, Med. Sci. Monit
Read, Obeid, Ahlenstiel, The role of zinc in antiviral immunity, Adv. Nutr
Sabetta, Depetrillo, Cipriani R, Smar-Din, Burns et al., Serum25-hydroxy vitamin D and the incidence of acute viral respiratory tract infections in healthy adults, PLoS ONE
Sharma, Kumar, Neurological manifestations in COVID-19 patients: A meta-analysis, ACS Chemical Neuroscience
Sheybani, Dokoohaki, Negahdaripour, Dehdashti, Zolghadr et al., The role of folic acid in the management of respiratory disease caused by COVID-19, Chem. Rxiv
Shi, Mclean, Campbell, Nair H, Etiological role of common respiratory viruses in acute lower respiratory infections in children under five years: A systematic review and meta-analysis, J. Glob. Health,
doi:10.7189/JOGH.05.010408Sims, Xiao, Yue, Lipsky P, Modulatory effects of 1,25-dihydroxy vitamin D3 on human B cell differentiation, The Journal of Immunology
Skalny, Rink, Ajsuvakova, Aschner, Gritsenko et al., Zinc and respiratory tract infections: Perspectives for COV-ID-19 (Review), Int. J. Mol. Med. Jul
Subramanian, Deepe, Metallothioneins: Emerging modulators in immunity and infection, Int. J. Mol. Sci
Uchide, Ohyama, Bessho, Effect of antioxidants on apoptosis induced by influenza virus infection: Inhibition of viral gene replication and transcription with pyrrolidine dithiocarbamate, Antiviral Res
Velthuis, Van Den Worm, Sims, Zn2+ inhibits coronavirus and arterivirus RNA polymerase activity in vitro and zinc ionophores block the replication of these viruses in cell culture, PLoS Pathog
Who, Coronavirus disease 2019. Events as they happen
Wu, Lewis, Pae, Meydani S, Nutritional modulation of immune function: Analysis of evidence, mechanisms, and clinical relevance, Front Immunol,
doi:10.3389/fimmu.2018.03160Wu, Mu, Gu, Min, Mu et al., Predictive Significance of the Prognostic Nu-tritional Index (PNI) in Patients with Severe COVID-19, Journal of Immunology Research
Zhang, Roh, Han, Park, Lee, Role of selenoproteins in redox regulation of signaling and the antioxidant system: A review, Antioxidants,
doi:10.3390/antiox9050383DOI record:
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