By Massimiliano Borgia
Those who unfortunately get Coronavirus should mainly eat high protein foods. The body that is doing everything to defeat the disease you can also help with proteins. Slice of veal, chicken breast, fish, in short, the "second", balanced with an accompaniment of vegetables, are the recommended foods for those who must stay in bed with the Covid-19. And protein foods are the foods that are targeted even while the patient is in hospital.
"Protein - he explains Marco Tinivella, dietician of the Dietetics and Clinical Nutrition facility of the San Luigi Gonzaga hospital in Orbassano (TO) - they represent the nutritional component necessary to supply nitrogen to the cells that have to rebuild tissues but also the mediators of the immune system that, in a sick body, are carrying out the battle against pathogens. Of course, nutrition must always be as balanced as possible, carbohydrates and lipids are also needed to give energy but, to support the anabolic function of cells, we need proteins, always balanced and never alone ». So not a grilled chicken breast alone, but with a side dish of vegetables.
«The meal administered in hospital is balanced and digestible. And, in the wards, the nursing staff normally takes note of what the patient has eaten. We note that, for taste or habit, hospitalized patients tend to prefer the first course (especially pasta), or the puree and fruit. These are also important foods but, in disease conditions, they are of little use to the metabolism. For this reason the advice is to start from the second and, only afterwards, if you are still hungry, to eat the first and the fruit ».
It makes no sense to distinguish nutritional needs by type of disease. Each pathology must be tackled by a well-nourished and less deteriorated body, also taking into account that the body "consumes more" when it is sick, especially when you have a fever. Maybe you don't have an appetite but this does not mean you have less nutritional needs, in fact, we need to eat more.
So there is no specific diet for the Covid-19 patient but only a correct and balanced diet that helps the immune system to counterattack and supports the body to support this defense.
But what if you have to feed an ICU patient?
When it comes to supporting the battle against disease, we are not talking about simple nutrition but about "Nutritional therapy", that is, a real help to the body and to the pharmacological treatment by nutrients. Nutritional therapy is a full-fledged therapy as it replaces an organ function (digestion and absorption of nutrients) that is temporarily or permanently lost. (Law 219/2017).
This is the case of guests in intensive care for the aggravation of the respiratory picture by Coronavirus.
«When the patient cannot eat independently, we use a tube that introduces the food directly into the digestive system. In artificial nutrition, nutrients must be balanced taking into account the individual clinical picture. Obviously, macronutrients must never be missing: proteins, lipids and carbohydrates; but neither micronutrients such as electrolyte salts (especially sodium and potassium) nor vitamins. Of course, water, which in itself is a nutrient, must not be missing. Some of the micronutrients may also have a pharmacological role which must be taken into account: I speak, for example, of omega 3 which are powerful antioxidants and some amino acids which have a trophic role for cells. However, the opinions of the scientific community on this role do not agree ».
Feeding a patient is therefore not a simple thing. "Yes, it's not about giving him some glucose and two salts. It is certainly not enough. The balance must be carefully studied ».
People intubated for Coronavirus respiratory failure are then fed with a nasogastric tube. Those admitted to low-intensity COVID wards must instead be monitored, even in regular nutrition. «The standard" tray "guarantees an adequate meal even for those suffering from Covid-19. If you notice a prolonged lack of appetite then you change your diet perhaps with protein-calorie supplements, up to a real nutritional support. The goal is always to guarantee the satisfaction of the estimated protein-caloric needs. Short periods of fasting can be tolerated when, for example, life-saving maneuvers have been implemented, but then, if the fast is prolonged, the deterioration of the nutritional status could also compromise the body's ability to respond to therapies. Again, the rule applies that with a fatigued body that consumes more, the main weapon is always to feed it at its best ».
