With no cure for COVID-19 as yet, the dietitian plays a critical role in any multi-disciplinary approach to treatment, from the acute care setting right through to support in the community.
The first area where a dietitian’s expertise is called for is that of assessment. The symptoms which typically present with a COVID-19 infection (fever, pneumonia, chest pains, diarrhoea, nausea and vomiting) may contribute to nutritional imbalances and further compromise immunity. The dietitian’s primary task, then, is to assess whether this is, indeed, the case and, if so, how further malnutrition can be addressed and prevented.
This is especially important in the case of unconscious or ventilated patients, for whom nutrition must be delivered through feeding tubes. Here, the dietitian must assess each patient’s condition, taking into account nutritional status, gender, age and possible co-morbidities to ensure that the optimal blend of nutrition and hydration is available.
Patients who live with co-morbidities, such as heart disease, diabetes, hypertension and obesity, are particularly at risk during this time. Dietitians can aid here by monitoring their existing conditions and ensuring that they are eating according to a personal plan which provides all necessary nutrition, while also bolstering their immunity.
It is also vital to create an individual nutritional plan for patients who have not displayed severe symptoms, as this will provide critical support while their bodies strive for recovery.
Those patients who are convalescing from the disease may find that they are affected by muscle loss. Increasingly, scientists are learning that the virus may cause several complications even after it is shed. Therefore, dietitians must be an integrated part of a medical team, ensuring that the diet followed by the patient in the weeks ensuring recovery help to build the body without placing it under strain.
Access to food is one of the key issues that has emerged through the coronavirus pandemic. This is increasingly the case, as rising unemployment contributes to poverty and, linked to this, a growing number of families experiencing hunger. This is critical, as the resulting malnutrition has a severely negative impact on clinical outcomes. Again, this is where the dietitian comes to the fore: apart from identifying at-risk individuals, dietitians must support government initiatives by developing meal plans or suggesting aid and assistance to individuals living in poverty. They have a further role to play in raising awareness around the role of nutrition in immunity, for example, as well help government find ways to develop a more sustainable food system. They can also collaborate with other stakeholders to create a multi-pronged approach to the issue.