Prolonged progressive hypermetabolism during COVID-19 hospitalization undetected by common predictive energy equations

Indirect calorimetry (IC) is the gold-standard for determining measured resting energy expenditure (mREE) in critical illness. When IC is not available, predicted resting energy expenditure (pREE) equations are commonly utilized, which often inaccurately predict metabolic demands leading to over- or under-feeding.

This study aims to longitudinally assess mREE via IC in critically ill patients with SARS-CoV-2 (COVID-19) infection throughout the entirety of, often prolonged, intensive care unit (ICU) stays and compare mREE to commonly utilized pREE equations.

In this single-center prospective cohort study of mechanically ventilated COVID-19 patients, the Q-NRG® Metabolic Monitor was used to obtain IC data.

The study results show a truly unique metabolic response in COVID-19 ICU patients, characterized by significant and prolonged, progressive hypermetabolism.

This response is unique and distinct from any previously described model of ICU stress response in its prolonged hypermetabolic nature and was poorly predicted by most all commonly used pREE equations. This data reaffirms the need for routine, longitudinal IC measures to provide accurate energy targets in COVID-19 ICU patients.

Article details:

- Title: Prolonged progressive hypermetabolism during COVID-19 hospitalization undetected by common predictive energy equations
- Authors: Laura E. Niederer, Hilary Miller, Krista L. Haines, David B. MacLeod, Stephen A. McClave, Paul E. Wischmeyer
- Published in: Clinical Nutrition ESPEN: 03 August 2021
- Link: https://doi.org/10.1016/j.clnesp.2021.07.021