COVID-19 infection in patients on long-term home parenteral nutrition for chronic intestinal failure

Loris Pironi*, Denise Jezerski, Jacek Sobocki, Simon Lal, Tim Vanuytsel, Miriam Theilla, Anna S. Sasdelli, Cecile Chambrier, Konrad Matysiak, Umberto Aimasso, Henrik H. Rasmussen, Amelia Jukes, Marek Kunecki, David Seguy, Stéphane M. Schneider, Joanne Daniels, Florian Poullenot, Manpreet S. Mundi, Przemysław Matras, Marcin FolwarskiAdriana Crivelli, Nicola Wyer, Lars Ellegard, Lidia Santarpia, Marianna Arvanitakis, Corrado Spaggiari, Georg Lamprecht, Francesco W. Guglielmi, Antonella Lezo, Sabrina Layec, Esther Ramos Boluda, Anat Guz-Mark, Paolo Gandullia, Cristina Cuerda, Emma Osland, Maria I. Spagnuolo, Zeljko Krznaric, Luisa Masconale, Brooke Chapman, María Maíz-Jiménez, Paolo Orlandoni, Mariana Hollanda Martins da Rocha, M. Nuria Virgili-Casas, Maryana Doitchinova-Simeonova, Laszlo Czako, Andrè Van Gossum, Lorenzo D'Antiga, Looi C. Ee, Daruneewan Warodomwichit, Marina Taus, Sanja Kolaček, Ronan Thibault, Giovanna Verlato, Aurora E. Serralde-Zúñiga, José I. Botella-Carretero, Pilar Serrano Aguayo, Gabriel Olveira, Sirinuch Chomtho, Veeradej Pisprasert, Georgijs Moisejevs, Ana Zugasti Murillo, Ma Estrella Petrina Jáuregui, Marta Bueno Díez, Mohammad Shukri Jahit, Narumon Densupsoontorn, Ali Tamer, Giorgia Brillanti, Francisca Joly

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Background and aims: To investigate the incidence and the severity of COVID-19 infection in patients enrolled in the database for home parenteral nutrition (HPN) for chronic intestinal failure (CIF) of the European Society for Clinical Nutrition and Metabolism (ESPEN). Methods: Period of observation: March 1st, 2020 March 1st, 2021. Inclusion criteria: patients included in the database since 2015 and still receiving HPN on March 1st, 2020 as well as new patients included in the database during the period of observation. Data related to the previous 12 months and recorded on March 1st 2021: 1) occurrence of COVID-19 infection since the beginning of the pandemic (yes, no, unknown); 2) infection severity (asymptomatic; mild, no-hospitalization; moderate, hospitalization no-ICU; severe, hospitalization in ICU); 3) vaccinated against COVID-19 (yes, no, unknown); 4) patient outcome on March 1st 2021: still on HPN, weaned off HPN, deceased, lost to follow up. Results: Sixty-eight centres from 23 countries included 4680 patients. Data on COVID-19 were available for 55.1% of patients. The cumulative incidence of infection was 9.6% in the total group and ranged from 0% to 21.9% in the cohorts of individual countries. Infection severity was reported as: asymptomatic 26.7%, mild 32.0%, moderate 36.0%, severe 5.3%. Vaccination status was unknown in 62.0% of patients, non-vaccinated 25.2%, vaccinated 12.8%. Patient outcome was reported as: still on HPN 78.6%, weaned off HPN 10.6%, deceased 9.7%, lost to follow up 1.1%. A higher incidence of infection (p = 0.04), greater severity of infection (p < 0.001) and a lower vaccination percentage (p = 0.01) were observed in deceased patients. In COVID-19 infected patients, deaths due to infection accounted for 42.8% of total deaths. Conclusions: In patients on HPN for CIF, the incidence of COVID-19 infection differed greatly among countries. Although the majority of cases were reported to be asymptomatic or have mild symptoms only, COVID-19 was reported to be fatal in a significant proportion of infected patients. Lack of vaccination was associated with a higher risk of death.

Original languageEnglish
Pages (from-to)212-220
Number of pages9
JournalClinical Nutrition ESPEN
Volume55
DOIs
StatePublished - Jun 2023

Funding

FundersFunder number
Abbott, Fresenius, Nutricia, Nestle, Takeda
Danone/Nutricia
Leadership for Croatian Medical Association
Oktal Pharma
Nestlé Nutrition Institute

    Keywords

    • COVID-19
    • Epidemiology
    • Home parenteral nutrition
    • Intestinal failure
    • Pandemic
    • SARS-CoV-2

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