Discussions

COVID-19 Taskforce Monthly Statement - March 2022

Posted by Xunhan LI on March 29, 2022 at 1:12pm

Since its inception, NNEdPro’s COVID-19 Taskforce has worked to improve health during the COVID-19 pandemic, by focusing on nutrition research, clinical practice and public health. As a global organisation, our dedicated microsites contain a repository of generic and region specific public health resources to highlight up-to-date policy and practice across our regional networks(1). Additionally, the taskforce has identified areas for research and evidence synthesis relating to the nutritional aspects of COVID-19 prevention and treatment, including issues of food and nutrition security(2). Our aim has been to coordinate and share resources with NNEdPro’s global and regional networks, and the public, to highlight key challenges, policy updates and best guidance on good nutrition and health practices in the context of COVID-19.

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Public Health Updates

 

 On February 21st 2022, the UK government published their revised long-term plan for living with COVID-19. The guidance is underpinned by the success of the nation’s vaccine roll-out, and outlines the ruling to remove all remaining legal restrictions, whilst protecting the people most vulnerable to COVID-19 and maintaining resilience(3). The government will also secure innovations and opportunities from the COVID-19 response. This news accompanies the decreasing daily number of confirmed COVID-19 cases and COVID-19 related deaths in the UK; 27,000 cases 92 deaths on the 27th February 2022(4). Additionally, COVID-19 vaccines will now be offered to children between the ages of five and eleven in the UK, in line with advice from the Joint Committee on Vaccination and Immunisation (JCVI)(5,6).  

 

Another major update from this month, has been the publishing of several papers describing cases of COVID-19 reinfection(7,8). The CDC has also updated their website to include more information on COVID-19 reinfection to help guide public health action(9). It has become increasingly apparent the negative effects the COVID-19 pandemic has had on our younger population. A BMJ article highlights the pandemics’ disproportionate impact on children’s mental health, an important topic needing urgent action across the globe(10).

 

Several studies have explored the long-term effects on COVID-19. One study’s findings suggest that Covid-19 antibodies after AstraZeneca and Pfizer vaccines may decrease with age and are higher in women(11). The authors suggest that many individuals acquire sufficient immunity after two vaccine doses, however further follow-up is required to determine the longevity of this protection. Another study explored a new COVID-19 prediction model(12). Despite public health measures, vaccines, antiviral treatments, and monoclonal antibodies, covid-19 continues to overrun hospital wards and strain health systems. This model has the potential to significantly reduce morbidity and mortality, and reduce the burden on health systems.

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Nutrition highlights

 

​This month’s updates begin with a wide-reaching, referenced analysis documenting the effects of COVID-19 infection on olfactory and/or gustatory dysfunction (13) – factors which are well understood to influence wider nutritional status. This is perhaps an underappreciated relationship when we consider the impact of lasting changes in these senses on disease recovery and rehabilitation.  

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Following this we share insights from the online space and population-wide shifts in dietary interests during the pandemic based on analysis of online databases (14,15). With so much change since the beginning of the pandemic it is a reminder of the power of the new online world and where nutrition should be place in this space. Another area on which the pandemic shone light was global food insecurity across both developed and under-developed nations. A further paper added this month examines the impact COVID-19 has had on food assistance programmes in the US (16).  

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Turning to the clinical space we have added new papers on nutrition screening. The first considering sarcopenia as a prognostic factor in ICU populations with COVID-19 (17). This is a patient group in whom there has been significant published observation and interest related to body composition. The second paper considers nutrition risk in paediatric populations admitted to hospital with COVID-19 using a validated tool to assess nutrition risk in this populations (18). Further to this we have added a comparison of clinical practice between waves of the pandemic through a dietetic led service in the UK (19). This paper highlights the changing medical and nutritional needs of COVID-19 patients and how this posed significant challenges in the provision of nutrition support between waves. It also provides some considerations for the impact of complex nutrition needs on discharge from hospital and how ongoing and comprehensive nutrition support can be a strategy to combat this. Finally, we have added a follow up study evaluating persistent malnutrition and sarcopenia at different periods post-discharge from the ICU (20).  

 

Taskforce Discussions

 

​During this month’s meeting, the taskforce reflected on two years of the COVID-19 pandemic in the UK. We discussed how different the current phase of the pandemic is to the position one or two years ago, and how in 2022 the media has started to shift attention away from COVID-19 as we enter this new way of living with the disease. We looked back at the successes and challenges of our outputs over the two years, and used this to prioritise which topics were still relevant. We used this to prioritise our work accordingly. Over the next 6-12 months, the taskforce will focus its efforts on the following points: 

  • Clinical Nutrition in COVID-19; prevention, management, recovery, how diets and nutrition have changed during the pandemic 

  • Tailoring Sci-comms health advice to different regions, at different times during pandemic; using nutrition as a case study  

  • Long COVID & nutrition; in younger people (children, adolescents), different regions etc 

  • Equity of access / inequalities in different parts of the world, relate to food security / vaccine access. The relationship between these areas e.g. UK/Europe vs Africa perspectives 

   

We will use these ideas to drive our future projects, events and communication to continue to improve human health during the COVID-19 pandemic. The Taskforce is collaborating on a multi-centre long COVID clinical trial, and we have recently submitted a grant application for our own research into nutrition and long COVID.  

  

References

 

  1. COVID-19: Useful Resources: https://www.nnedpro.org.uk/coronavirus

  2. COVID-19: Nutrition Resources: https://www.nnedpro.org.uk/covid-19nutrition-resources

  3. COVID-19 Response: Living with COVID-19: https://www.gov.uk/government/publications/covid-19-response-living-with-covid-19

  4. OurWorldInData – UK: https://ourworldindata.org/coronavirus/country/united-kingdom#what-is-the-daily-number-of-confirmed-deaths

  5. Covid-19: Vaccine will be offered to 5-11 year olds throughout UK: https://www.bmj.com/content/376/bmj.o411

  6. Department of Health and Social Care. Independent report: JCVI statement on vaccination of children aged 5 to 11 years old. 16 Feb 2022. https://www.gov.uk/government/publications/jcvi-update-on-advice-for-covid-19-vaccination-of-children-aged-5-to-11/jcvi-statement-on-vaccination-of-children-aged-5-to-11-years-old

  7. Severe, Symptomatic Reinfection in a Patient with COVID-19: https://pubmed.ncbi.nlm.nih.gov/33172223/    

  8. A case of COVID-19 reinfection in the UK: https://pubmed.ncbi.nlm.nih.gov/33303623/

  9. CDC Reinfections: https://www.cdc.gov/coronavirus/2019-ncov/your-health/reinfection.html

  10. Covid-19: Pandemic has disproportionately harmed children’s mental health, report finds: https://www.bmj.com/content/376/bmj.o430

  11. Covid-19: Antibodies after AstraZeneca and Pfizer vaccines decrease with age and are higher in women, data show: https://www.bmj.com/content/376/bmj.o428

  12. Early identification of patients admitted to hospital for covid-19 at risk of clinical deterioration: model development and multisite external validation study: https://www.bmj.com/content/376/bmj-2021-068576 - Predicting covid-19 outcomes: https://www.bmj.com/content/376/bmj.o354

  13. Olfactory and Gustatory Dysfunction in COVID-19: A Global Bibliometric and Visualized Analysis https://pubmed.ncbi.nlm.nih.gov/35240864/     

  14. Using Social Media to Promote School Nutrition Programs During the COVID-19 Pandemic https://pubmed.ncbi.nlm.nih.gov/35234278/   

  15. Population-scale dietary interests during the COVID-19 pandemic https://pubmed.ncbi.nlm.nih.gov/35228539/    

  16. Patterns of Food Assistance Program Participation, Food Insecurity, and Pantry Use among U.S. Households with Children during the COVID-19 Pandemic https://www.mdpi.com/2072-6643/14/5/988   

  17. Low muscle mass in COVID-19 critically-ill patients: Prognostic significance and surrogate markers for assessment https://www.clinicalnutritionjournal.com/article/S0261-5614(22)00070-X/fulltext   

  18. Increased nutrition risk at admission is associated with longer hospitalization in children and adolescents with COVID-19 https://aspenjournals.onlinelibrary.wiley.com/doi/10.1002/ncp.10846    

  19. Dietetic-Led Nutrition Interventions in Patients with COVID-19 during Intensive Care and Ward-Based Rehabilitation: A Single-Center Observational Study https://www.mdpi.com/2072-6643/14/5/1062   

  20. Long Term Follow-Up of Sarcopenia and Malnutrition after Hospitalization for COVID-19 in Conventional or Intensive Care Units https://www.mdpi.com/2072-6643/14/4/912  

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