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. 2021 Aug;34(4):660-669.
doi: 10.1111/jhn.12896. Epub 2021 May 12.

A UK survey of nutritional care pathways for patients with COVID-19 prior to and post-hospital stay

Victoria Lawrence  1 , Mary Hickson  2 , C Elizabeth Weekes  3   4 , Anna Julian  5 , Gary Frost  6 , Jane Murphy  1
Affiliations

A UK survey of nutritional care pathways for patients with COVID-19 prior to and post-hospital stay

Victoria Lawrence et al. J Hum Nutr Diet. 2021 Aug.

Abstract

Background: During the global COVID-19 pandemic, UK dietitians have delivered the best care to help patients recover from the infection. The present study examined the development and evaluation of care pathways to manage nutritional care of patients following COVID-19 infection prior to and after discharge.

Methods: Registered UK dietitians completed an online questionnaire comprising 26 questions about the development of a pathway, its use, evaluation and training needs.

Results: Of 57 responses from organisations, 37 (65%) were involved in the planning/management of nutritional care. Only 19 responses had a new or adapted COVID-19 pathway. Of these, 74% reported involvement of dietetic services, 47% reported > 1 eligibility criteria for pathway inclusion and 53% accepted all positive or suspected cases. All respondents used nutritional screening, first-line dietary advice (food first) and referral for further advice and monitoring. Weight and food intake were the most used outcome measure. All pathways addressed symptoms related to nutrition, with the most common being weight loss with poor appetite, not being hungry and skipping meals in 84% of pathways. Over half of respondents (54%) planned to evaluate their pathway and 83% reported that they were 'very or reasonably confident' in their team's nutritional management of COVID-19. Less than half (42%) reported on training needs.

Conclusions: Despite challenges encountered, pathways were developed and implemented. Dietitians had adapted to new ways of working to manage nutritional care in patients prior to and after discharge from hospital following COVID-19 infection. Further work is needed to develop strategies for evaluation of their impact.

Keywords: COVID-19 infection; care pathway; dietitians; nutrition; nutritional care.

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Conflict of interest statement

The authors have no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Number of respondents involved in planning and/or management of nutritional care and have a COVID‐19 pathway for patients with COVID‐19 infection
FIGURE 2
FIGURE 2
Aspects of nutritional care included in new or adapted nutritional care pathways for patients following COVID‐19 infection (n = 19). ONS, oral nutritional supplement
FIGURE 3
FIGURE 3
Assessment of nutrition‐related symptoms included in nutritional care pathways for patients following COVID‐19 infection (n = 19)
FIGURE 4
FIGURE 4
Assessment of physical or functional symptoms associated with COVID‐19 infection (n = 19)
FIGURE 5
FIGURE 5
Assessment of emotional or psychological related symptoms associated with COVID‐19 infection (n = 19)
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