Healthcare resource utilization among critically-ill COVID-19 survivors: results from the NUTRICOVID study

Background: critically ill patients admitted to the intensive care unit (ICU) are often associated with malnutrition and nutrition therapy is recommended. Previous studies on COVID-19 focused on the recovery of critically ill patients after hospital discharge; however, there are limited data on healthcare resource utilization (HRU) after discharge. Aims: to describe and analyze the HRU and nutritional status of COVID-19 patients during hospitalization and one year after discharge. Methods: during hospitalization and 12-month follow-up after discharge, we collected data on hospital and ICU length of stay, ventilatory support therapies, medical nutrition therapy, and outpatient visits. Factors contributing to outpatient visits and readmissions during the follow-up period were also analyzed. Results: a total of 199 patients were included, with a median hospital and ICU length of stay of 53.0 and 23.5 days, respectively. During hospitalization, 86.4 % of the patients needed invasive ventilation and 51.5 % non-invasive ventilation; 50.3 % of the patients required parenteral nutrition, while 84.3 % required enteral nutrition and 66.0 % oral nutritional supplements. After discharge a mean number of visits per patient to general practitioner, specialized care, and emergency department of 4.5, 14.7, and 0.8, respectively, were registered, most of them directly or possibly related to COVID-19. Additionally, a better health-related quality of life (HRQoL) at discharge and lower weight loss during hospitalization were associated with lower HRU during follow-up. Conclusions: our study shows a high HRU among patients with COVID-19 admitted to ICU in the year following discharge and highlights the importance of the nutrition status during admission and its relation to HRU.