The Association Between an Enteral Nutrition Protocol and Achievement of Target Energy Intake in Critically Ill COVID-19 Patients: A Retrospective Observational Study

Background and objective Enteral nutrition (EN) protocols are commonly used to support energy delivery in critically ill patients. However, to our knowledge, no studies have examined the use of EN protocols in critically ill coronavirus disease 2019 (COVID-19) patients. Therefore, we conducted a single-center, retrospective study to examine whether the use of an EN protocol was associated with achieving the target energy intake of 25 kcal/kg/day within seven days after ICU admission in critically ill COVID-19 patients. Methods The retrospective study included critically ill COVID-19 patients between April 1, 2020, and March 31, 2023. The primary outcome was the achievement of the target energy intake, and secondary outcomes were clinical outcomes and the frequency of adverse events according to EN protocol use. Results Twenty-five patients (16 males; median age: 65.0 years) were included, and EN was initiated at a median of 44.0 (interquartile range (IQR): 33.0-46.5) hours after ICU admission. The EN protocol was used in 15 patients. The EN protocol was used significantly more frequently among patients who met the target energy intake than among those who did not (p = 0.015). A multivariable analysis identified the use of the EN protocol as an independent factor associated with achieving the target energy intake (odds ratio (OR) = 11.00; 95% confidence interval (CI): 1.60-75.50; p = 0.015). Moreover, clinical outcomes and adverse events did not significantly differ between patients with and without the EN protocol. Conclusions Based on our findings, target energy delivery was associated with the use of an EN protocol in critically ill COVID-19 patients.