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Poor nutritional status, risk of sarcopenia and nutrition related complaints are prevalent in COVID-19 patients during and after hospital admission

BACKGROUND AND AIMS: Patients with COVID-19 infection presents with a broad clinical spectrum of symptoms and complications. As a consequence nutritional requirements are not met, resulting in weight- and muscle loss, and malnutrition. The aim of the present study is to delineate nutritional complaints, the (course of the) nutritional status and risk of sarcopenia of COVID-19 patients, during hospitalisation and after discharge.METHODS: In this prospective observational study in 407 hospital admitted COVID-19 patients in four university and peripheral hospitals, data were collected during dietetic consultations. Presence of nutrition related complaints (decreased appetite, loss of smell, changed taste, loss of taste, chewing and swallowing problems, nausea, vomiting, feeling of being full, stool frequency and consistency, gastric retention, need for help with food intake due to weakness and shortness of breath and nutritional status (weight loss, BMI, risk of sarcopenia with SARC-F ≥4 points) before, during hospital stay and after discharge were, where possible, collected.RESULTS: Included patients were most men (69%), median age of 64.8 ± 12.4 years, 60% were admitted to ICU at any time point during hospitalisation with a median LOS of 15 days and an in-hospital mortality rate of 21%. The most commonly reported complaints were: decreased appetite (58%), feeling of being full (49%) and shortness of breath (43%). One in three patients experienced changed taste, loss of taste and/or loss of smell. Prior to hospital admission, 67% of the patients was overweight (BMI >25 kg/m2), 35% of the patients was characterised as malnourished, mainly caused by considerable weight loss. Serious acute weight loss (>5 kg) was showed in 22% of the patents during the hospital stay; most of these patients (85%) were admitted to the ICU at any point in time. A high risk of sarcopenia (SARC-F ≥ 4 points) was scored in 73% of the patients during hospital admission.CONCLUSION: In conclusion, one in five hospital admitted COVID-19 patients suffered from serious acute weight loss and 73% had a high risk of sarcopenia. Moreover, almost all patients had one or more nutritional complaints. Of these complaints, decreased appetite, feeling of being full, shortness of breath and changed taste and loss of taste were the most predominant nutrition related complaints. These symptoms have serious repercussions on nutritional status. Although nutritional complaints persisted a long time after discharge, only a small group of patients received dietetic treatment after hospital discharge in recovery phase. Clinicians should consider the risks of acute malnutrition and sarcopenia in COVID-19 patients and investigate multidisciplinary treatment including dietetics during hospital stay and after discharge.

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Poor nutritional status, risk of sarcopenia and nutrition related complaints are prevalent in COVID-19 patients during and after hospital admission

BACKGROUND AND AIMS: Patients with COVID-19 infection presents with a broad clinical spectrum of symptoms and complications. As a consequence nutritional requirements are not met, resulting in weight- and muscle loss, and malnutrition. The aim of the present study is to delineate nutritional complaints, the (course of the) nutritional status and risk of sarcopenia of COVID-19 patients, during hospitalisation and after discharge.METHODS: In this prospective observational study in 407 hospital admitted COVID-19 patients in four university and peripheral hospitals, data were collected during dietetic consultations. Presence of nutrition related complaints (decreased appetite, loss of smell, changed taste, loss of taste, chewing and swallowing problems, nausea, vomiting, feeling of being full, stool frequency and consistency, gastric retention, need for help with food intake due to weakness and shortness of breath and nutritional status (weight loss, BMI, risk of sarcopenia with SARC-F ≥4 points) before, during hospital stay and after discharge were, where possible, collected.RESULTS: Included patients were most men (69%), median age of 64.8 ± 12.4 years, 60% were admitted to ICU at any time point during hospitalisation with a median LOS of 15 days and an in-hospital mortality rate of 21%. The most commonly reported complaints were: decreased appetite (58%), feeling of being full (49%) and shortness of breath (43%). One in three patients experienced changed taste, loss of taste and/or loss of smell. Prior to hospital admission, 67% of the patients was overweight (BMI >25 kg/m2), 35% of the patients was characterised as malnourished, mainly caused by considerable weight loss. Serious acute weight loss (>5 kg) was showed in 22% of the patents during the hospital stay; most of these patients (85%) were admitted to the ICU at any point in time. A high risk of sarcopenia (SARC-F ≥ 4 points) was scored in 73% of the patients during hospital admission.CONCLUSION: In conclusion, one in five hospital admitted COVID-19 patients suffered from serious acute weight loss and 73% had a high risk of sarcopenia. Moreover, almost all patients had one or more nutritional complaints. Of these complaints, decreased appetite, feeling of being full, shortness of breath and changed taste and loss of taste were the most predominant nutrition related complaints. These symptoms have serious repercussions on nutritional status. Although nutritional complaints persisted a long time after discharge, only a small group of patients received dietetic treatment after hospital discharge in recovery phase. Clinicians should consider the risks of acute malnutrition and sarcopenia in COVID-19 patients and investigate multidisciplinary treatment including dietetics during hospital stay and after discharge.

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Tot hier ... en nú verder - behoeften van ouderen tijdens de coronapandemie in Nederland

Begin 2020 bereikte het coronavirus Nederland. Hoewel we nu een stuk meer weten over het coronavirus SARS-CoV-2, was er in het begin vooral heel veel onbekend. Ouderen werden in één keer als ‘kwetsbaar’ bestempeld.1 De coronamaatregelen waren gericht op het beschermen van ouderen tegen COVID-19 infectie, maar zorgden ook voor minder participatie en meer angst en eenzaamheid bij ouderen.3 4 1 5 Bovendien kwam de autonomie van ouderen onder druk te staan.6 Hoewel ouderenparticipatie aan een opmars bezig is, wordt de mening van ouderen niet altijd meegenomen in beleid over ouderen. Deze periode heeft nog eens benadrukt hoe belangrijk het is om niet alleen te spreken over ouderen, maar om vooral ook in gesprek te blijven met ouderen. Dit is een van de belangrijkste lessen uit ons onderzoek naar welzijn en ondersteuning van ouderen tijdens de coronaperiode. We blikken hier terug op de situatie van twee jaar corona, en kijken ook vooruit naar wat er nodig is in de toekomst.

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Tot hier ... en nú verder - behoeften van ouderen tijdens de coronapandemie in Nederland

Begin 2020 bereikte het coronavirus Nederland. Hoewel we nu een stuk meer weten over het coronavirus SARS-CoV-2, was er in het begin vooral heel veel onbekend. Ouderen werden in één keer als ‘kwetsbaar’ bestempeld.1 De coronamaatregelen waren gericht op het beschermen van ouderen tegen COVID-19 infectie, maar zorgden ook voor minder participatie en meer angst en eenzaamheid bij ouderen.3 4 1 5 Bovendien kwam de autonomie van ouderen onder druk te staan.6 Hoewel ouderenparticipatie aan een opmars bezig is, wordt de mening van ouderen niet altijd meegenomen in beleid over ouderen. Deze periode heeft nog eens benadrukt hoe belangrijk het is om niet alleen te spreken over ouderen, maar om vooral ook in gesprek te blijven met ouderen. Dit is een van de belangrijkste lessen uit ons onderzoek naar welzijn en ondersteuning van ouderen tijdens de coronaperiode. We blikken hier terug op de situatie van twee jaar corona, en kijken ook vooruit naar wat er nodig is in de toekomst.

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Cultural tourism during the covid-19 pandemic in Portugal

The COVID-19 (SARS-CoV-2) pandemic represented a significant break with previous patterns of cultural consumption, effectively halting the growth of “mass cultural tourism” driven by cheap flights and collaborative economy accommodation. Surveys conducted by the ATLAS Cultural Tourism Group in Portugal were used to develop a detailed picture of cultural tourism consumption during the pandemic. In 2020 and early 2021 surveys were conducted at different locations in the country, generating over 500 responses. The research shows that COVID-19 had significant impacts on the profile and activities of cultural tourists in Portugal, with much more domestic tourism at most sites, and fewer visitors staying away from home. Levels of satisfaction and intention to return remained high, as did perceived authenticity. There was a significant drop in touring holidays, with visitors more likely to stay in a single location. Those tourists visiting cultural attractions during the pandemic had a positive experience, despite the challenging conditions. Levels of satisfaction increased compared with previous surveys in Portugal in 2004, but there were also fluctuations in levels of satisfaction during the pandemic period, correlated with levels of COVID-19 infections. Some indications of emerging alternative forms of cultural tourism include an increased proclivity for rural locations and inland areas, away from destinations usually associated with mass (cultural) tourism. The article concludes by considering a number of implications for the development of cultural tourism in Portugal and other destinations in the postpandemic era.

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Cultural tourism during the covid-19 pandemic in Portugal

The COVID-19 (SARS-CoV-2) pandemic represented a significant break with previous patterns of cultural consumption, effectively halting the growth of “mass cultural tourism” driven by cheap flights and collaborative economy accommodation. Surveys conducted by the ATLAS Cultural Tourism Group in Portugal were used to develop a detailed picture of cultural tourism consumption during the pandemic. In 2020 and early 2021 surveys were conducted at different locations in the country, generating over 500 responses. The research shows that COVID-19 had significant impacts on the profile and activities of cultural tourists in Portugal, with much more domestic tourism at most sites, and fewer visitors staying away from home. Levels of satisfaction and intention to return remained high, as did perceived authenticity. There was a significant drop in touring holidays, with visitors more likely to stay in a single location. Those tourists visiting cultural attractions during the pandemic had a positive experience, despite the challenging conditions. Levels of satisfaction increased compared with previous surveys in Portugal in 2004, but there were also fluctuations in levels of satisfaction during the pandemic period, correlated with levels of COVID-19 infections. Some indications of emerging alternative forms of cultural tourism include an increased proclivity for rural locations and inland areas, away from destinations usually associated with mass (cultural) tourism. The article concludes by considering a number of implications for the development of cultural tourism in Portugal and other destinations in the postpandemic era.

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PRactice of VENTilation in Patients with Novel Coronavirus Disease (PRoVENT-COVID)

Background: The coronavirus disease 2019 (COVID-19) pandemic is rapidly expanding across the world, with more than 100,000 new cases each day as of end-June 2020. Healthcare workers are struggling to provide the best care for COVID-19 patients. Approaches for invasive ventilation vary widely between and within countries and new insights are acquired rapidly. We aim to investigate invasive ventilation practices and outcome in COVID-19 patients in the Netherlands.Methods: PRoVENT-COVID ('study of PRactice of VENTilation in COVID-19') is an investigator-initiated national, multicenter observational study to be undertaken in intensive care units (ICUs) in The Netherlands. Consecutive COVID-19 patients aged 18 years or older, who are receiving invasive ventilation in the participating ICUs, are to be enrolled during a 10-week period, with a daily follow-up of 7 days. The primary outcome is ventilatory management (including tidal volume expressed as mL/kg predicted body weight and positive end-expiratory pressure expressed as cmH2O) during the first 3 days of ventilation. Secondary outcomes include other ventilatory variables, use of rescue therapies for refractory hypoxemia such as prone positioning and extracorporeal membrane oxygenation, use of sedatives, vasopressors and inotropes; daily cumulative fluid balances; acute kidney injury; ventilator-free days and alive at day 28 (VFD-28), duration of ICU and hospital stay, and ICU, hospital and 90-day mortality.Discussion: PRoVENT-COVID will be the largest observational study to date, with high density ventilatory data and major outcomes. There is urgent need for a better understanding of ventilation practices, and the effects of ventilator settings on outcomes in COVID-19 patients. The results of PRoVENT-COVID will be rapidly disseminated through electronic presentations, such as webinars and electronic conferences, and publications in international peer-reviewed journals. Access to source data will be made available through local, regional and national anonymized datasets on request, and after agreement of the PRoVENT-COVID steering committee.Trial Registration: PRoVENT-COVID is registered at clinicaltrials.gov (identifier NCT04346342).

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PRactice of VENTilation in Patients with Novel Coronavirus Disease (PRoVENT-COVID)

Background: The coronavirus disease 2019 (COVID-19) pandemic is rapidly expanding across the world, with more than 100,000 new cases each day as of end-June 2020. Healthcare workers are struggling to provide the best care for COVID-19 patients. Approaches for invasive ventilation vary widely between and within countries and new insights are acquired rapidly. We aim to investigate invasive ventilation practices and outcome in COVID-19 patients in the Netherlands.Methods: PRoVENT-COVID ('study of PRactice of VENTilation in COVID-19') is an investigator-initiated national, multicenter observational study to be undertaken in intensive care units (ICUs) in The Netherlands. Consecutive COVID-19 patients aged 18 years or older, who are receiving invasive ventilation in the participating ICUs, are to be enrolled during a 10-week period, with a daily follow-up of 7 days. The primary outcome is ventilatory management (including tidal volume expressed as mL/kg predicted body weight and positive end-expiratory pressure expressed as cmH2O) during the first 3 days of ventilation. Secondary outcomes include other ventilatory variables, use of rescue therapies for refractory hypoxemia such as prone positioning and extracorporeal membrane oxygenation, use of sedatives, vasopressors and inotropes; daily cumulative fluid balances; acute kidney injury; ventilator-free days and alive at day 28 (VFD-28), duration of ICU and hospital stay, and ICU, hospital and 90-day mortality.Discussion: PRoVENT-COVID will be the largest observational study to date, with high density ventilatory data and major outcomes. There is urgent need for a better understanding of ventilation practices, and the effects of ventilator settings on outcomes in COVID-19 patients. The results of PRoVENT-COVID will be rapidly disseminated through electronic presentations, such as webinars and electronic conferences, and publications in international peer-reviewed journals. Access to source data will be made available through local, regional and national anonymized datasets on request, and after agreement of the PRoVENT-COVID steering committee.Trial Registration: PRoVENT-COVID is registered at clinicaltrials.gov (identifier NCT04346342).

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Prescribing errors in post - COVID-19 patients

Abstract Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), has challenged healthcare globally. An acute increase in the number of hospitalized patients has neces‑ sitated a rigorous reorganization of hospital care, thereby creating circumstances that previously have been identifed as facilitating prescribing errors (PEs), e.g. a demanding work environment, a high turnover of doctors, and prescrib‑ ing beyond expertise. Hospitalized COVID-19 patients may be at risk of PEs, potentially resulting in patient harm. We determined the prevalence, severity, and risk factors for PEs in post–COVID-19 patients, hospitalized during the frst wave of COVID-19 in the Netherlands, 3months after discharge. Methods: This prospective observational cohort study recruited patients who visited a post-COVID-19 outpatient clinic of an academic hospital in the Netherlands, 3months after COVID-19 hospitalization, between June 1 and October 1 2020. All patients with appointments were eligible for inclusion. The prevalence and severity of PEs were assessed in a multidisciplinary consensus meeting. Odds ratios (ORs) were calculated by univariate and multivariate analysis to identify independent risk factors for PEs. Results: Ninety-eight patients were included, of whom 92% had ≥1 PE and 8% experienced medication-related harm requiring an immediate change in medication therapy to prevent detoriation. Overall, 68% of all identifed PEs were made during or after the COVID-19 related hospitalization. Multivariate analyses identifed ICU admission (OR 6.08, 95% CI 2.16–17.09) and a medical history of COPD / asthma (OR 5.36, 95% CI 1.34–21.5) as independent risk fac‑ tors for PEs. Conclusions: PEs occurred frequently during the SARS-CoV-2 pandemic. Patients admitted to an ICU during COVID19 hospitalization or who had a medical history of COPD / asthma were at risk of PEs. These risk factors can be used to identify high-risk patients and to implement targeted interventions. Awareness of prescribing safely is crucial to prevent harm in this new patient population.

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Poor nutritional status, risk of sarcopenia and nutrition related complaints are prevalent in COVID-19 patients during and after hospital admission

Poor nutritional status, risk of sarcopenia and nutrition related complaints are prevalent in COVID-19 patients during and after hospital admission

Tot hier ... en nú verder - behoeften van ouderen tijdens de coronapandemie in Nederland

Tot hier ... en nú verder - behoeften van ouderen tijdens de coronapandemie in Nederland

Cultural tourism during the covid-19 pandemic in Portugal

Cultural tourism during the covid-19 pandemic in Portugal

PRactice of VENTilation in Patients with Novel Coronavirus Disease (PRoVENT-COVID)

PRactice of VENTilation in Patients with Novel Coronavirus Disease (PRoVENT-COVID)

Prescribing errors in post - COVID-19 patients

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3D scanning voor passende mondkapjes

Nieuwe moleculen voor de diagnose van infectieziekten

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Poor nutritional status, risk of sarcopenia and nutrition related complaints are prevalent in COVID-19 patients during and after hospital admission

Poor nutritional status, risk of sarcopenia and nutrition related complaints are prevalent in COVID-19 patients during and after hospital admission

Tot hier ... en nú verder - behoeften van ouderen tijdens de coronapandemie in Nederland

Tot hier ... en nú verder - behoeften van ouderen tijdens de coronapandemie in Nederland

Cultural tourism during the covid-19 pandemic in Portugal

Cultural tourism during the covid-19 pandemic in Portugal

PRactice of VENTilation in Patients with Novel Coronavirus Disease (PRoVENT-COVID)

PRactice of VENTilation in Patients with Novel Coronavirus Disease (PRoVENT-COVID)

Prescribing errors in post - COVID-19 patients

Projects 2

3D scanning voor passende mondkapjes

Nieuwe moleculen voor de diagnose van infectieziekten