{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T02:49:58Z","timestamp":1774666198246,"version":"3.50.1"},"reference-count":15,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,4,11]],"date-time":"2022-04-11T00:00:00Z","timestamp":1649635200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>Malnutrition and its complications is usually neglected in critically ill COVID-19 patients. We conducted the present study to investigate the prevalence of refeeding syndrome and its related factors in this group of patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this prospective cohort study, 327 patients were assessed for being at risk and developing refeeding syndrome. The criteria was ASPEN consensus recommendations for refeeding syndrome released in 2020. Malnutrition was assessed based on global leadership initiative on malnutrition (GLIM) criteria. The relation between actual protein, calorie intake, and refeeding syndrome was also evaluated <jats:italic>via<\/jats:italic> cox regression model. The data concerning calorie and protein intake were gathered for 5 days after initiating feeding. The daily protein and calorie intake were divided by kilogram body weight in order to calculate the actual protein (g\/kg\/day) and energy (kcal\/kg\/day) intake.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among the subjects, 268 (82%) were at risk of refeeding syndrome and 116 (36%) got involved in this syndrome. Malnutrition, according to the GLIM criteria, was found in 193 (59%) of the subjects. In the at-risk population, the risk of refeeding syndrome was reduced by 90% with the rise in protein intake (CI; 0.021\u20130.436, <jats:italic>P<\/jats:italic> = 0.002), increased by 1.04 times with the increase in age (CI; 1.032\u20131.067, <jats:italic>P<\/jats:italic> &amp;lt; 0.001), and by 1.19 times with the rise in the days from illness onset to admission (CI; 1.081\u20131.312, <jats:italic>P<\/jats:italic> &amp;lt; 0.001) in adjusted cox model analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The incidence of refeeding syndrome is relatively high, which threatens the majority of critically ill COVID-19 patients. Increased protein intake was found to reduce the occurrence of refeeding syndrome.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fnut.2022.830457","type":"journal-article","created":{"date-parts":[[2022,4,11]],"date-time":"2022-04-11T07:38:22Z","timestamp":1649662702000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":15,"title":["Refeeding Syndrome and Its Related Factors in Critically Ill Coronavirus Disease 2019 Patients: A Prospective Cohort Study"],"prefix":"10.3389","volume":"9","author":[{"given":"Zahra","family":"Vahdat Shariatpanahi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maryam","family":"Vahdat Shariatpanahi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erfan","family":"Shahbazi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shaahin","family":"Shahbazi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,4,11]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"871","DOI":"10.1038\/s41430-020-0642-3","article-title":"Prevalence of malnutrition and analysis of related factors in elderly patients with COVID-19 in Wuhan, China.","volume":"74","author":"Li","year":"2020","journal-title":"Eur J Clin Nutr"},{"key":"B2","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1038\/s41430-020-00757-6","article-title":"How the Covid-19 epidemic is challenging our practice in clinical nutrition\u2014feedback from the field.","volume":"75","author":"Ronan","year":"2021","journal-title":"Eur J Clin Nutr."},{"key":"B3","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.nupar.2021.08.001","article-title":"Evaluation of Anorexia and Analysis of Related Factors in Patients with COVID-19.","author":"Shahbazi","year":"2022","journal-title":"Nutrition Clinique et M\u00e9tabolisme."},{"key":"B4","doi-asserted-by":"publisher","first-page":"178","DOI":"10.1002\/ncp.10474","article-title":"ASPEN consensus recommendations for refeeding syndrome.","volume":"35","author":"da Silva","year":"2020","journal-title":"Nutr Clin Pract."},{"key":"B5","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1016\/j.clnesp.2021.03.020","article-title":"The validity of the global leadership initiative on malnutrition criteria for diagnosing malnutrition in critically ill patients with COVID-19: A prospective cohort study.","volume":"43","author":"Shahbazi","year":"2021","journal-title":"Clin Nutr ESPEN."},{"key":"B6","doi-asserted-by":"publisher","first-page":"1043","DOI":"10.1001\/archsurg.1996.01430220037007","article-title":"Refeeding hypophosphatemia in critically ill patients in an intensive care unit. A prospective study.","volume":"131","author":"Marik","year":"1996","journal-title":"Arch Surg."},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2012-002173","article-title":"Occurrence of refeeding syndrome in adults started on artificial nutrition support: prospective cohort study.","volume":"3","author":"Rio","year":"2013","journal-title":"BMJ Open."},{"key":"B8","year":"2020","journal-title":"Clinical Management of COVID-19: Interim Guidance."},{"key":"B9","doi-asserted-by":"publisher","first-page":"1439","DOI":"10.1002\/jpen.1996","article-title":"Challenges of maintaining optimal nutrition status in COVID-19 patients in intensive care settings.","volume":"44","author":"Minnelli","year":"2020","journal-title":"JPEN J Parenter Enteral Nutr."},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1007\/s11894-019-0724-3","article-title":"Refeeding syndrome in the critically ill: a literature review and clinician\u2019s guide.","volume":"21","author":"McKnight","year":"2019","journal-title":"Curr Gastroenterol Rep."},{"key":"B11","first-page":"116","article-title":"Incidence of refeeding syndrome in internal medicine patients.","volume":"74","author":"Kraaijenbrink","year":"2016","journal-title":"Neth J Med."},{"key":"B12","doi-asserted-by":"publisher","first-page":"1071","DOI":"10.1016\/j.clnu.2020.06.038","article-title":"Incidence and outcome of refeeding syndrome in neurocritically ill Patients.","volume":"40","author":"Ruiqi","year":"2020","journal-title":"Clin Nutr."},{"key":"B13","doi-asserted-by":"crossref","first-page":"56","DOI":"10.21859\/ajcm.25.1.56","article-title":"Assessment of the outcome of refeeding syndrome patients admitted to intensive care unit.","volume":"25","author":"Gharebaghi","year":"2018","journal-title":"Avic J Clin Med."},{"key":"B14","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1002\/jpen.1440","article-title":"GLIM criteria for the diagnosis of malnutrition: a consensus report from the global clinical nutrition community.","volume":"43","author":"Jensen","year":"2019","journal-title":"JPEN J Parent Ent Nutr."},{"key":"B15","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1177\/0148607115621863","article-title":"Society of critical care medicine; american society for parenteral and enteral nutrition. guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: society of critical care medicine (SCCM) and american society for parenteral and enteral nutrition (A.S.P.E.N.).","volume":"40","author":"McClave","year":"2016","journal-title":"JPEN J Parent Ent Nutr."}],"container-title":["Frontiers in Nutrition"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2022.830457\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,4,11]],"date-time":"2022-04-11T07:38:27Z","timestamp":1649662707000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2022.830457\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,11]]},"references-count":15,"alternative-id":["10.3389\/fnut.2022.830457"],"URL":"https:\/\/doi.org\/10.3389\/fnut.2022.830457","relation":{},"ISSN":["2296-861X"],"issn-type":[{"value":"2296-861X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4,11]]},"article-number":"830457"}}