Managing nutrition of COVID patient at home post-ICU

Covid-19 infection affects the lungs and makes us sick. In severe case, one has to be admitted to the ICU to support in breathing process with a ventilator. In the ICU, you receive nutrition through your veins to fight against infection. After being discharged from hospital, maintaining your health status depends upon your diet knowledge. So, here we will focus more about home based management of nutrition post-ICU.

At home you may feel too weak or tired to eat, and notice you have lost weight. You also might be eating and drinking less than you would normally eat (before you got sick). This is completely normal, however, you need to prevent further weight loss to rebuild your strength. Here are some tips to rebuild your strength, grow your muscles, and get you back to your regular daily activities:

  • Eat food with protein in each meal.
  • Try to have whole grain breads, roti, rice, or cereals at each meal.
  • Include adequate vegetables and fruits.
  • Keep track of what you are eating at each meal. For example 0%, 25%, 50%, 75%, 100% of your plate. If you are eating 50% or less than normal, make a milkshake with yogurt or buy a nutrition supplement (meal replacement for between meals).
  • Try to drink 8 to 10 cups of fluids per day (water, fruit juice, milk, nutrition supplement).

Maintaining High Calorie and High Protein Diet

  • Try eating 6 times a day, every 2 to 3 hours. Eat even if you are not hungry.
  • Calories are important to protect against breakdown of muscle for energy. Due to increase stress from COVID 19, you need more calories than your normal diet.
  • Try to eat 75 to 100 g of protein per day ( egg, meat, milk, paneer, yogurt, chicken, fish, Nutrila (soy chunks), paneer, tofu, dal, pulses, legumes).
  • Eat nutrient dense food.
  • Double or triple the portion sizes of fat and oils.
  • Eat small amount for several times.
  • High calorie, high protein shake

¾ cup of full fat yogurt, 1 cup of whole milk, 2 tbspn of peanut butter, fresh fruit (banana, mango, berries), nuts

Maintaining Hydration status

  • 60 to 120ml of fluid every half an hour.
  • Optimal fluid intake to drink are clear liquid beverages with calories and protein, oral rehydration solutions, or sports drinks.
  • Rehydration drinks

You may also try this easy recipe for hydration if accessible:

Mix the following in a pitcher: 2 to 3g tsp salt, 1 cup of juice (orange, grape, apple, cranberry) and drink fresh

What if you are having problem eating at home? Try the following steps

Poor appetite, fatigue, feeling full quickly  eat small frequent meals 4 to 6 times per day or eat every couple of hours, eat foods high in protein, during first meal eat high calorie and protein food such as cheese, high fat and yogurt, peanut butter, cream cheese, or cream soups with whole milk, add gravies and sauces to meat, poultry, and side dishes drink milk shakes or meal replacement/  protein drink between meals consider a multivitamin supplements if you are not eating enough (50% or less)  
  Taste changeseat foods that are bland to start and then add flavour, try colder foods to start since hot foods can have a strong taste, add sugar, salt, seasonings to flavour food, use sour candies, mints or gum before and after meals if your mouth is dry brush teeth regularly

Other recommendations

Always try to be busy with some little work, make yourself active with engagement in daily life activities. You need adequate sleep. Try to make same sleeping time every day. You may need support in recovery post-COVID. So, take help from your friends and family.

This recommendation is for normal people with no other complications. If you have other problems and disease conditions, kindly take help from a dietician. For now, Sochai has been collaborating with Nepal Dietetic Association and Diet Clinic and Nutrition Counseling Centre to initiate free tele-nutrition service. Take advantage of this free tele-nutrition counseling service from experts to improve your health and nutrition status.

Kiran Tiwari is a Dietitian at Chitwan Medical College

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