Coronavirus Disease 2019 (COVID-19) has had an impact on nutrition at individual, community, national, and global levels. COVID-19 has been associated with weight loss and also has been linked to cachexia and sarcopenia. Anorexia was the most common symptom during COVID-19 infection among patients at an academic long-term, chronic care facility, with 70.8% of residents developing anorexia during the illness course. In addition to effects of the disease itself, there are potential unintended consequences of infection control measures. A study of residents in a nursing home without a COVID-19 outbreak in the month following implementation of restrictions on visitors and group dining designed to mitigate the spread of COVID-19 showed significant weight loss among residents.
The study found weight loss among both COVID-positive and COVID-negative residents in a nursing home population after a widespread COVID-19 outbreak. Residents who were COVID-positive had both a larger absolute weight loss and trended toward a larger percentage weight loss. This is the first study that we are aware of that shows clinical evidence of a consistent weight loss trend in an SNF population during and after a COVID-19 infection that is distinct from weight loss related to restrictive infection control measures.
Weight loss in older adults has been associated with mortality overall and is a common feature of other geriatric syndromes. These findings support the call to proactively address COVID-19 associated weight loss as part of a COVID-19 management strategy at SNFs. Creative strategies and policies are needed to ensure residents receive adequate mealtime support, symptom management, weight monitoring, and comprehensive nutrition assessments. What is your team doing to address this troubling “side-effect” of COVID-19? Walk your halls during mealtimes and observe how residents are served, what they are consuming, if there is enough social interaction, etc. Remember, dining is a “social event,” the one thing most residents look forward to in their day. Talk to your caregivers and bring some ideas to your QAPI committee!
Stay the course, stay well, mask up, get vaccinated, and stay tuned!