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The world is currently facing the coronavirus disease (COVID-19) pandemic which places great pressure on health care systems and workers, often presents with severe clinical features, and sometimes requires admission into intensive care units. Derangements in nutritional status, both for obesity and malnutrition, are relevant for the clinical outcome in acute illness. Systemic inflammation, immune system impairment, sarcopenia, and preexisting associated conditions, such as respiratory, cardiovascular, and metabolic diseases related to obesity, could act as crucial factors linking nutritional status and the course and outcome of COVID-19. Nevertheless, vitamins and trace elements play an essential role in modulating immune response and inflammatory status. Overall, evaluation of the patient's nutritional status is not negligible for its implications on susceptibility, course, severity, and responsiveness to therapies, in order to perform a tailored nutritional intervention as an integral part of the treatment of patients with COVID-19. The aim of this study was to review the current data on the relevance of nutritional status, including trace elements and vitamin status, in influencing the course and outcome of the disease 3 mo after the World Health Organization's declaration of COVID-19 as a pandemic., Highlights • Derangements in nutritional status can influence the course of coronavirus disease (COVID-19). • Obesity may worsen the outcome of COVID-19, requiring the most intensive care. • Vitamins and trace elements have a crucial role in immunomodulation.

Short-Bowel-Syndrome (SBS) is one of the most common causes of a rare disease: Intestinal-Failure (IF). Home-Parenteral-Nutrition (HPN) is a life-saving-therapy, the main and most effective medical-nutritional treatment to prevent malnutrition in SBS. A regular monitoring of the nutritional-status is essential to estimate the effectiveness of the treatment. We detected anthropometric measures, BIA-BIVA, parenteral-enteral nutrition-intakes and outputs (diuresis-feces-stoma) to describe the trends during 1year follow-up from the beginning of the HPN. We collected data on 39-SBS patients (M23+F16), age 63±13, residual-bowel-length cm103±54 (65% patients without ileocecal-valve, 64% with Ileostomy) in charge to our center during the last 2 year (T0 = early-assessment-treatment, T1 = after 2-months, T2 = after 6-months, T3 = after-1 year) to assess nutritional status using BIA-BIVA values, BMI, nutritional intakes and outputs. Body composition trend is described in tab.1. We found a significant reduction in TBW% both for males and females from T0vsT3 (p BIVA may represent a simple and affordable non-invasive way to monitor SBS patients, helping nutritional follow-up during HPD. Our results suggest an adaptation of residual-bowel-function after 1-year confirmed by a reduction of fecal-output. An increase in oral-intake was observed which allowed a reduction of parenteral-nutrition burden. Strict and adequate nutritional monitoring is a key-point to obtain improvements in body-composition and nutritional-status in these patients.

In this retrospective-observational study we investigated on the role of p-citrulline as a possible marker of dependence on PN with a cut-off of 20 µmol/l. Fasting p-citrulline was analyzed with Ion-Exchange HPLC in IICB patients enrolled in SC Dietetics and Clinical Nutrition. Inclusion criteria: small bowel length Data reported were expressed as median (range) or mean (± ds) as appropriate. Correlations and a multivariate analysis were performed between p-cit and age, intestinal features, eGFR and PN nutrition. Twenty-seven 21- 82 years old (14M/13F) patients participated in this study; small bowel length was 60 cm (2-200); percent of colon: 50% (0-100); ileo-cecal valve 1 yes/26 no; diagnosis: 11 pts mesenteric vasculopathy, 6 pts surgical outcome, 7 pts IBD, 3 pts other diseases. HPN duration 712 days (167-7239); PN energy: 69,6 %BEE (5-120); PN volume 1900 ml (1000-3600); BMI 21,8 kg/m2 (16-32,1); eGFR 78 ml/min/1,73m2 (43-141); p-cit (reference range 29.1-42.8 µmol/l): 24,5 µmol/l (5-49,6); 9 pts 29,1 µmol/l: 33,3 % of pts was below literature cut-off. Significant correlations were found for: age, r=0,418 (p ≤ 0,05); small bowel length, r = 0,48 (p ≤ 0,01); eGFR, r= −0,4 (p ≤ 0,05); PN-energy, r = −0,49 (p ≤ 0,01); PN volume, r= −0,48 (p≤0,01). The multivariate analysis confirms the correlation with the same variables (F = 4,26; P = 0,0079). The significant correlation between p-cit and small bowel length confirmed p-cit as a possible indicator of spontaneous bowel adaptation but different cut-off for PN dependence could be assessed beacause the 66,6% of pts in HPN had values > 20 µmol/l.