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Summary Background & aims ESPEN guidelines advocate that energy needs of critically ill patients with COVID 19 should be assessed using indirect calorimetry, if safely available. This study described energy needs of intubated patients with COVID-19 and explores whether neuromuscular blockade administration (NMBAs) is associated with altered energy expenditure. Methods Resting energy expenditure (REE) and respiratory exchange rate (RER) evaluated among critically ill intubated COVID-19 patients until 28th day of intensive care unit stay (ICU–S) by indirect calorimetry. Paralysed patients were defined as those with drug induced paralysis using cicatracurium, for at least 3 days during their ICU-S. Results 34 adult COVID 19 patients (59.8% male, 35.2% obese) requiring mechanical ventilation were assessed prospectively. REE measurements suggest a gradual increase of energy needs post 3rd day of ICU-S in both patients without obesity (non ob) ((from 17.8 kcal/kgr up to 29.3 kcal/kgr actual body weight (AcBW) during 28th day of ICU-S, p = 0.011)) and patients with obesity (ob) ((from 18.1 kcal/kgr up to 30.1 kcal/kgr adjusted body weight (AjBW) during 28th day of ICU-S, p = 0.021)). NMBAs use was accompanied by a significant drop in REE, especially during first 7 days of hospitalization, both in non ob (22.9 vs 17.9 kcal/kgr AcBW, p = 0.014) and ob patients (22.5 vs 19.5 kcal/kgr ABW, p = 0.027). Conclusion We identified the energy needs of COVID-19 intubated patients and highlighted a significant increase beyond the 1st week in the ICU. Administration of NMBAs should be considered, as it may impact resting energy expenditure.

Greece has a long tradition in cheesemaking, with 22 cheeses registered as protected designation of origin (PDO), 1 as protected geographical indication (PGI), and 1 applied for PGI. Several other cheeses are produced locally without any registration, which significantly contribute to the local economy. The present study investigated the composition (moisture, fat, salt, ash, and protein content), color parameters, and oxidative stability of cheeses that do not have a PDO/PGI certification, purchased from a Greek market. Milk and cheese types were correctly assigned for 62.8 and 82.1 % of samples, respectively, through discriminant analysis. The most important factors for milk type discrimination were L, a and b color attributes, salt, ash, fat-in-dry-matter, moisture-in-non-fat-substance, salt-in-moisture, and malondialdehyde contents, whereas a and b, and moisture, ash, fat, moisture-in-non-fat substance contents, and pH were the most influential characteristics for sample discrimination according to cheese type. A plausible explanation may be the differences in milk chemical composition between three animal species, namely cows, sheep, and goats and for the manufacture procedure and ripening. This is the very first report on the proximate analysis of these, largely ignored, chesses aiming to simulate interest for further study and production valorization.