A new article published by the American Society of Parenteral and Enteral Nutrition stated that the body loses water in febrile conditions. For an adult with fever of 102oF or 39oC, sweating alone, results in the loss of about 30 ounces of fluid every 24 hours—with an additional 3 ounces lost during coughing and breathing. Nausea, vomiting and diarrhea, as well as inadequate food intake and poor appetite further contribute to fluid deficit.

Hydration and nutrition play an important role in the body’s response to recovery from COVID-19 virus – and form an essential part of the medical treatment. Precautionary measures for the prevention and management of COVID-19 include:

• Drinking adequate water and clear fluids – one must 2-4 ounces of fluid every 15 minutes.
• Monitoring for signs of dehydration and body weight – increase fluid intake to ensure that you are passing light yellow urine every 3-4 hours.
• Intake of oral rehydration solution (ORS) should be advocated in the case of occurrence of vomiting or diarrhea.
• The optimal liquids recommended are clear liquid beverages containing calories and protein, ORS or sports drinks. Such fluids provide the body with sufficient calories and essential electrolytes and minerals.
• ORS provides the body with essential electrolytes and minerals that are lost during dehydrating conditions.
• Rehydration drink recipe – a mix of ½ - ¾ tsp salt; 1 cup of fresh fruit juice; and 3 ½ cups of water.
• A high-calorie, high-protein diet is recommended, to maintain the muscle mass. The use of oral nutritional supplements may be helpful.
• For normal weight maintenance, caloric intake should be 1500-2000 calories. This should be increased by 400-500 calories during episodes of increased stress and infection.
• Approximately, 75-100 grams of protein – or 10-14 ounces of a protein source, is needed per day.
• Bad taste in the mouth is common during infectious sates and dehydration. Nevertheless, food intake should be maintained to sustain body mass and functions.
• Cool room temperature foods may taste better to some patients who are sensitive to food odors.
• If patients complain of metallic taste in the mouth – advise eating with plastic utensils.
• Less sweet foods must be chosen; add sugar if foods and beverages seem too salty or bitter.
• Encourage addition of spices to flavor plain foods.
• Patients who are unable to eat regular foods should be given additional servings of nutritional supplements.
• Sipping child oral nutritional supplements should be advised, throughout the day.
• Optimize the intake of oral nutritional supplements that provide a minimum of 150 calories and 15-30 grams of proteins per 8 ounces.
• Monitor body weight daily. Weight loss during illness indicates reducing muscle mass, which can lead to weakness and inability to perform daily chores. Preventing weight loss during the acute phase of illness will speedup recovery.
• The recovery period after COVID-19 should incorporate a high-calorie, high-protein diet, along with regular exercise—to reinstate the muscle mass and strength.

Source: American Society of Parenteral and Enteral Nutrition. 2020 ASPEN. Available from: https://www.nutritioncare.org/