tetano
Editor, Senior Moderator
Nutrition
. 2021 Mar 7;89:111236.
doi: 10.1016/j.nut.2021.111236. Online ahead of print.
Clinical efficacy of eucaloric ketogenic nutrition in the COVID-19 cytokine storm: A retrospective analysis of mortality and intensive care unit admission
Samir Giuseppe Sukkar[SUP] 1 [/SUP], Ludovica Cogorno[SUP] 2 [/SUP], Livia Pisciotta[SUP] 3 [/SUP], Andrea Pasta[SUP] 3 [/SUP], Antonio Vena[SUP] 4 [/SUP], Raffaella Gradaschi[SUP] 3 [/SUP], Chiara Dentone[SUP] 4 [/SUP], Erica Guiddo[SUP] 3 [/SUP], Eleonora Martino[SUP] 3 [/SUP], Sabrina Beltramini[SUP] 5 [/SUP], Lorenzo Maria Donini[SUP] 6 [/SUP], Luca Carmisciano[SUP] 7 [/SUP], Maria Pia Sormani[SUP] 7 [/SUP], Matteo Bassetti[SUP] 4 [/SUP], GECOVID Study Group
Affiliations
Abstract
Objectives: Our primary objective was to explore the effect of a eucaloric ketogenic diet (EKD) on mortality, admission to the intensive care unit, and need for non-invasive ventilation in hospitalized patients with COronaVIrus Disease 19 (COVID-19), in comparison to a eucaloric standard diet. Secondary objectives were verification of the safety and feasibility of the diet and its effects on inflammatory parameters, particularly interleukin-6.
Methods: The study is a retrospective analysis of 34 patients fed with an EKD in comparison to 68 patients fed with a eucaloric standard diet, selected and matched using propensity scores 1:2 to avoid the confounding effect of interfering variables. Our hypothesis was that an EKD would reduce mortality, admission to the intensive care unit, and need for non-invasive ventilation in patients with COVID-19.
Results: The preliminary multivariate analysis showed a statistically significant difference in survival (P = 0.046) and need for the intensive care unit (P = 0.049) for the EKD compared with a eucaloric standard diet. Even considering the EKD start day as a time-dependent variable, the results maintain a positive trend for application of the diet, and it is not possible to reject the null hypothesis (P < 0.05). Interleukin-6 concentrations between t0 and t7 (7 d after the beginning of the diet) in the ketogenic nutrition group show a trend that is almost significant (P = 0.062). The EKD was safe and no adverse events were observed.
Conclusions: These results show a possible therapeutic role of an EKD in the clinical management of COVID-19. Currently, a prospective controlled randomized trial is running to confirm these preliminary data.
Keywords: Aerobic glycolysis; COVID-19; Cytokine storm syndrome; Hyperglycemia; IL-6; Ketogenic diet; SARS-CoV-2; Warburg effect.
. 2021 Mar 7;89:111236.
doi: 10.1016/j.nut.2021.111236. Online ahead of print.
Clinical efficacy of eucaloric ketogenic nutrition in the COVID-19 cytokine storm: A retrospective analysis of mortality and intensive care unit admission
Samir Giuseppe Sukkar[SUP] 1 [/SUP], Ludovica Cogorno[SUP] 2 [/SUP], Livia Pisciotta[SUP] 3 [/SUP], Andrea Pasta[SUP] 3 [/SUP], Antonio Vena[SUP] 4 [/SUP], Raffaella Gradaschi[SUP] 3 [/SUP], Chiara Dentone[SUP] 4 [/SUP], Erica Guiddo[SUP] 3 [/SUP], Eleonora Martino[SUP] 3 [/SUP], Sabrina Beltramini[SUP] 5 [/SUP], Lorenzo Maria Donini[SUP] 6 [/SUP], Luca Carmisciano[SUP] 7 [/SUP], Maria Pia Sormani[SUP] 7 [/SUP], Matteo Bassetti[SUP] 4 [/SUP], GECOVID Study Group
Affiliations
- PMID: 33895559
- DOI: 10.1016/j.nut.2021.111236
Abstract
Objectives: Our primary objective was to explore the effect of a eucaloric ketogenic diet (EKD) on mortality, admission to the intensive care unit, and need for non-invasive ventilation in hospitalized patients with COronaVIrus Disease 19 (COVID-19), in comparison to a eucaloric standard diet. Secondary objectives were verification of the safety and feasibility of the diet and its effects on inflammatory parameters, particularly interleukin-6.
Methods: The study is a retrospective analysis of 34 patients fed with an EKD in comparison to 68 patients fed with a eucaloric standard diet, selected and matched using propensity scores 1:2 to avoid the confounding effect of interfering variables. Our hypothesis was that an EKD would reduce mortality, admission to the intensive care unit, and need for non-invasive ventilation in patients with COVID-19.
Results: The preliminary multivariate analysis showed a statistically significant difference in survival (P = 0.046) and need for the intensive care unit (P = 0.049) for the EKD compared with a eucaloric standard diet. Even considering the EKD start day as a time-dependent variable, the results maintain a positive trend for application of the diet, and it is not possible to reject the null hypothesis (P < 0.05). Interleukin-6 concentrations between t0 and t7 (7 d after the beginning of the diet) in the ketogenic nutrition group show a trend that is almost significant (P = 0.062). The EKD was safe and no adverse events were observed.
Conclusions: These results show a possible therapeutic role of an EKD in the clinical management of COVID-19. Currently, a prospective controlled randomized trial is running to confirm these preliminary data.
Keywords: Aerobic glycolysis; COVID-19; Cytokine storm syndrome; Hyperglycemia; IL-6; Ketogenic diet; SARS-CoV-2; Warburg effect.