Hypermetabolism and Coronavirus Disease 2019
Pey‐Jen Yu, Hugh A. Cassiere, Sarah DeRosa, Karl Bocchieri, Shaher Yar, Alan Hartman
Abstract
Abstract Background Hypermetabolism has been described in stress states such as trauma, sepsis, acute respiratory distress syndrome, and severe burn injuries. We hypothesize that patients with Coronavirus disease 2019 (COVID‐19) may develop a hypermetabolic state, which may be a major contributing factor to the extraordinary ventilatory and oxygenation demands in patients with COVID‐19. Method Resting energy expenditure (REE), carbon dioxide production (VCO 2 ), and oxygen consumption (VO 2 ) were measured by indirect calorimetry on 7 critically ill patients with COVID‐19. Results The median measured REE was 4044 kcal/d, which was 235.7% ± 51.7% of predicted. The median VCO 2 was 452 mL/min (range, 295–582 mL/min), and the median VO 2 was 585 mL/min (range, 416–798 mL/min). Conclusion Critically ill patients with COVID‐19 are in an extreme hypermetabolic state. This may explain the high failure rates for mechanical ventilation for these patients and highlights the potential need for increased nutrition requirements for such patients.