Late Breaking/Rapid Science Poster Session 2

(LB02-19-25) The Nutrition Care Process Reduces Mortality Risk in COVID-19 Patients Admitted to the Intensive Care Unit - The RESTORE Nationwide Registry Study

Sunday, June 1, 2025

11:45 AM - 12:45 PM ET

Location: Poster Board D-95

Presenting Author(s)

Taylor C. Wallace, PhD, CFS, FACN, FAND, FASN (he/him/his)

CEO
Think Healthy Group, LLC
Washington, District of Columbia, United States

Co-Author(s)

LW

Lindsay Woodcock

Academy of Nutrition and Dietetics, United States
AS

Alexa Steiber

University of Minnesota, School of Public Health, Division of Epidemiology and Community Health, United States
Zhongqi Fan, MS

Graduate Student
Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University
Malden, Massachusetts, United States
Lauren E. Louck, MS (she/her/hers)

PhD Candidate
Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University
Washington, District of Columbia, United States
Alison L. Steiber, PhD, RDN (she/her/hers)

Chief Mission, Impact and Strategy Officer
Academy of Nutrition and Dietetics
Shaker Heights, Ohio, United States
CP

Constantina Papoutsakis

Academy of Nutrition and Dietetics, United States

Disclosure(s):

Taylor C. Wallace, PhD, CFS, FACN, FAND, FASN: No relevant financial relationship(s) with ineligible companies to disclose.

Objectives: To assess the real-world effectiveness of the nutrition care process (NCP) used by registered dietitian nutritionists (RDNs) on mortality in COVID-19 patients admitted to the ICU.

Methods: RDNs working in 8 ICUs throughout the United States utilized the Academy of Nutrition and Dietetics Health Inframatic Infrastructure (ANDHII) registry platform to document standard care practices, per the NCP, used with COVID-19 patients admitted from April 2021 to April 2022. Mortality was reported for all patients at the last visit and served as the primary outcome. A multivariable logistic regression model, adjusted for sex, age, body mass index (BMI), and number of patient visits by the RDN, was applied to estimate risk of mortality as a function of the NCP problem status (i.e., improving or resolved).

Results: Participants (N=90) were mostly male (68.2%), with a mean age of 57.2 ± 15.7 years. C-reactive protein (CRP) levels were high at baseline (55.9 ± 74.2 mg/L) and about two-thirds of participants were obese (63.7%), per their BMI. A total of 33 patients died over the study duration. The most common NCP problems identified in patients were related to inadequate energy and protein intake, with 62.5% being resolved through enteral nutrition interventions implemented by RDNs. Improvement and resolution of the NCP problem by the RDN was associated with a 86% (OR: 0.14, 95% CI: 0.03 – 0.52, p=0.004) and 89% (OR: 0.11, 95% CI: 0.01 – 0.67, p=0.023) reduced risk of death, respectively.

Conclusions: We show for the first time in a real-world setting that use of the NCP by RDNs significantly reduces risk of mortality among COVID-19 patients admitted to the ICU; however, due to inherent limitations in longitudinal registry study design, a smaller sample size, and use of logistic modeling, future larger-scale cohorts and clinical trials are needed to fully confirm these findings.

Funding Sources: This work was supported by unrestricted educational grants from Nestlé Health Sciences and the Clyde F. Wallace, Jr. Memorial Fund, both administered by the Academy of Nutrition and Dietetics Foundation.