The impact of glutamine supplementation on the short-term mortality of COVID-19 diseased patients admitted to the ICU: A single-blind randomized clinical trial

Abstract

Background Intravenous glutamine supplementation of nutrition in ICU patients is based on substantial clinical evidence that it boosts the immune system, particularly by inhibiting inflammatory reactions. This study aimed to see how glutamine affected COVID-19 short-term ICU mortality (7 days) and its clinical course. Methods Sixty patients were randomized in this single-blind clinical study and were divided into equal groups. Group EN, was delivered with standard enteral nutrition. Group GN was delivered intravenous glutamine supplementation to enteral nutrition. Both groups were monitored and assessed for 7 days. Short-term ICU mortality, monitoring of the inflammatory response and oxygenation, were compared between the two groups. Results During the 7-day follow-up period, ten patients (33.3%) died in the GN group, compared to 11 patients (37.6%) in the EN group, with no statistically significant difference between the two groups. On the 7th day, both NLR and PLR showed considerably higher values in the EN group than in the GN group, and on the 4th day, the PLR ratio showed significantly higher values in the EN group than in the GN group. In terms of unsuccessful enteral nutrition and transition to total parenteral nutrition, group GN had a considerably lower rate than group EN (ten patients (33.3%) against 22 patients (73.3%), respectively, P-value = 0.002). Conclusions Although there is little indication that glutamine supplementation could prevent short-term mortality in COVID-19 ICU admitted patients, the GN group had a lower inflammatory response and fewer patients switched to total parenteral nutrition.

Keywords

• covid-19
• glutamine supplementation
• severe acute respiratory syndrome coronavirus 2 (sars-cov-2)
• short-term mortality