Clinical efficacy of eucaloric ketogenic nutrition in the Covid-19 cytokine storm (CSS): a retrospective analysis of mortality and Intensive Care Unit admission
SG Sukkar Nutrition Available online 7 March 2021,
Highlights
• Nutritional therapies in Covid-19 have never been investigated before.
• Eucaloric Ketogenic Diet (EKD) is safe and feasible in patients with Covid-19.
• EKD could reduce mortality and ICU access in patients with Covid-19.
• EKD seems to have a role in modulate inflammatory markers in particular on IL-6.
• Further studies are mandatory to clarify the role of ketogenic nutrition in Covid-19
Objective:
Primary objective is to explore the effect of eucaloric ketogenic diet (EKD) on mortality, admission to intensive care unit (ICU) and the need for non-invasive ventilation (NIV) in hospitalized patients affected by COVID-19 in comparison to eucaloric standard diet (ESD). Secondary objectives are: the verification of safety and feasibility of the diet and its impact on inflammatory parameters, in particular interleukin-6 (IL-6).
Results:
The preliminary multivariate analysis shows a statistical significance in survival (P=0,046) and need for ICU (P=0,049) with EKD compared with ESD.
Considering EKD start day as a "time-dependent" variable, however, the results maintain a positive trend towards the application of the diet and it is not possible to reject the null hypothesis (p <0.05).
IL-6 concentrations between t 0 and t 7 (seven days after the beginning of the diet) in the ketogenic nutrition group shows a trend almost significant (P = 0.062). EKD was safe and no adverse events were observed.
Conclusions:
These results show a possible therapeutic role of EKD in the clinical management of COVID-19. Currently, a prospective controlled randomized trial is running out in order to confirm these preliminary data.