key: cord-0699552-dgqtu3zp authors: Caccialanza, Riccardo; Lobascio, Federica; Masi, Sara; Crotti, Silvia; Cereda, Emanuele title: Early nutritional supplementation in non-critically ill coronavirus disease 2019 (COVID-19) patients date: 2020-11-06 journal: Nutrition DOI: 10.1016/j.nut.2020.111050 sha: 362d9eea109a22211bc61519be2dd34b6ed8910f doc_id: 699552 cord_uid: dgqtu3zp nan We read with interest the letter of Piquet et al. (1) , who presented their nutritional management protocol in hospitalized non-ICU coronavirus disease 2019 (COVID-19) patients. While certainly sharing the same ideas on the fundamental importance of early nutritional management of hospitalized COVID-19 patients, we would like to point out the following clarifications. We did not mention any restrictive and/or low-sugar/low-salt diet in our protocol, but we indicated that high-calorie dense diets in a variety of different textures and consistencies with highly digestible foods and snacks (yogurt, custard, fruit mousse, sliced fruit, soft cheese, etc.) were available for all hospitalized patients, in order to favour the maintenance/increase of protein-calorie intake (2) . With regards to nutritional screening an assessment, we are well aware that most patients reduce their food intake during the early phases of the disease and that a nutritional supplementation is likely to be promptly necessary. For this purpose, we proposed a systematic supplementation of whey proteins orally (20 g/day) and multivitamin, multimineral, trace elements solutions intravenously upon admission. However, we believe that a basic nutritional assessment should be performed for trying to tailor nutritional interventions according to actual calorie-protein needs. This was certainly hard to implement during the beginning of the COVID-19 outbreak, but the current situation would allow the safe recording of most nutritional parameters and the customization of nutritional support. Similarly, the initial emergency scenario In conclusions, we are happy that our article stimulated the development and adoption of several protocols aimed at promptly implementing nutritional care in COVID-19 patients, and we hope that early appropriate nutritional management will be systematically considered in this fragile patient population, as it is potentially beneficial to clinical outcomes and effective in preventing the consequences of malnutrition. Early nutritional supplementation in non-critically ill patients hospitalized for the 2019 novel coronavirus disease (COVID-19): Rationale and feasibility of a shared pragmatic protocol Early nutritional supplementation in non-critically ill patients hospitalized for the 2019 novel coronavirus disease (COVID-19): Rationale and feasibility of a shared pragmatic protocol Perspective: Vitamin D deficiency and COVID-19 severity -plausibly linked by latitude, ethnicity, impacts on cytokines, ACE2 and thrombosis Optimal Nutritional Status for a Well-Functioning Immune System Is an Important Factor to Protect against Viral Infections The authors declare no conflict of interest.