Nutrition & Hydration for People Recovering from COVID-19

posted by Judy Erickson, RDN, LD on Friday, April 24, 2020

Our Spencer Hospital team is prepared to care for a potential influx of patients who test positive for COVID-19 and require hospitalization.  Yet, according to the Center for Disease Control & Prevention’s COVID-19 Response Team only about 12 percent of those infected will require hospitalization; the remaining 88 percent will recover at home. Our goal is to provide healthcare resources for all those in need of care.

If you are a caregiver for someone recovering at home, what should you do?  Fighting a fever burns more energy (calories) and causes more fluid loss.  So even if a person does not feel hungry or thirsty, it is important to keep eating (to provide energy) and drinking fluids to replace fluids lost through sweating, coughing, urinating, etc.  Eating and drinking are just two “weapons” your body needs to fight the virus & support your immune system.

So what fluids to drink?

Water; clear fruit juices, like apple, grape, cranberry; broth; popsicles; Jello; ginger ale, Sprite, 7-Up.  If you are vomiting or having diarrhea, try to drink beverages that have some calories, electrolytes (like sodium & potassium), and minerals. Examples of these include sports drinks, Abbott Nutrition Ensure Clear or Nestle’s Nutrition Boost Breeze.  Or you can make your own using this simple recipe provided by ASPEN (American Society of Parenteral & Enteral Nutrition):

Rehydration Solution Recipe

Mix the following in a pitcher:

• ½ to ¾ tsp salt
• 1 cup of juice (orange, grape, apple, or cranberry)
• 3 ½ cups (8 ounce cups) of water.

How much fluid should you drink?

• An adult should drink a minimum of 8 – 8 ounce cups up to 12- 8 ounce cups in 24 hours. (If you have every been told to follow a fluid restriction or have had low sodium levels, talk to your doctor first).
• Take frequent, small sips every few minutes if you are not able to drink large amounts at one time.
• Use a variety of beverages, so you don’t get tired of the same ones.
• Keep liquids at your bedside at all times to sip on.

A good way to know if you are drinking enough is by observing the color of your urine.  If it is dark colored, you need to drink more.  If you are passing light colored urine every 3-4 hours, you are probably drinking enough.

Providing Calories & Protein

Your body needs calories and protein to maintain its metabolic functions and body weight during this critical time.  Protein and calories are important to protect against muscle loss while you are fighting COVID-19, especially if you are bedridden or inactive.  Muscle loss may make you feel weaker and may affect your ability to get out of bed, walk, and function at home.  Rebuilding muscle takes a long time, so preventing muscle loss is best.

What foods are high in calories & protein?

Milk, eggs, peanut butter or other nut butters, nuts, yogurt, especially Greek yogurt, cheese, cottage cheese, meat, chicken, fish, protein shakes, smoothies and commercial supplements, such as Ensure, Boost, and Carnation Instant Breakfast.  One may increase calories in foods by adding butter, sour cream, cream cheese or avocado to them.  Add half and half, brown sugar, maple syrup, dried fruit or peanut butter to oatmeal. Use extra mayonnaise and butter on sandwiches; add some cheese.  Add half & half, butter, or sour cream to a soup or vegetables.

How many calories do you need?

Normally you need 1500 to 2000 calories per day, but with increased stress on your body with infection, you need 400 to 500 calories more per day for a total of 1900 to 2500 calories.

How much protein do you need?

Normally about 60 grams of protein is needed, but, when fighting infection, 75 to 100 grams is recommended. Three ounces of skinless chicken breast provides about 28 grams of protein, while one egg has 6 grams.  One 8-ounce cup of milk has 8 grams of protein.

If you are not able to eat enough food, nutrition supplement drinks may be an easy way to help consume the calories and protein you need.  Look for ones that provide at least 150 calories (the higher the better) and 15 to 30 grams of protein per 8 ounce serving.  Sip on a chilled supplement throughout the day.  If you are unable to eat regular food, drink more supplements.

Weighing yourself daily can help you determine if you are eating and drinking enough.  Weight loss can indicate fluid loss, muscle loss and fat loss, and that you need to eat and drink more.

As you recover from your infection, continue to eat a high calorie, high protein diet.  This, along with regular activity and exercise, will help you regain strength and get you back to your normal activities.

Together, we will get through this!

Information adapted from American Society of Parenteral & Enteral Nutrition (ASPEN) online resource by Judy Erickson, RDN, LD for Spencer Hospital.