Meta-Resilience for Covid-19 survivors

Patients with COVID-19 have longer than double the average length of ICU stays. The prolonged ICU stay leads to a significant burden of healthcare systems and puts the Covid-19 survivors at higher risk for developing a state referred to as Persistent Inflammatory Catabolism Syndrome (PICS), which is highly associated with malnutrition in ICU. New ICU nutrition to facilitate the recovery of survivors is urgently needed.

Meta-Resilience is a modified ICU-nutrition program designed to tackle the fragility by unleashing the endogenous resilience. It bypasses the suppression of the conventional ICU nutrition on a metabolic program, which helps control inflammation, promotes post-injury tissue regeneration, and ameliorates neurological disorders. The gain of resilience will allow the COVID-19 survivors and the healthcare system to better adapt to the post-pandemic challenges.

The consistent decrease in in-hospital mortality has yielded more than 
1.3 million COVID-19 survivors worldwide. The recovery for many of 
COVID-19 survivors begins in the intensive care unit (ICU). COVID-19 patients typically have long ICU stays (from 10 days to 1 month or more, versus ~4 days in average) and are at higher risk for developing Persistent Inflammatory Catabolism Syndrome (PICS), which is highly associated with malnutrition in ICU. An improved ICU nutrition, therefore, is urgently needed to ease the burden of current healthcare systems and to prepare them for the next pandemic challenges.

I propose an application of a nutrition strategy focusing on diet-induced metabolic responses and metabolite signaling to improve early rehabilitation in ICU. The nutrition program, Meta-Resilience, is designed to induce an anti-inflammatory and pro-regenerative metabolic state that is otherwise deficient with conventional ICU nutrition. The effects on multi-organ resilience have been extensively tested in the preclinical models of infections, injuries, and aging. The targeted metabolic and hormonal responses have also been demonstrated to be feasible in human trials.

ICU patients, including 1.3 million of COVID-19 survivors worldwide. Healthcare systems, including hospitals with >80% occupied ICU, worldwide.

Meta-Resilience aims to unleash the endogenous resilience and therefore, the strategy requires no or minimal new materials. It can be easily applied to conventional ICU system and affordable for current ICU patients. The gain of resilience in COVID-19 survivors and the healthcare system will further help the communities around the world better prepare for emerging pandemics and health security threats.