This issue of Topics in Clinical Nutrition provides our first collection of articles related to the COVID-19 pandemic. A summary of official nutrition recommendations related to COVID-19 from various organizations, the role of vitamin D in the prevention of COVID-19, a case study highlighting the challenges of enterally feeding a critically ill patient with COVID-19 in the prone position, and the perception of academic and health impacts of COVID-19 by dietetics students is provided. In addition, the effect of nutrition training on health information technology student knowledge, comparison of an online diet assessment tool, the Boden Food Plate, with 24-hour diet recalls, and the knowledge, attitudes, and practices (KAP) toward iron-deficiency anemia (IDA) in Jordanian women are also highlighted.

Detopoulou et al provide an overview of 19 official recommendations related to nutrition in the COVID-19 pandemic provided by international, Asian, European, Canadian, Australian, and US organizations. The recommendations address guidelines for lactation and young children, general health and nutrition, nutrition in high-risk groups, those recovering from COVID-19, and hospitalized patients.

Shoemaker et al provide a review of the role of vitamin D as a nutritional strategy for reducing risk of infection, complications, and mortality from respiratory tract infections (RTIs) including COVID-19. The review encompasses evaluation of vitamin D status and immune function, vitamin D status as a risk factor for RTIs, and vitamin D supplementation as a preventive strategy. Although data support a relationship between adequate vitamin D status and reduced risk of RTIs, the relationship between vitamin D and RTIs requires further study.

Brown et al provide a narrative review and case study highlighting the challenges of providing enteral nutrition (EN) in patients with acute respiratory distress syndrome (ARDS) requiring prone positioning. The results of 3 studies show that EN tolerance was comparable in patients who were fed in prone and supine positions. Findings from a case report of a patient with ARDS due to COVID-19 who was enterally fed in the prone position emphasized the importance of using current guidelines to successfully provide EN. Education of health care team members on nutrition protocols is key to improving clinical outcomes in this patient population.

Coakley and Gonzales-Pacheco conducted a cross-sectional study using an online survey to evaluate US undergraduate dietetics students' perceptions of the COVID-19 pandemic's influence on their academics and physical and mental health. Although 62% identified that their educational needs were met during the pandemic, the same percentage reported that it negatively impacted education quality, and approximately half reported learning less than normal. Health-related findings included increased stress, mental health concerns, and disordered eating. Further research is needed to assess whether the pandemic has negatively influenced the preparedness of RDNs in the long term.

Mousavi Baigi et al conducted a before-after study to examine the effect of nutrition training via a mobile application (app) on the nutrition knowledge of 25 health information technology students in Iran. After 1 month of using the app, students demonstrated an increase in 3 types of nutritional knowledge. A nutrition training intervention through a mobile app may be beneficial in increasing nutrition knowledge, although further research is needed.

Bessell et al compared the online diet assessment tool, the Boden Food Plate, with 24-hour recalls in 42 overweight and obese adults. The differences in energy, macronutrients, and micronutrients between the 2 methods were not statistically significantly different. The Boden Food Plate was found to be comparable with the 24-hour recall but with wide limits of agreement.

Al-Qerem et al conducted a cross-sectional study of 4110 Jordanian women assessing their KAP related to IDA. Although it was found that Jordanian women had adequate knowledge in several areas related to iron and IDA, the factors that most significantly influenced KAP scores were income and education/working field. It was also noted that knowledge about IDA symptoms in children needs improvement. Educational programs could improve KAP related to IDA in this population.

Thank you for your interest in and support of Topics in Clinical Nutrition. We hope you find this compilation of COVID-19 articles and other clinically relevant topics useful to clinical practice and education and training.

-Kelly Kane, MS, RD, CNSC

Editor

Topics in Clinical Nutrition