Clinical Outcomes and Prevalence of Sarcopenia in Patients with Moderate to Severe COVID-19

Abstract

Background: The purpose of this study was to investigate the effectiveness and clinical outcomes of inpatient rehabilitation for patients with severe COVID-19 in Japan. Methods: Patients with severe COVID-19 who underwent rehabilitation during hospitalization were included. The Medical Research Council (MRC) score and short physical performance battery (SPPB), such as physical function assessment and the intensive care unit (ICU) mobility scale, the functional status score for the ICU, and Barthel index as activities of daily living (ADLs) were evaluated at admission and discharge or transfer from the hospital. The correlation between SPPB at discharge and each factor at admission were also analyzed. Furthermore, the prevalence of sarcopenia was evaluated by defining SPPB of <9 points at discharge as sarcopenia. Results: The median age of the total of 23 patients was 59 years (interquartile range (IQR): 47–67), 73.9% were male, and the median PaO2/FiO2 at admission was 172.0 (IQR: 123.0–209.0). All physical function and ADL parameters were significantly improved from the time of admission to discharge (p = 0.014 for the MRC score and p < 0.001 for all others). Moreover, SPPB at discharge significantly correlated with WBC (Spearman’s rho = −0.473, p = 0.041), C-reactive protein (Spearman’s rho = −0.468, p = 0.044), and exhibited a significant trend with PaO2/FiO2 (Spearman’s rho = 0.429, p = 0.067) and age (Spearman’s rho = 0.409, p = 0.083). Although the median Barthel index at discharge was 90 points, 47% of patients had sarcopenia as defined by an SPPB of <9 points. Conclusions: Early rehabilitation for patients with severe COVID-19 improved physical function and ADLs during hospitalization. However, 47% of patients had the same level of sarcopenia at discharge.

No genetically predicted association between sarcopenia and COVID-19

“…Sarcopenia was reported to be in connection with the increasing severity and morality of COVID-19 [18] . A few studies suggested that patients infected with COVID-19 had a higher incidence of sarcopenia, which varies among patients infected with different types of COVID-19 [19,20] . Patients in ICU who had COVID-19 were inclined to be diagnosed with sarcopenia, compared to other patients hospitalized for COVID-19 [20,21] .…”

“…A few studies suggested that patients infected with COVID-19 had a higher incidence of sarcopenia, which varies among patients infected with different types of COVID-19 [19,20] . Patients in ICU who had COVID-19 were inclined to be diagnosed with sarcopenia, compared to other patients hospitalized for COVID-19 [20,21] . Moreover, the risk of sarcopenia was higher among the patients after severe or moderate COVID-19 infection with prolonged length of hospital stay and invasive mechanical ventilation [22] .…”