COVID-19 as an Independent Risk Factor for Weight Loss in Older Adults Living in Nursing Homes

Abstract

Introduction In nursing homes, where residents are at elevated risk for malnutrition, the specific additive effect of the coronavirus disease 2019 (COVID-19) on weight loss has not yet been adequately evaluated. This study aimed to determine the factors independently associated with weight loss in nursing home residents who survived the first wave of the COVID-19 pandemic, whether they have contracted COVID-19 or not. Methods This research was a retrospective study conducted in three nursing homes. Residents who survived the first French COVID-19 lockdown (March to May 2020) were included, provided their weight records were available. Baseline data included the body mass index (BMI), capacity to self-feed, need for texture-modified food, disability, and legal guardianship status. The diagnosis of COVID-19 was based on the results of a positive reverse transcriptase-polymerase chain reaction test. Univariate and multivariate logistic regression analyses were used to investigate associations between resident characteristics, COVID-19 status and at least 5% weight loss. Results Of the 316 included residents (72% female, mean age of 88 years, 48% severely disabled, and 38% under legal guardianship), 111 (35%) contracted COVID-19 and 102 (32%) lost at least 5% of their body weight. No difference was observed between the baseline characteristics of residents subsequently affected or unaffected by COVID-19. In the univariate analysis, old age, severe disability, texture-modified food, the need for close mealtime supervision, and COVID-19 were significantly associated with at least 5% weight loss. In the multivariate logistic regression analysis, COVID-19 (p = 0.02) and the need for close mealtime supervision (p = 0.02) were associated with weight loss in a model that also included age, BMI, texture-modified food, disability and nursing home. Discussion/Conclusion For nursing home residents, COVID-19 was an independent risk factor for weight loss. Weight loss was most common in residents needing close mealtime supervision, suggesting that organizational issues may have affected the quality of the nutritional care provided during the lockdown.

Nutrition and Physical Activity as Modulators of Osteosarcopenic Adiposity: A Scoping Review and Recommendations for Future Research

“…However, it is surprising that COVID-19 infection in the Cvijetić et al [ 16 ] study participants did not show any impact on OSA prevalence, weight loss, or nutritional status. This is contrary to the just published study in French nursing homes [ 47 ], where those infected with COVID-19 experienced about 5% of weight loss. Due to some other limitations of both studies, e.g., cross-sectional nature, a small number of participants in Keser et al [ 17 ], and the inability of BIA-ACC device to distinguish bone mass/quality in different skeletal regions, more studies such as this, where OSA can be diagnosed with one instrument (e.g., BIA or DXA) and conducted in critical populations (like nursing home residents), are warranted.…”

Nutrition and Physical Activity as Modulators of Osteosarcopenic Adiposity: A Scoping Review and Recommendations for Future Research

“…However, it is surprising that COVID-19 infection in the Cvijetić et al, [14] study participants did not show any impact on OSA prevalence, weight loss, or nutritional status. This is contrary to the just published study in French nursing homes [46], where those infected with COVID-19 experienced about 5% of weight loss. Due to some other limitations of both studies, e.g., cross-sectional nature, small number of participants in Keser, et al, [15], and inability of BIA-ACC device to distinguish bone mass/quality in different skeletal regions, more studies like this, where OSA can be diagnosed with one instrument (e.g., BIA or DXA) and conducted in critical populations (like nursing home residents), are warranted.…”

Post‐acute sequelae of SARS‐CoV‐2 (PASC) in nursing home residents: A retrospective cohort study

“…One US study explored weight changes among NH residents between March 2020 and May 2020 and found that all residents lost weight over this time period but residents who had COVID‐19 experienced 4.6% greater weight loss compared to non‐infected residents 17 . Potential mechanisms of this weight decrease include loss of taste and smell as a symptom of COVID‐19, as well as decreased mealtime assistance in quarantine 18,19 . NH residents are vulnerable to weight loss that could potentially lead to sarcopenia and nutritional deficiencies, fatigue, and subsequently, functional decline 10 .…”

“…17 Potential mechanisms of this weight decrease include loss of taste and smell as a symptom of COVID-19, as well as decreased mealtime assistance in quarantine. 18,19 NH residents are vulnerable to weight loss that could potentially lead to sarcopenia and nutritional deficiencies, fatigue, and subsequently, functional decline. 10 This study is limited by lack of precise weight trajectories that precludes a direct link with our findings, as weight loss is recorded in MDS data only if greater than 5% of body weight in the past 1 month or 10% in the past 180 days.…”