Extrapulmonary features of post-COVID-19 patients: muscle function, physical activity, mood, and sleep quality

Abstract

Background Coronavirus disease 2019 (COVID-19) represents a wide range of clinical manifestations, even if mild disease severity. It has been known that pulmonary function is affected by COVID-19 during infection and mid-to-long term. However, there is inadequate evidence about extrapulmonary features in post-COVID-19 patients. Aims This study aimed to investigate extrapulmonary features in post-COVID-19 patients who recovered from mild and moderate disease severity in the mid-term. Methods This cross-sectional study was carried out after at least 12 weeks from the COVID-19 diagnosis. Disease severity was defined using criteria for clinical severity of confirmed COVID-19 pneumonia. The peripheral muscle strength was measured using the dynamometer. Physical performance was assessed with five times sit-to-stand and 4-m gait speed. Physical activity level (PAL), mood, and sleep quality were assessed with the International Physical Activity Questionnaire, Hospital Anxiety, and Depression Scale, and Pittsburgh Sleep Quality Index, respectively. Results A total of 48 participants with post-COVID-19 (39.2 ± 7.9 years, 54.2% women) were included in the study. Handgrip and quadriceps weakness was observed in 39.6% and 35.4% of the participants, respectively. PAL was low in 39.6%, moderate in 33.3%, and high in 27.1% of the participants. Anxiety, depression, and poor sleep quality were observed in 33.3%, 29.2%, and 50% of the participants, respectively. Conclusions Extrapulmonary features are adversely affected in a substantial proportion of post-COVID-19 patients who recovered from mild and moderate disease severity in the mid-term. Comprehensive assessment and appropriate intervention strategies should also be considered for non-severe post-COVID-19 patients.

Postural balance and its association with functionality and quality of life in non‐hospitalized patients with post‐acute COVID‐19 syndrome

“…Unlike our study, which showed no significant differences in HGS between patients with PCS and controls, Tanriverdi et al. ( 2021 ) observed reduced HGS in 39.6% of the participants when they were evaluated 3 months after the diagnosis of COVID‐19. Comparing institutionalized older adults at two moments of the COVID‐19 pandemic, Greco et al.…”

Poor Nutritional Status and Dynapenia Are Highly Prevalent in Post-Acute COVID-19

“…As far as muscle function is concerned, low handgrip strength (HGS), a proxy marker of muscle strength and a marker of sarcopenia, has been associated with all-cause and disease-specific mortality, future function, bone mineral density, fractures, cognition and depression, and hospitalization (13). In critical ICU COVID-19 patients, muscle wasting and decreased muscle strength occurred early and rapidly (14) and still persisted at 3 months from discharge (15); similar observations were also reported in patients who recovered from mild-to-moderate disease (16). Thus, in COVID-19 patients, muscle weakness, fatigue, and low exercise capacity may be related to poor muscle quality and low HGS (17), while a lower HGS is an independent risk factor for disease severity (18,19), longer hospitalization (20), and mortality (21).…”

“…As for muscle function, it is worth recalling that in critical ICU COVID-19 patients, muscle wasting and decreased muscle strength occurred early and rapidly ( 14) and persisted at 3 months from discharge (15), with similar observations also in mild-to-moderate disease (16). COVID-19 can accelerate the aging process of institutionalized older adults (17), while lower HGS is an independent risk factor for disease severity (18,19), hospital stay (20), and mortality (21).…”

Double Trouble—COVID-19 and the Widespread Use of Corticosteroids: Are We Staring at an Osteonecrosis Epidemic?

“…Systemic CS such as dexamethasone (DX) and methylprednisolone (MPS) are frequently used in the treatment of hospitalised and critically ill COVID-19 patients to alleviate “cytokine storm” [ 13 ], and to reduce the need for mechanical ventilation, duration of hospitalisation, and mortality [ 9 – 11 ]. Furthermore, critically ill patients with severe COVID-19 may have an associated adrenal insufficiency which may require CS treatment [ 46 ]. Cano et al [ 10 ] reported that CS was administered in 51.3% of ICU patients, in 35.3% of mechanically ventilated patients, and in 40% with severe COVID-19.…”