Long Term Follow-Up of Sarcopenia and Malnutrition after Hospitalization for COVID-19 in Conventional or Intensive Care Units

Abstract

Background: The post-COVID-19 condition, defined as COVID-19-related signs and symptoms lasting at least 2 months and persisting more than 3 months after infection, appears now as a public health issue in terms of frequency and quality of life alterations. Nevertheless, few data are available concerning long term evolution of malnutrition and sarcopenia, which deserve further attention. Method: Sarcopenia was investigated prospectively, together with weight evolution, at admission and at 3 and 6 months after hospital discharge in 139 COVID-19 patients, using the European Working Group on Sarcopenia in Older People (EWGSOP2) criteria, associating both decreased muscle strength and muscle mass, assessed, respectively, with hand dynamometer and dual-energy X-ray absorptiometry. Results: Of the 139 patients, 22 presented with sarcopenia at 3 months; intensive care units (ICU) length of stay was the sole factor associated with sarcopenia after multivariate analysis. Although the entire group did not demonstrate significant weight change, weight decreased significantly in the sarcopenia group (Five and eight patients, showing, respectively, > 5 or > 10% weight decrease). Interestingly, at 6 months, 16 of the 22 patients recovered from sarcopenia and their weight returned toward baseline values. Conclusions: Sarcopenia and malnutrition are frequently observed in patients hospitalized for COVID-19, even 3 months after infection occurrence, but can largely be reversed at 6 months after discharge. Enhanced patient care is needed in sarcopenic patients, particularly during long stays in an ICU.

Prevalence of Sarcopenia in Patients With COVID-19: A Systematic Review and Meta-Analysis

“…Figure 1 presents the PRISMA diagram for the study selection and reasons for exclusion. (25,30,50,51), 2 from France (43,49), 3 from the United Kingdom (27,48,53), 1 from Germany (52), and 1 from Netherlands (45)], and the rest of included studies (7/21) included individuals from Asia [3 from China (31,33,46), 2 from Turkey (26,32), and 1 from South Korea (42)] and North America [2 from Mexico (29,47)]. Only three included studies had a cross-sectional design (32,44,50), and the remaining eighteen studies were observational cohort studies (25-27, 29-31, 33, 41-43, 45-49, 51-53).…”

“…The 21 included studies comprised of 5,407 patients with COVID-19 with the mean age ranging from 44.5 to 86.1 years. Most studies (14/21) included individuals from Europe [2 from Spain ( 41 , 44 ), 4 from Italy ( 25 , 30 , 50 , 51 ), 2 from France ( 43 , 49 ), 3 from the United Kingdom ( 27 , 48 , 53 ), 1 from Germany ( 52 ), and 1 from Netherlands ( 45 )], and the rest of included studies (7/21) included individuals from Asia [3 from China ( 31 , 33 , 46 ), 2 from Turkey ( 26 , 32 ), and 1 from South Korea ( 42 )] and North America [2 from Mexico ( 29 , 47 )]. Only three included studies had a cross-sectional design ( 32 , 44 , 50 ), and the remaining eighteen studies were observational cohort studies ( 25 – 27 , 29 – 31 , 33 , 41 – 43 , 45 – 49 , 51 – 53 ).…”

“…Most studies (14/21) included individuals from Europe [2 from Spain ( 41 , 44 ), 4 from Italy ( 25 , 30 , 50 , 51 ), 2 from France ( 43 , 49 ), 3 from the United Kingdom ( 27 , 48 , 53 ), 1 from Germany ( 52 ), and 1 from Netherlands ( 45 )], and the rest of included studies (7/21) included individuals from Asia [3 from China ( 31 , 33 , 46 ), 2 from Turkey ( 26 , 32 ), and 1 from South Korea ( 42 )] and North America [2 from Mexico ( 29 , 47 )]. Only three included studies had a cross-sectional design ( 32 , 44 , 50 ), and the remaining eighteen studies were observational cohort studies ( 25 – 27 , 29 – 31 , 33 , 41 – 43 , 45 – 49 , 51 – 53 ). A total of eleven included studies ( n = 1,603 patients with COVID-19) described the specific sarcopenia events between male and female patients with COVID-19 ( 26 , 29 – 31 , 42 , 43 , 47 , 49 – 52 ).…”

“…Of the three studies conducted in the United Kingdom (27,48,53), the pooled prevalence of sarcopenia was 41.2% (95% CI: 0 to 98.9%, k = 3, I 2 = 99.60%, p = 0.000). Among the 2 studies conducted in France (43,49), the pooled prevalence of sarcopenia was 21.8% (95% CI: 15.6 to 28.7%, k = 2, I 2 = 96.50%, p = 0.000). The prevalence in the 2 Mexico studies (29, 47) was 25.4% (95% CI: 21.9 to 28.9%, k = 2, I 2 = 95%, p = 0.000).…”

The Effects of the ‘Catabolic Crisis’ on Patients’ Prolonged Immobility after COVID-19 Infection

“…The results of the study indicate the presence of sarcopenia (SARC-F score ≥ 4) in 37.21% (group C) and 32.39% (group NC), respectively. D. Levy et al demonstrate the incidence of sarcopenia in 16% ( 22) of 139 patients evaluated 3 months after the onset of COVID-19 infection [43]. The only risk factor identified was prolonged hospitalization due to viral infection.…”