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

Blasio, Francesco De; Scalfi, Luca; Castellucci, Bianca; Sacco, Anna Maria; Berlingieri, Giulia Miracco; Capitelli, Ludovica; Alicante, Paola; Sanduzzi, Alessandro; Bocchino, Marialuisa

doi:10.3389/fnut.2022.888485

Cited by 6 publications

(6 citation statements)

References 55 publications

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“…As well, very few reports commented on whether a possible role for vitamin D insufficiency was worthy of consideration as far as mediating COVID risk and its severity [22] even though this along with a calcium deficit might explain some degree of pain and muscle weakness and depression described by COVID survivors, plus a possible bone loss [23]. Also observed has been a high prevalence of skeletal complications, such as vertebral fractures, poor nutritional status and bone mass declines [24] that could stem from deficits in both calcium and vitamin D, plus poorly managed post acute COVID-19 complications. Muscle based com-plications have appeared to emerge following a COVID-19 infection and that can lead to or account for symptoms of fatigue, lower mobility, weakness, and declines in function [25], along with an array of cognitive and physical ability deficits [26,27].…”

Section: Resultsmentioning

confidence: 99%

https://actascientific.com/ASOR/pdf/ASOR-06-0704.pdf

Marks¹

2023

Act Scie Ortho

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Since the emergence of the novel virus later termed COVID-19, its rate of infection and its widespread impact remains an immense public health concern and challenge. But how specifically can orthopaedic problems such as hip fractures and falls injuries, plus painful arthritis become specifically impacted? This mini review updates what is known about the recently observed long COVID syndrome neuromuscular challenges not apparently associated with their health history profile in all cases. A second was to establish if any health associated preventive and intervention can be recommended especially for the older adult with long COVID-19 manifestations, who may still be very vulnerable to falling, and fracturing a bone, plus varying degrees of joint pain. Although long COVID symptoms have been attributed to psychosocial factors, it appears that more attention to how COVID-19 can induce neuromuscular disability through biological mechanisms is indicated. Abbreviations SARS-COV-2 2019: Severe Acute Respiratory Syndrome-Coronavirus-2 Infection Introduction As of January 2023, endless reports pertaining to the outcomes of a lethal and novel corona virus later termed COVID-19 that emerged in Wuhan, China in December 2019 prevail. A pandemic of immense proportion [1], now, over three years since its onset, COVID-19 disease and its variants not only remain a serious global health concern, but a subgroup of older as well as younger postacute COVID-19 survivors are now found to manifest a wide array of persistent physical, neurological, functional, and mental health complaints deemed attributable to COVID-19 and variably termed 'long or post-acute COVID-19' syndrome [2,3-5]. As per current data, this complex non uniform health condition, which can manifest for up to one year, and possibly longer, is especially common in older COVID-19 survivors, who often have underlying multiple health conditions impacting multiple body systems including the neurological and musculoskeletal systems [5,6]. This mini review sought specific details on what is known about those multiple debilitating symptoms that include, but are not limited to: fatigue, shortness of breath, persistent coughing, joint and chest pain, muscle aches, muscle mass losses, headaches, and a cognitive condition situation known as 'brain fog' [1,3,6-8] that all have ramifications for the pursuit of optimal functional wellbeing among the older population. At present however, although the organ specific COVID-19 disease targets are quite well established [7], the emergent long COVID musculoskeletal and neurological disturbances observed in a sizeable percentage of COVID-19 survivors and how these interact at the physical, mental, and emotional health levels in older adults are less well charted, defined, differentiated, and understood, albeit clearly of high clinical as well as fiscal significance [9-15]. However, rather than examining all topical long COVID discussion papers and clinical reports, this present report elected to focus primarily on what is known about long CO...

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Section: Resultsmentioning

confidence: 99%

https://actascientific.com/ASOR/pdf/ASOR-06-0704.pdf

Marks¹

2023

Act Scie Ortho

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“…Nevertheless, little is known about nutritional status in older adults after CAP discharge except in relation to COVID-19 pneumonia. Reports of COVID-19 patients at hospital discharge have shown malnutrition in 18% and risk of malnutrition in 62%, with bedridden patients having even worse nutritional status [ 33 ]. In our study, the risk factors for malnutrition were previous dependency for basic ADL, institutionalization, and, again, an important, potentially modifiable risk factor, length of hospital stay.…”

Section: Discussionmentioning

confidence: 99%

Malnutrition, Functional Decline, and Institutionalization in Older Adults after Hospital Discharge Following Community-Acquired Pneumonia

Clotet-Vidal,

Saez Prieto,

Duch Llorach

et al. 2023

Nutrients

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Background and aims: Community-acquired pneumonia (CAP) is a major threat to older adults, but mid-term implications are poorly described. The aim was to analyze functional decline, institutionalization, malnutrition, and risk factors after hospital admission for CAP. Methods: This prospective observational study included patients over 65 years discharged after CAP between May 2019 and July 2021. We performed a comprehensive geriatric assessment and a general nutritional assessment 30–60 days after CAP. This included the MNA and blood test with trace elements and vitamins. The main outcomes were functional decline, institutionalization, and malnutrition. Multivariate logistic regression was used for the analyses. Results: In total, 144 patients of 77.15 ± 7.91 years, 55.6% male, and 9% previously institutionalized were analyzed. At hospital admission, the Charlson Comorbidity Index (CCI) was 1.5 ± 1.6, the Pneumonia Severity Index was 98.1 ± 25.9, and the previous Barthel Index (BI) was 93.06 ± 17.13. Hospital stay was 9.72 ± 7.88 days. After 44.6 ± 14.4 days, 48.6% patients showed functional decline and 19.4% were institutionalized. Age (OR 1.17; CI 95% 1.09–1.26), previous institutionalization (29.1; 3.7–224.7), BI (1.09; 1.05–1.14), CCI (1.5; 1.1–2.1), and length of stay (1.1, 1.02–1.18) were independently associated with functional decline. The only predictors of new institutionalization were previous BI (0.96; 0.93–0.99) and length of stay (1.06; 1.00–1.13). The MNA indicated malnutrition in 28% of the community-dwelling patients and 67.9% of those institutionalized, with risk of malnutrition being 45.7% and 9.5%, respectively, after an average of 44.6 days of CAP diagnosis. The predictors of malnutrition were previous institutionalization (10.62; 2.20–51.21), BI (0.95; 0.92–0.98), and length of stay (1.12; 1.04–1.20). Micronutrient deficiencies were mainly zinc (61.8%), vitamin D (54.5%), and vitamin C (45.1%). An MNA score < 17 points or hypoalbuminemia showed good specificity to identify these deficiencies. Conclusions: After CAP admission, functional decline, institutionalization, and malnutrition rates were high. Longer hospital stay was a common risk factor for all outcomes. The presence of hypoalbuminemia or an MNA < 17 in older patients should prompt suspicion of deficiencies in micronutrients, such as vitamin D, C, and zinc.

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“…SARS-CoV-2 infection increases the risk of clinically relevant reductions in HGS [28]. Low muscle strength, as measured using the HGS test, was present in 65% of men and 47% of women transferred to a pulmonary rehabilitation facility after hospitalisation for COVID-19 [29]. HGS was lower in malnourished individuals and was correlated with malnutrition scores [29].…”

Section: Introductionmentioning

confidence: 98%

“…Low muscle strength, as measured using the HGS test, was present in 65% of men and 47% of women transferred to a pulmonary rehabilitation facility after hospitalisation for COVID-19 [29]. HGS was lower in malnourished individuals and was correlated with malnutrition scores [29]. Currently, there is a limited understanding of the dynamics of physical function and their influence on the health outcomes of COVID-19 patients in the months after hospital discharge.…”

Section: Introductionmentioning

confidence: 99%

Longitudinal Changes in Physical Function and Their Impact on Health Outcomes in COVID-19 Patients

De Lorenzo,

Di Filippo,

Scelfo

et al. 2023

Nutrients

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Background: Coronavirus disease (COVID-19) is correlated with a variety of long-term sequelae that affect different aspects of health, including physical function. This study investigated the longitudinal changes in handgrip strength (HGS) over six months post-hospital discharge in COVID-19 patients and explores the associations between HGS, health-related quality of life, dyspnoea, exercise capacity, and body mass index (BMI). Methods: Adult COVID-19 patients were followed up at one, three, and six months after hospital discharge. HGS, BMI, exercise capacity, and health-related quality of life were assessed. Data from patients with HGS measurements at all three time points were analysed. Results: Low HGS was prevalent one month post-discharge (35%). Participants with low HGS exhibited more severe disease (30.5% vs. 5.9% were admitted to the intensive care unit, p < 0.01), longer hospital stays (median [IQR] 21 [10.0;40.5] vs. 12.0 [8.0; 20.0] days, p < 0.01), greater weight loss (−5.7 [−9.1; −0.6] vs. −3.2 [−5.7; −0.0] kg, p = 0.004), and reduced exercise capacity (6 min walking test [6 MWT], 95.7 [84.0;102.0] vs. 100.0 [92.9; 105.0]% predicted, p = 0.007). Those with persistently low HGS (40% of the initial low HGS group) had worse exercise capacity (6-MWT 93.3 [78.3; 101.0] vs. 101.0 [95.0; 107.0]% predicted, p < 0.001), more dyspnoea (29.0% vs. 2.0% of participants, p < 0.001), poorer quality of life (visual analogue scale score, 75 [50; 75] vs. 85 [75; 95], p < 0.001), and higher rates of problems in various health dimensions. HGS at 1 month was the only significant predictor of HGS improvement from 1 month to 6 months (odds ratio [95% CI] 1.11 [1.03; 1.20], p = 0.008). Conclusions: This study highlights the prevalence of reduced physical function among COVID-19 survivors and emphasises the importance of early identification and intervention to optimise their long-term health. Monitoring HGS, a simple and reliable tool, can provide valuable insights into patients’ overall physical function, aiding in tailored care and improved outcomes.

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

Cited by 6 publications

References 55 publications

https://actascientific.com/ASOR/pdf/ASOR-06-0704.pdf

https://actascientific.com/ASOR/pdf/ASOR-06-0704.pdf

Malnutrition, Functional Decline, and Institutionalization in Older Adults after Hospital Discharge Following Community-Acquired Pneumonia

Longitudinal Changes in Physical Function and Their Impact on Health Outcomes in COVID-19 Patients

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