Weight Loss in COVID-19–Positive Nursing Home Residents

Abstract

has had an impact on nutrition at individual, community, national, and global levels. 1 COVID-19 has been associated with weight loss and also has been linked to cachexia and sarcopenia. 2 Anorexia was the most common symptom during COVID-19 infection among patients at an academic long-term chronic care facility, with 70.8% of residents developing anorexia during the illness course. 3 In addition to effects of the disease itself, there are potential unintended consequences of infection control measures. A study of residents in a nursing home without a COVID-19 outbreak in the month following implementation of restrictions on visitors and group dining designed to mitigate the spread of COVID-19 showed significant weight loss among residents. 4 We conducted a retrospective chart review assessing the outcome of a COVID-19 outbreak on resident weights in a >200-bed skilled nursing facility (SNF) in Chicago, IL. The medical charts of each resident in the facility between March 1, 2020, and May 31, 2020, were reviewed in the electronic medical record (EMR) (PointClickCare) at the SNF and the affiliated academic medical center (Epic, 2020 Epic Systems Corporation). Among the residents included in the sample (n ¼ 209), the average age was 75.3 years (SD ¼ 11.9 years); residents were predominantly Black (93.3%) and women (56.0%). Hypertension (89.5%) and cognitive impairment (67.9%) were the most common chronic conditions present, followed by cardiac disease (43.5%) and diabetes (39.2%).There was no significant difference in age, race, gender, or comorbidities between the COVID-positive (n ¼ 172) and COVID-negative groups (n ¼ 32). Prevalence testing was completed for all residents in the facility twice at 7-day intervals in addition to as-needed testing based on symptoms and exposure. 5 The results of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction

Malnutrition and Sarcopenia in COVID-19 Survivors

“…Focusing on the subacute course of COVID-19 in older nursing home residents, Martinchek et all demonstrated that there was a mean weight loss of 4.6% (3.5 kg) in patients with COVID-19 2 months after the onset of COVID-19-related symptoms. 10 It also seems important to mention that preventive restrictions during a local outbreak 10 and general contact restrictions for nursing homes during the pandemic 11 can have a negative impact on the nutritional status including weight loss of COVID-19 negative residents. However, the respective consequences seem to be less severe than in those that have been infected by the coronavirus.…”

“…However, the respective consequences seem to be less severe than in those that have been infected by the coronavirus. 10 In this context psychological factors and a lack of mealtime assistance may be of special relevance.…”

Post-COVID-19 acute sarcopenia: physiopathology and management

“…The acute inflammatory response to the infection, which includes marked elevation of inflammatory markers up to the level of cytokine storm, has a high potential to harm a broad spectrum of organs and organ systems [2]. Clinical observation indicates that during the acute phase of infection, lasting approximately 2 weeks, the patient is at risk of losing 5-10% of body weight [3,4]. Although dehydration and muscle loss likely contribute the most to this, the issue has not been elucidated in detail [5,6].…”

Health impact of the first and second wave of COVID-19 and related restrictive measures among nursing home residents: a scoping review

“…Only six studies were performed elsewhere, namely in Canada [7,[22][23][24][25] and South Korea [26]. The number of nursing homes per study varied significantly across studies, ranging from one [27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42] to 12,576 nursing homes [43]. The number of residents per study ranged from four [27] to 696,310 [44].…”

“…[63,69], the number of outbreaks (N = 1) [23] or temperature (N = 2) [72,76]. One study focused on the impact of COVID-19 on weight loss [41]. Data was mainly collected using swab testing (n = 32, 56%) or electronic health records (n = 21, 37%).…”