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Menozzi R, Valoriani F, Prampolini F, Banchelli F, Boldrini E, Martelli F, Galetti S, Fari' R, Gabriele S, Palumbo P, Forni D, Pantaleoni M, D'Amico R, Pecchi AR. Impact of sarcopenia in SARS-CoV-2 patients during two different epidemic waves. Clin Nutr ESPEN 2022; 47:252-259. [PMID: 35063210 PMCID: PMC8648616 DOI: 10.1016/j.clnesp.2021.12.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 12/01/2021] [Indexed: 01/11/2023]
Abstract
Background Sarcopenia was reported to be associated with poor clinical outcome, higher incidence of community-acquired pneumonia, increased risk of infections and reduced survival in different clinical settings. The aim of our work is to evaluate the prognostic role of sarcopenia in patients with the 2019 novel coronavirus disease (COVID-19). Materials and methods 272 COVID-19 patients admitted to the University Hospital of Modena (Italy) from February 2020 to January 2021 were retrospectively studied. All included patients underwent a chest computed tomography (CT) scan to assess pneumonia during their hospitalization and showed a positive SARS-CoV-2 molecular test. Sarcopenia was defined by skeletal muscle area (SMA) evaluation at the 12th thoracic vertebra (T12). Clinical, laboratory data and adverse clinical outcome (admission to Intensive Care Unit and death) were collected for all patients. Results Prevalence of sarcopenia was high (41.5%) but significantly different in each pandemic wave (57.9% vs 21.6% p < 0.0000). At the multivariate analysis, sarcopenia during the first wave (Hazard Ratio 2.29, 95% confidence intervals 1.17 to 4.49 p = 0.0162) was the only independent prognostic factor for adverse clinical outcome. There were no significant differences in comorbidities and COVID19 severity in terms of pulmonary involvement at lung CT comparing during the first and second wave. Mixed pattern with peripheral and central involvement was found to be dominant in both groups. Conclusion We highlight the prognostic impact of sarcopenia in COVID-19 patients hospitalized during the first wave. T12 SMA could represent a potential tool to identify sarcopenic patients in particular settings. Further studies are needed to better understand the association between sarcopenia and COVID-19.
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Affiliation(s)
- R Menozzi
- Division of Metabolic Diseases and Clinical Nutrition, University Hospital of Modena, Modena, Italy.
| | - F Valoriani
- Division of Metabolic Diseases and Clinical Nutrition, University Hospital of Modena, Modena, Italy
| | - F Prampolini
- Department of Radiology, University Hospital of Modena, Modena, Italy
| | - F Banchelli
- Unit of Clinical Statistics, University Hospital of Modena, Modena, Italy
| | - E Boldrini
- Division of Metabolic Diseases and Clinical Nutrition, University Hospital of Modena, Modena, Italy
| | - F Martelli
- Department of Radiology, University Hospital of Modena, Modena, Italy
| | - S Galetti
- Division of Metabolic Diseases and Clinical Nutrition, University Hospital of Modena, Modena, Italy
| | - R Fari'
- Department of Radiology, University Hospital of Modena, Modena, Italy
| | - S Gabriele
- Division of Metabolic Diseases and Clinical Nutrition, University Hospital of Modena, Modena, Italy
| | - P Palumbo
- Division of Metabolic Diseases and Clinical Nutrition, University Hospital of Modena, Modena, Italy
| | - D Forni
- Department of Radiology, University Hospital of Modena, Modena, Italy
| | - M Pantaleoni
- Division of Metabolic Diseases and Clinical Nutrition, University Hospital of Modena, Modena, Italy
| | - R D'Amico
- Unit of Clinical Statistics, University Hospital of Modena, Modena, Italy
| | - A R Pecchi
- Department of Radiology, University Hospital of Modena, Modena, Italy
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Wilkinson TJ, Yates T, Baker LA, Zaccardi F, Smith AC. Sarcopenic obesity and the risk of hospitalization or death from coronavirus disease 2019: findings from UK Biobank. JCSM RAPID COMMUNICATIONS 2022; 5:3-9. [PMID: 34541518 PMCID: PMC8441916 DOI: 10.1002/rco2.47] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 04/29/2021] [Accepted: 06/08/2021] [Indexed: 05/18/2023]
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2. The role of skeletal muscle mass in modulating immune response is well documented. Whilst obesity is well established as a key factor in COVID-19 and outcome, no study has examined the influence of both sarcopenia (low muscle mass) and obesity, termed 'sarcopenic obesity' on the risk of severe COVID-19. METHODS This study uses data from UK Biobank. Probable sarcopenia was defined as low handgrip strength. Sarcopenic obesity was mutually exclusively defined as the presence of obesity and low muscle mass [based on two established criteria: appendicular lean mass (ALM) adjusted for either (i) height or (ii) body mass index]. Severe COVID-19 was defined by a positive severe acute respiratory syndrome coronavirus 2 test result in a hospital setting and/or death with a primary cause reported as COVID-19. Fully adjusted logistic regression models were used to analyse the associations between sarcopenic status and severe COVID-19. This work was conducted under UK Biobank Application Number 52553. RESULTS We analysed data from 490 301 UK Biobank participants (median age 70.0 years, 46% male); 2203 (0.4%) had severe COVID-19. Individuals with probable sarcopenia were 64% more likely to have had severe COVID-19 (odds ratio 1.638; P < 0.001). Obesity increased the likelihood of severe COVID-19 by 76% (P < 0.001). Using either ALM index or ALM/body mass index to define low muscle mass, those with sarcopenic obesity were 2.6 times more likely to have severe COVID-19 (odds ratio 2.619; P < 0.001). Sarcopenia alone did not increase the risk of COVID-19. CONCLUSIONS Sarcopenic obesity may increase the risk of severe COVID-19, over that of obesity alone. The mechanisms for this are complex but could be a result of a reduction in respiratory functioning, immune response, and ability to respond to metabolic stress.
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Affiliation(s)
- Thomas J. Wilkinson
- Leicester Kidney Lifestyle Team, Department of Health SciencesUniversity of LeicesterLeicesterUK
- Leicester NIHR Biomedical Research CentreLeicesterUK
| | - Thomas Yates
- Leicester NIHR Biomedical Research CentreLeicesterUK
- Leicester Diabetes Research CentreLeicesterUK
| | - Luke A. Baker
- Leicester Kidney Lifestyle Team, Department of Health SciencesUniversity of LeicesterLeicesterUK
- Leicester NIHR Biomedical Research CentreLeicesterUK
| | - Francesco Zaccardi
- Leicester Diabetes Research CentreLeicesterUK
- Leicester Real World Evidence UnitUniversity of LeicesterLeicesterUK
- NIHR Applied Research Collaboration (ARC) East Midlands, Diabetes Research CentreLeicesterUK
| | - Alice C. Smith
- Leicester Kidney Lifestyle Team, Department of Health SciencesUniversity of LeicesterLeicesterUK
- Leicester NIHR Biomedical Research CentreLeicesterUK
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Frailty but not sarcopenia nor malnutrition increases the risk of developing COVID-19 in older community-dwelling adults. Aging Clin Exp Res 2022; 34:223-234. [PMID: 34689315 PMCID: PMC8541803 DOI: 10.1007/s40520-021-01991-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 09/25/2021] [Indexed: 12/12/2022]
Abstract
Background The identification of coronavirus disease 2019 (COVID-19) risk factors is requested to implement prevention strategies. Aim To explore the associations between the COVID-19 incidence and malnutrition, sarcopenia, and frailty, identified as potential risk factors in previous cross-sectional studies. Methods Malnutrition, sarcopenia, and frailty were assessed at the last available follow-up from the Sarcopenia and Physical Impairments with Advancing Age (SarcoPhAge) cohort (i.e., the fifth year that ended in 2019) according to the Mini-Nutritional Assessment short-form, the European Working Group on Sarcopenia in Older People (EWGSOP2), and the Fried criteria, respectively. Information regarding the COVID-19 was gathered by phone calls interviews in April 2021 to measure its self-declared incidence. Adjusted Cox regressions and Kaplan–Meier curves were performed. Results The present study included 241 participants [median age 75.6 (73.0–80.6) years, 63.1% women]. Among them, 27 participants (11.2%) developed the non-fatal Covid-19. No significant increased risks of COVID-19 were observed in patients with malnutrition [adjusted HR 1.14 (0.26–5.07)] and sarcopenia [adjusted HR 1.25 (0.35–4.42)]. Nevertheless, the incidence of COVID-19 was significantly higher in frail (44.4%) than in robust participants (8.5%) [Adjusted HR 7.01 (2.69–18.25)], which was confirmed by the Kaplan–Meier curves (p < 0.001). Among the frailty syndrome components, a low physical activity level was the only one significantly associated with an increased risk of COVID-19 [adjusted HR 5.18 (1.37–19.54)]. Conclusion Despite some limitations in the methodology of this study (i.e., limited sample size, COVID-19 incidence self-reported and not assessed systematically using objective measurements) requiring careful consideration, an increased risk to develop COVID-19 was observed in the presence of the frailty syndrome. Further investigations are needed to elaborate on our findings. Supplementary Information The online version contains supplementary material available at 10.1007/s40520-021-01991-z.
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Lengelé L, Locquet M, Moutschen M, Beaudart C, Kaux JF, Gillain S, Reginster JY, Bruyère O. Frailty but not sarcopenia nor malnutrition increases the risk of developing COVID-19 in older community-dwelling adults. Aging Clin Exp Res 2022. [PMID: 34689315 DOI: 10.1007/s40520-021-01991-z[publishedonlinefirst:2021/10/25]] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
BACKGROUND The identification of coronavirus disease 2019 (COVID-19) risk factors is requested to implement prevention strategies. AIM To explore the associations between the COVID-19 incidence and malnutrition, sarcopenia, and frailty, identified as potential risk factors in previous cross-sectional studies. METHODS Malnutrition, sarcopenia, and frailty were assessed at the last available follow-up from the Sarcopenia and Physical Impairments with Advancing Age (SarcoPhAge) cohort (i.e., the fifth year that ended in 2019) according to the Mini-Nutritional Assessment short-form, the European Working Group on Sarcopenia in Older People (EWGSOP2), and the Fried criteria, respectively. Information regarding the COVID-19 was gathered by phone calls interviews in April 2021 to measure its self-declared incidence. Adjusted Cox regressions and Kaplan-Meier curves were performed. RESULTS The present study included 241 participants [median age 75.6 (73.0-80.6) years, 63.1% women]. Among them, 27 participants (11.2%) developed the non-fatal Covid-19. No significant increased risks of COVID-19 were observed in patients with malnutrition [adjusted HR 1.14 (0.26-5.07)] and sarcopenia [adjusted HR 1.25 (0.35-4.42)]. Nevertheless, the incidence of COVID-19 was significantly higher in frail (44.4%) than in robust participants (8.5%) [Adjusted HR 7.01 (2.69-18.25)], which was confirmed by the Kaplan-Meier curves (p < 0.001). Among the frailty syndrome components, a low physical activity level was the only one significantly associated with an increased risk of COVID-19 [adjusted HR 5.18 (1.37-19.54)]. CONCLUSION Despite some limitations in the methodology of this study (i.e., limited sample size, COVID-19 incidence self-reported and not assessed systematically using objective measurements) requiring careful consideration, an increased risk to develop COVID-19 was observed in the presence of the frailty syndrome. Further investigations are needed to elaborate on our findings.
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Affiliation(s)
- Laetitia Lengelé
- Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, University of Liège, CHU-Sart Tilman, Quartier Hôpital, Avenue Hippocrate 13 (Bât. B23), 4000, Liège, Belgium.
| | - Médéa Locquet
- Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, University of Liège, CHU-Sart Tilman, Quartier Hôpital, Avenue Hippocrate 13 (Bât. B23), 4000, Liège, Belgium
| | - Michel Moutschen
- Department of Infectious Diseases and General Internal Medicine, CHU Sart-Tilman, University of Liège, 4000, Liège, Belgium
| | - Charlotte Beaudart
- Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, University of Liège, CHU-Sart Tilman, Quartier Hôpital, Avenue Hippocrate 13 (Bât. B23), 4000, Liège, Belgium
- Physical, Rehabilitation Medicine and Sports Traumatology, SportS2, University Hospital of Liège, 4000, Liège, Belgium
| | - Jean-François Kaux
- Physical, Rehabilitation Medicine and Sports Traumatology, SportS2, University Hospital of Liège, 4000, Liège, Belgium
- Department of Sport Rehabilitation Sciences, University of Liège, 4000, Liège, Belgium
| | - Sophie Gillain
- Geriatrics Department, University Hospital of Liège, Liège, Belgium
| | - Jean-Yves Reginster
- Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, University of Liège, CHU-Sart Tilman, Quartier Hôpital, Avenue Hippocrate 13 (Bât. B23), 4000, Liège, Belgium
| | - Olivier Bruyère
- Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, University of Liège, CHU-Sart Tilman, Quartier Hôpital, Avenue Hippocrate 13 (Bât. B23), 4000, Liège, Belgium
- Physical, Rehabilitation Medicine and Sports Traumatology, SportS2, University Hospital of Liège, 4000, Liège, Belgium
- Department of Sport Rehabilitation Sciences, University of Liège, 4000, Liège, Belgium
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Mittal A, Dua A, Gupta S, Injeti E. A research update: Significance of cytokine storm and diaphragm in COVID-19. CURRENT RESEARCH IN PHARMACOLOGY AND DRUG DISCOVERY 2021; 2:100031. [PMID: 34870147 PMCID: PMC8086263 DOI: 10.1016/j.crphar.2021.100031] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 03/31/2021] [Accepted: 04/26/2021] [Indexed: 12/23/2022] Open
Abstract
Emerging research on severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) shows that it is spreading to multiple organs in addition to the respiratory system. Though the SARS-CoV2 enters the human body by binding to ACE2 receptors on pulmonary alveolar cells, recent studies indicate that it is spreading to the central nervous system, cardiac and skeletal muscles leading to various pathological conditions in these organs. In particular, the effects of SARS-CoV-2 on triggering the cytokine storm and its consequential effects on skeletal muscles has generated a lot of discussion. The effects of this virus on muscular function especially in susceptible elderly populations is still being explored. However, its effects on diaphragm, a respiratory muscle which plays an important role in determining lung capacity are not completely explored. Currently, as new evidence on using lung ultrasounds to confirm COVID-19 diagnosis is gaining traction, it is necessary to explore the role of diaphragm in treating COVID-19 patients. This article will review the effects of cytokine storm triggered by the SARS-CoV-2 and its resultant effects on skeletal muscle with a specific focus on the diaphragm in order to identify knowledge gaps in effectively treating COVID-19 patients, especially those who are on a mechanical ventilator.
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Affiliation(s)
- Ashwani Mittal
- Skeletal Muscle Laboratory, Institute of Integrated & Honors Studies, Kurukshetra University, Kurukshetra, Haryana, 136119, India
| | - Anita Dua
- Skeletal Muscle Laboratory, Institute of Integrated & Honors Studies, Kurukshetra University, Kurukshetra, Haryana, 136119, India
| | - Sanjeev Gupta
- Skeletal Muscle Laboratory, Institute of Integrated & Honors Studies, Kurukshetra University, Kurukshetra, Haryana, 136119, India
| | - Elisha Injeti
- Cedarville University School of Pharmacy, Cedarville, OH, 45314, USA
- Corresponding author.
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Riesgo H, Castro A, Del Amo S, San Ceferino MJ, Izaola O, Primo D, Gómez Hoyos E, López Gómez JJ, de Luis DA. Prevalence of Risk of Malnutrition and Risk of Sarcopenia in a Reference Hospital for COVID-19: Relationship with Mortality. ANNALS OF NUTRITION AND METABOLISM 2021; 77:324-329. [PMID: 34673644 DOI: 10.1159/000519485] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 08/26/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Many elderly patients with COVID-19 are at risk of malnutrition. The aim of our study was to evaluate the risk of malnutrition and sarcopenia in elderly COVID-19 patients with the R-MAPP (Remote-Malnutrition APP). MATERIALS AND METHODS A cross-sectional study of 337 consecutive outpatients ≥65 years who attended the Central Emergency COVID-19 Hospital of Castilla y Leon was conducted. In all patients, the protocol of R-MAPP (Malnutrition Universal Screening Tool [MUST] and Simple Questionnaire to Rapidly Diagnose Sarcopenia [SARC-F]) was realized. RESULTS The mean age was 86.1 ± 8.7 years, with a sex distribution of 167 males (49.5%) and 170 females (51.5%). According to the MUST test, patients with 0 points have a low nutritional risk (n = 50, 14.8%), 1 point a medium nutritional risk (n = 19, 5.6%), and 2 or more points a high nutritional risk (n = 268, 79.6%). The SARC-F questionnaire generates patients with 4 or more points as predictive of sarcopenia (n = 304, 80.2%) and <4 points without prediction of sarcopenia (n = 33, 9.8%). Global mortality was 24.03% (n = 81). The mortality rate was related to the pathological SARC-F score ≥4 (27.1% vs. 3.1%; p = 0.01) and MUST score ≥2 (26.7% vs. 16.4%; p = 0.04). In the logistic regression analysis, only the SARC-F score ≥4 remained as an independent variable related to mortality; odds ratio was 8.34 (95% CI: 1.1-63.8; p = 0.04), adjusted for age, sex, albumin levels, and MUST test. CONCLUSIONS During COVID-19 infection, hospitalized patients at risk of sarcopenia have a high risk of mortality and have a poor nutritional status.
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Affiliation(s)
- Henar Riesgo
- Center of Investigation of Endocrinology and Nutrition, Medicine School, Department of Endocrinology and Nutrition, Hospital Clinico Universitario, University of Valladolid, Valladolid, Spain
| | - Angeles Castro
- Center of Investigation of Endocrinology and Nutrition, Medicine School, Department of Endocrinology and Nutrition, Hospital Clinico Universitario, University of Valladolid, Valladolid, Spain
| | - Sofía Del Amo
- Center of Investigation of Endocrinology and Nutrition, Medicine School, Department of Endocrinology and Nutrition, Hospital Clinico Universitario, University of Valladolid, Valladolid, Spain
| | - Maria Jesus San Ceferino
- Center of Investigation of Endocrinology and Nutrition, Medicine School, Department of Endocrinology and Nutrition, Hospital Clinico Universitario, University of Valladolid, Valladolid, Spain
| | - Olatz Izaola
- Center of Investigation of Endocrinology and Nutrition, Medicine School, Department of Endocrinology and Nutrition, Hospital Clinico Universitario, University of Valladolid, Valladolid, Spain
| | - David Primo
- Center of Investigation of Endocrinology and Nutrition, Medicine School, Department of Endocrinology and Nutrition, Hospital Clinico Universitario, University of Valladolid, Valladolid, Spain
| | - Emilia Gómez Hoyos
- Center of Investigation of Endocrinology and Nutrition, Medicine School, Department of Endocrinology and Nutrition, Hospital Clinico Universitario, University of Valladolid, Valladolid, Spain
| | - Juan Jose López Gómez
- Center of Investigation of Endocrinology and Nutrition, Medicine School, Department of Endocrinology and Nutrition, Hospital Clinico Universitario, University of Valladolid, Valladolid, Spain
| | - Daniel A de Luis
- Center of Investigation of Endocrinology and Nutrition, Medicine School, Department of Endocrinology and Nutrition, Hospital Clinico Universitario, University of Valladolid, Valladolid, Spain
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Cheval B, Sieber S, Maltagliati S, Millet GP, Formánek T, Chalabaev A, Cullati S, Boisgontier MP. Muscle strength is associated with COVID-19 hospitalization in adults 50 years of age or older. J Cachexia Sarcopenia Muscle 2021; 12:1136-1143. [PMID: 34363345 PMCID: PMC8426913 DOI: 10.1002/jcsm.12738] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 03/22/2021] [Accepted: 05/21/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Weak muscle strength has been associated with a wide range of adverse health outcomes. Yet, whether individuals with weaker muscle strength are more at risk for hospitalization due to severe COVID-19 is still unclear. The objective of this study was to investigate the independent association between muscle strength and COVID-19 hospitalization. METHODS Data from adults 50 years of age or older were analysed using logistic models adjusted for several chronic conditions, body-mass index, age, and sex. Hand-grip strength was repeatedly measured between 2004 and 2017 using a handheld dynamometer. COVID-19 hospitalization during the lockdown was self-reported in summer 2020 and was used as an indicator of COVID-19 severity. RESULTS The study was based on the Survey of Health, Ageing and Retirement in Europe (SHARE) and included 3600 older adults (68.8 ± 8.8 years, 2044 female), among whom 316 were tested positive for the severe acute respiratory syndrome coronavirus 2 (8.8%), and 83 (2.3%) were hospitalized due to COVID-19. Results showed that higher grip strength was associated with a lower risk of COVID-19 hospitalization [adjusted odds ratio (OR) per increase of 1 standard deviation in grip strength = 0.64, 95% confidence interval (95% CI) = 0.45-0.87, P = 0.015]. Results also showed that age (OR for a 10 -year period = 1.70, 95% CI = 1.32-2.20, P < 0.001) and obesity (OR = 2.01, 95% CI = 1.00-3.69, P = 0.025) were associated with higher risk of COVID-19 hospitalization. Sensitivity analyses using different measurements of grip strength as well as robustness analyses based on rare-events logistic regression and a different sample of participants (i.e. COVID-19 patients) were consistent with the main results. CONCLUSIONS Muscle strength is an independent risk factor for COVID-19 severity in adults 50 years of age or older.
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Affiliation(s)
- Boris Cheval
- Swiss Center for Affective SciencesUniversity of GenevaGenevaSwitzerland
- Laboratory for the Study of Emotion Elicitation and Expression (E3Lab), Department of PsychologyUniversity of GenevaGenevaSwitzerland
| | - Stefan Sieber
- Swiss NCCR ‘LIVES—Overcoming Vulnerability: Life Course Perspectives’University of GenevaGenevaSwitzerland
| | | | | | - Tomáš Formánek
- Department of Public Mental HealthNational Institute of Mental HealthKlecanyCzech Republic
- EpiCentre, Department of PsychiatryUniversity of CambridgeCambridgeUK
| | | | - Stéphane Cullati
- Population Health LaboratoryUniversity of FribourgFribourgSwitzerland
- Department of Readaptation and GeriatricsUniversity of GenevaGenevaSwitzerland
| | - Matthieu P. Boisgontier
- School of Rehabilitation Sciences, Faculty of Health SciencesUniversity of OttawaOttawaOntarioCanada
- Bruyère Research InstituteOttawaOntarioCanada
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Silvah JH, de Lima CMM, Nicoletti CF, Barbosa AC, Junqueira GP, da Cunha SFDC, Marchini JS. Protein provision and lower mortality in critically ill patients with COVID-19. Clin Nutr ESPEN 2021; 45:507-510. [PMID: 34620363 PMCID: PMC8282450 DOI: 10.1016/j.clnesp.2021.07.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 07/04/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND AIMS Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) severely impacted the management of critically ill patients, including nutritional therapy. This study aimed to verify an association between mortality and the energy and protein provided to critically ill patients affected by the SARS-CoV-2 and receiving enteral nutrition support. METHODS Patients with confirmed COVID-19, with >7 days of stay in the ICU, on enteral nutrition were followed from the moment of hospitalization until discharge from the ICU or death. Data about age, gender, Simplified Acute Physiology Score III (SAPS3), intensive care unit (ICU) length of stay, days on mechanical ventilation (MV), clinical endpoint outcome (discharge or death), and daily energy and protein provision were collected from electronic medical records. Cox regression analyses and Kaplan-Meyer curves were used in statistical analysis. RESULTS Fifty-two patients (66.2 ± 13.1 years; 53.8% women) were enrolled in the present study. The mean length of hospitalizations and SAPS3 score were 17.8 ± 9.8 days and 78.7 ± 14.7, respectively; all patients needed mechanical ventilation (mean of days was 16.42 ± 9.1). For most patients (73.1%) the endpoint was death. Twenty-five percent of patients had protein supply >0.8 g/IBW/day. Survival during COVID-19 hospitalization at ICU was significantly different among patients according to protein supply (p = 0.005). Hazard Ratios (HR) for protein supply showed that a protein intake >0.8 g/IBW/day was associated with significantly lower mortality (HR 0.322, p = 0.049). CONCLUSION Our study suggests that a protein supply at least > 0.8 g/IBW/day could be related to reduced mortality in ICU patients with COVID-19.
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Affiliation(s)
- Jose Henrique Silvah
- Division of Medical Nutrition, Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil; ATN - Alimentar Terapia Nutricional, Coordination and Assistance in Nutritional Therapy, Ribeirão Preto, SP, Brazil.
| | - Cristiane Maria Martires de Lima
- Division of Medical Nutrition, Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil; ATN - Alimentar Terapia Nutricional, Coordination and Assistance in Nutritional Therapy, Ribeirão Preto, SP, Brazil
| | - Carolina Ferreira Nicoletti
- Departament of Health Science, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Ana Carolina Barbosa
- ATN - Alimentar Terapia Nutricional, Coordination and Assistance in Nutritional Therapy, Ribeirão Preto, SP, Brazil
| | - Gizela Pedroso Junqueira
- Division of Medical Nutrition, Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Selma Freire de Carvalho da Cunha
- Division of Medical Nutrition, Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Julio Sergio Marchini
- Division of Medical Nutrition, Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
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Pickering ME. Cross-Talks between the Cardiovascular Disease-Sarcopenia-Osteoporosis Triad and Magnesium in Humans. Int J Mol Sci 2021; 22:ijms22169102. [PMID: 34445808 PMCID: PMC8396464 DOI: 10.3390/ijms22169102] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 08/11/2021] [Accepted: 08/13/2021] [Indexed: 02/06/2023] Open
Abstract
Magnesium (Mg) is a pivotal and very complex component of healthy aging in the cardiovascular-muscle-bone triad. Low Mg levels and low Mg intake are common in the general aging population and are associated with poorer outcomes than higher levels, including vascular calcification, endothelial dysfunction, osteoporosis, or muscle dysfunction/sarcopenia. While Mg supplementation appears to reverse these processes and benefit the triad, more randomized clinical trials are needed. These will allow improvement of preventive and curative strategies and propose guidelines regarding the pharmaceutical forms and the dosages and durations of treatment in order to optimize and adapt Mg prescription for healthy aging and for older vulnerable persons with comorbidities.
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Affiliation(s)
- Marie-Eva Pickering
- Rheumatology Department, CHU Gabriel Montpied, 63000 Clermont-Ferrand, France
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Impact of body mass index on primary immunoglobulin A nephropathy prognosis: a systematic review and meta-analysis. Int Urol Nephrol 2021; 54:1067-1078. [PMID: 34383206 DOI: 10.1007/s11255-021-02978-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 08/08/2021] [Indexed: 12/13/2022]
Abstract
PURPOSE The impacts of body mass index (BMI) on the prognosis of primary IgA nephropathy (IgAN) remain controversial. This systematic review and meta-analysis aimed to solve these issues. METHODS We searched the PubMed, EMBASE, and Cochrane Library to screen articles investigating the BMI and primary IgAN. BMI was classified according to the World Health Organization as high (≥ 25.0 kg/m2) and low (< 25.0 kg/m2). The baseline renal indexes and the incidences of adverse renal outcomes were focused on. RESULTS Six studies with a total of 1723 patients were included in this study. High BMI was demonstrated to be associated with increased baseline levels of serum creatinine (weighted mean difference (WMD) 9.54, 95% confidence interval (CI) 0.63-18.45), blood uric acid (WMD 19.85, 95% CI 10.11-29.59) and urine protein (WMD 0.37, 95% CI 0.21-0.53). Patients with high BMI also showed compromised eGFR at diagnosis (WMD - 8.39, 95% CI - 11.62 to - 5.16) with a higher incidence rate of hypertension (odds ratios (OR) 2.59, 95% CI 1.44-4.66) and higher global optical scores (WMD 1.22, 95% CI 0.70-1.74). Regarding the prognosis, high BMI was significantly associated with the incidence of adverse renal outcomes (OR 2.43, 95% CI 1.66-3.55, P < 0.001) and deteriorated eGFR at the last follow-up (WMD - 11.10, 95% CI - 16.96 to - 5.25, P < 0.001), with non-significantly poorer renal disease-free survival (hazard ratio 1.79, 95% CI 0.58-5.50, P = 0.31). CONCLUSION High BMI was associated with severe onset and poor prognosis of primary IgAN. The management of BMI could be a novel method to promote the therapeutic outcomes of primary IgAN.
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Del Brutto OH, Mera RM, Pérez P, Recalde BY, Costa AF, Sedler MJ. Hand grip strength before and after SARS-CoV-2 infection in community-dwelling older adults. J Am Geriatr Soc 2021; 69:2722-2731. [PMID: 34124775 PMCID: PMC8447376 DOI: 10.1111/jgs.17335] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 06/02/2021] [Accepted: 06/07/2021] [Indexed: 12/23/2022]
Abstract
Objective To assess the association between SARS‐CoV‐2 infection and decreased hand grip strength (HGS). Design Longitudinal population‐based study. Setting Community‐dwelling older adults (aged ≥60 years) living in a rural Ecuadorian village struck by the SARS‐CoV‐2 pandemic. Participants Of 282 enrolled individuals, 254 (90%) finished the study. Measurements HGS was measured 3 months before (January 2020) and 9 months after the introduction of the virus into the population (January 2021). SARS‐CoV‐2 antibody testing was performed in two rounds: in May–June (early) and September–November (late), 2020. An independent association between SARS‐CoV‐2 infection and HGS decline was assessed by fitting linear mixed models for longitudinal data. Changes in HGS scores in SARS‐CoV‐2 seropositive subjects, according to the time elapsed since seroconversion, were compared with those who remained seronegative. Results Overall, 149 (59%) individuals became seropositive for SARS‐CoV‐2. The mean HGS (in kg) was 25.3 ± 8.3 at baseline and 23.7 ± 8.1 at follow‐up (p = 0.028), with 140 individuals having >5% HGS decline between both measurements. The follow‐up HGS measurement decreased by 1.72 kg in seropositive individuals, and by 0.57 kg in their seronegative counterparts (p < 0.001). SARS‐CoV‐2 seropositive individuals were 2.27 times more likely (95% CI: 1.33–3.87) to have a lower HGS measurement at the time of follow‐up than those who remained seronegative. When compared with seronegative subjects, seropositive patients with early seroconversion were 3.41 times (95% CI: 1.73–6.74) more likely to have >5% HGS decline at the time of the follow‐up than those with later, i.e., more recent, infections. Conclusions This study shows an independent deleterious impact of SARS‐CoV‐2 on HGS that is more marked among individuals with infections that occurred more than 8 months before follow‐up HGS. Results suggest the possibility of chronic damage to skeletal muscles by SARS‐CoV‐2.
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Affiliation(s)
- Oscar H Del Brutto
- School of Medicine, Universidad Espíritu Santo - Ecuador, Samborondón, Ecuador
| | - Robertino M Mera
- Department of Epidemiology, Gilead Sciences, Inc., Foster City, California, USA
| | - Pedro Pérez
- Department of Psychiatry, Mount Sinai Morningside, New York, New York, USA
| | | | - Aldo F Costa
- Department of Neurology, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - Mark J Sedler
- Renaissance School of Medicine, Stony Brook University, New York, New York, USA
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Clemente-Suárez VJ, Ramos-Campo DJ, Mielgo-Ayuso J, Dalamitros AA, Nikolaidis PA, Hormeño-Holgado A, Tornero-Aguilera JF. Nutrition in the Actual COVID-19 Pandemic. A Narrative Review. Nutrients 2021; 13:1924. [PMID: 34205138 PMCID: PMC8228835 DOI: 10.3390/nu13061924] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 05/27/2021] [Accepted: 05/31/2021] [Indexed: 02/08/2023] Open
Abstract
The pandemic of Coronavirus Disease 2019 (COVID-19) has shocked world health authorities generating a global health crisis. The present study discusses the main finding in nutrition sciences associated with COVID-19 in the literature. We conducted a consensus critical review using primary sources, scientific articles, and secondary bibliographic indexes, databases, and web pages. The method was a narrative literature review of the available literature regarding nutrition interventions and nutrition-related factors during the COVID-19 pandemic. The main search engines used in the present research were PubMed, SciELO, and Google Scholar. We found how the COVID-19 lockdown promoted unhealthy dietary changes and increases in body weight of the population, showing obesity and low physical activity levels as increased risk factors of COVID-19 affection and physiopathology. In addition, hospitalized COVID-19 patients presented malnutrition and deficiencies in vitamin C, D, B12 selenium, iron, omega-3, and medium and long-chain fatty acids highlighting the potential health effect of vitamin C and D interventions. Further investigations are needed to show the complete role and implications of nutrition both in the prevention and in the treatment of patients with COVID-19.
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Affiliation(s)
- Vicente Javier Clemente-Suárez
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain;
- Grupo de Investigación en Cultura, Educación y Sociedad, Universidad de la Costa, 080002 Barranquilla, Colombia
- Studies Centre in Applied Combat (CESCA), 45007 Toledo, Spain;
| | | | - Juan Mielgo-Ayuso
- Department of Health Sciences, Faculty of Health Sciences, University of Burgos, 09001 Burgos, Spain;
| | - Athanasios A. Dalamitros
- Laboratory of Evaluation of Human Biological Performance, School of Physical Education and Sport Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | | | | | - Jose Francisco Tornero-Aguilera
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain;
- Studies Centre in Applied Combat (CESCA), 45007 Toledo, Spain;
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Hasegawa Y, Takahashi F, Hashimoto Y, Munekawa C, Hosomi Y, Okamura T, Okada H, Senmaru T, Nakanishi N, Majima S, Ushigome E, Hamaguchi M, Yamazaki M, Fukui M. Effect of COVID-19 Pandemic on the Change in Skeletal Muscle Mass in Older Patients with Type 2 Diabetes: A Retrospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18084188. [PMID: 33920957 PMCID: PMC8071268 DOI: 10.3390/ijerph18084188] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 04/08/2021] [Accepted: 04/14/2021] [Indexed: 02/07/2023]
Abstract
Background: The aim of this study was to investigate the effect of the coronavirus disease (COVID-19) pandemic restrictions on the change in muscle mass in older patients with type 2 diabetes (T2D), who were not infected with COVID-19. Methods: In this retrospective cohort study, data were obtained from outpatients who underwent bioelectrical impedance analysis at least twice before April 2020 and at least once thereafter. Skeletal muscle mass index (SMI, kg/m2) was calculated as appendicular muscle mass (kg) divided by height squared (m2). Change in SMI (kg/m2/year) was calculated as (follow-up SMI-baseline SMI/follow-up period). The differences between the changes in SMI before and after the start of the COVID-19 pandemic were evaluated using paired t test. Results: This study recruited 56 patients, with a mean (SD) age of 75.2 (7.1) years. SMI changed from 6.7 (0.9) to 6.8 (0.9) kg/m2 before the COVID-19 pandemic, whereas SMI changed from 6.8 (0.9) to 6.6 (0.9) kg/m2 after the start of the COVID-19 pandemic. SMI decreased after the start of the COVID-19 pandemic compared with before the pandemic (-0.117 (0.240) vs. 0.005 (0.289) kg/m2/year, p = 0.049). This decrease was observed in men (-0.159 (0.257) vs. 0.031 (0.325) kg/m2/year, p = 0.038), patients with poor glycemic control (-0.170 (0.264) vs. 0.031 (0.285) kg/m2/year, p = 0.042), and those with a long diabetes duration (-0.153 (0.229) vs. 0.082 (0.291) kg/m2, p = 0.049). Conclusions: The COVID-19 pandemic restrictions caused muscle mass loss in older patents with T2D. Actions, including recommendation of exercise and adequate diet intake, are needed to prevent loss of muscle mass.
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