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Rostamzadeh S, Allafasghari A, Allafasghari A, Abouhossein A. Handgrip strength as a prognostic factor for COVID-19 mortality among older adult patients admitted to the intensive care unit (ICU): a comparison Alpha (B.1.1.7) and Delta (B.1.617.2) variants. Sci Rep 2024; 14:19927. [PMID: 39198687 PMCID: PMC11358457 DOI: 10.1038/s41598-024-71034-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 08/23/2024] [Indexed: 09/01/2024] Open
Abstract
Handgrip strength (HGS) is a non-invasive and reliable biomarker of overall health, physical function, mobility, and mortality. This study aimed to investigate the possible relationship between HGS and mortality in older adult patients hospitalized with COVID-19 in the intensive care unit (ICU) by Alpha (B.1.1.7) and Delta (B.1.617.2) variants. This retrospective cohort study was conducted on 472 COVID-19 patients (222 female and 250 male) aged 60-85 years admitted to the ICU. Demographic data, underlying comorbidities, COVID-19-related symptoms, as well as laboratory and computed tomography (CT) findings were obtained from the patient's medical records. Using a JAMAR® hydraulic dynamometer, the average grip strength value (kg) after three measurements on the dominant side was recorded for subsequent analysis. Low grip strength (LGS) was defined as an arbitrary cut-off of two standard deviations below the gender-specific peak mean value of normative HGS in Iranian healthy population, i.e. < 26 kg in males and < 14 kg in females. The findings showed lower mean grip strength and high frequency of LGS in the non-survivors patients versus survivors group and in the Delta (B.1.617.2) variant vs. Alpha (B.1.1.7) variant, respectively (both p < 0.01). The binary logistic regression analysis showed that chronic obstructive pulmonary disease (COPD) (adjusted odds ratio [OR] 5.125, 95% CI 1.425-25.330), LGS (OR 4.805, 95% CI 1.624-10.776), SaO2 (OR - 3.501, 95% CI 2.452-1.268), C-reactive protein (CRP) level (OR 2.625, 95% CI 1.256-7.356), and age (OR 1.118, 95% CI 1.045-1.092) were found to be independent predictors for mortality of patients with Alpha (B.1.1.7) variant (all p < 0.05). However, only four independent predictors including COPD (OR 6.728, 95% CI 1.683-28.635), LGS (OR 5.405, 95% CI 1.461-11.768), SaO2 (OR - 4.120, 95% CI 2.924-1.428), and CRP level (OR 1.893, 95% CI 1.127-8.692) can be predicted the mortality of patients with Delta (B.1.617.2) variant (p < 0.05). Along with the well-known and common risk factors (i.e. COPD, CRP, and SaO2), handgrip strength can be a quick and low-cost prognostic tool in predicting chances of mortality in older adults who are afflicted with COVID-19 variants.
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Affiliation(s)
- Sajjad Rostamzadeh
- Department of Ergonomics, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Atabak Allafasghari
- Department of Health, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Amin Allafasghari
- Department of Health, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Alireza Abouhossein
- Department of Ergonomics, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Gérard M, Mahmutovic M, Malgras A, Michot N, Scheyer N, Jaussaud R, Nguyen-Thi PL, Quilliot D. Long-Term Evolution of Malnutrition and Loss of Muscle Strength after COVID-19: A Major and Neglected Component of Long COVID-19. Nutrients 2021; 13:3964. [PMID: 34836219 PMCID: PMC8618979 DOI: 10.3390/nu13113964] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 10/29/2021] [Accepted: 11/03/2021] [Indexed: 01/21/2023] Open
Abstract
Post-acute consequences of COVID-19, also termed long COVID, include signs and symptoms persisting for more than 12 weeks with prolonged multisystem involvement; most often, however, malnutrition is ignored. METHOD The objective was to analyze persistent symptoms, nutritional status, the evolution of muscle strength and performance status (PS) at 6 months post-discharge in a cohort of COVID-19 survivors. RESULTS Of 549 consecutive patients hospitalized for COVID-19 between 1 March and 29 April 2020, 23.7% died and 288 patients were at home at D30 post-discharge. At this date, 136 of them (47.2%) presented persistent malnutrition, a significant decrease in muscle strength or a PS ≥ 2. These patients received dietary counseling, nutritional supplementation, adapted physical activity guidance or physiotherapy assistance, or were admitted to post-care facilities. At 6 months post-discharge, 91.0% of the 136 patients (n = 119) were evaluated and 36.0% had persistent malnutrition, 14.3% complained of a significant decrease in muscle strength and 14.9% had a performance status > 2. Obesity was more frequent in patients with impairment than in those without (52.8% vs. 31.0%; p = 0.0071), with these patients being admitted more frequently to ICUs (50.9% vs. 31.3%; p = 0.010). Among those with persistent symptoms, 10% had psychiatric co-morbidities (mood disorders, anxiety, or post-traumatic stress syndrome), 7.6% had prolonged pneumological symptoms and 4.2% had neurological symptoms. CONCLUSIONS Obese subjects as well as patients who have stayed in intensive care have a higher risk of functional loss or undernutrition 6 months after a severe COVID infection. Malnutrition and loss of muscle strength should be considered in the clinical assessment of these patients.
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Affiliation(s)
- Marine Gérard
- Transversal Nutrition Unit, University of Lorraine, Nancy University Hospital, 54500 Vandoeuvre-les-Nancy, France; (M.G.); (M.M.); (A.M.); (N.M.); (N.S.)
| | - Meliha Mahmutovic
- Transversal Nutrition Unit, University of Lorraine, Nancy University Hospital, 54500 Vandoeuvre-les-Nancy, France; (M.G.); (M.M.); (A.M.); (N.M.); (N.S.)
| | - Aurélie Malgras
- Transversal Nutrition Unit, University of Lorraine, Nancy University Hospital, 54500 Vandoeuvre-les-Nancy, France; (M.G.); (M.M.); (A.M.); (N.M.); (N.S.)
| | - Niasha Michot
- Transversal Nutrition Unit, University of Lorraine, Nancy University Hospital, 54500 Vandoeuvre-les-Nancy, France; (M.G.); (M.M.); (A.M.); (N.M.); (N.S.)
| | - Nicolas Scheyer
- Transversal Nutrition Unit, University of Lorraine, Nancy University Hospital, 54500 Vandoeuvre-les-Nancy, France; (M.G.); (M.M.); (A.M.); (N.M.); (N.S.)
| | - Roland Jaussaud
- Internal Medicine and Clinical Immunology Department, University of Lorraine, Nancy University Hospital, 54500 Vandoeuvre-les-Nancy, France;
| | - Phi-Linh Nguyen-Thi
- Medical Evaluation Department, Department of Clinical Research Support PARC, University of Lorraine, Nancy University Hospital, 54500 Vandoeuvre-les-Nancy, France;
| | - Didier Quilliot
- Transversal Nutrition Unit, University of Lorraine, Nancy University Hospital, 54500 Vandoeuvre-les-Nancy, France; (M.G.); (M.M.); (A.M.); (N.M.); (N.S.)
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Polastri M, Casertano L. Musculoskeletal and neurological sequelae of COVID-19: complicating full recovery. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2021. [DOI: 10.12968/ijtr.2021.0178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Massimiliano Polastri
- Department of Continuity of Care and Disability, Physical Medicine and Rehabilitation, St Orsola University Hospital, Bologna, Italy
| | - Lorenzo Casertano
- Advanced Clinician-Acute Care Neurology Service, Department of Physical Therapy, New York-Presbyterian Hospital, New York, USA
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Quilliot D, Gérard M, Bonsack O, Malgras A, Vaillant MF, Di Patrizio P, Jaussaud R, Ziegler O, Nguyen-Thi PL. Impact of severe SARS-CoV-2 infection on nutritional status and subjective functional loss in a prospective cohort of COVID-19 survivors. BMJ Open 2021; 11:e048948. [PMID: 34261689 PMCID: PMC8282420 DOI: 10.1136/bmjopen-2021-048948] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
UNLABELLED The nutritional sequelae of COVID-19 have not been explored in a large cohort study. OBJECTIVES To identify factors associated with the change in nutritional status between discharge and 30 days post-discharge (D30). Secondary objectives were to determine the prevalence of subjective functional loss and severe disability at D30 and their associated factors. METHODS Collected data included symptoms, nutritional status, self-evaluation of food intake, Performance Status (PS) Scale, Asthenia Scale, self-evaluation of strength (SES) for arms and legs at discharge and at D30. An SES <7 was used to determine subjective functional loss. A composite criteria for severe disability was elaborated combining malnutrition, subjective functional loss and PS >2. Patients were classified into three groups according to change in nutritional status between discharge and D30 (persistent malnutrition, correction of malnutrition and the absence of malnutrition). RESULTS Of 549 consecutive patients hospitalised for COVID-19 between 1 March and 29 April 2020, 130 died including 17 after discharge (23.7%). At D30, 312 patients were at home, 288 (92.3%) of whom were interviewed. Of the latter, 33.3% were malnourished at discharge and still malnourished at D30, while 23.2% were malnourished at discharge but no longer malnourished at D30. The highest predictive factors of persistent malnutrition were intensive care unit (ICU) stay (OR=3.42, 95% CI: 2.04 to 5.75), subjective functional loss at discharge (OR=3.26, 95% CI: 1.75 to 6.08) and male sex (OR=2.39, 95% CI: 1.44 to 3.97). Subjective functional loss at discharge (76.8%) was the main predictive factor of subjective functional loss at D30 (26.3%) (OR=32.6, 95% CI: 4.36 to 244.0). Lastly, 8.3% had a severe disability, with a higher risk in patients requiring an ICU stay (OR=3.39, 95% CI: 1.43 to 8.06). CONCLUSION Patients who survived a severe form of COVID-19 had a high risk of persistent malnutrition, functional loss and severe disability at D30. We believe that nutritional support and rehabilitation should be strengthened, particularly for male patients who were admitted in ICU and had subjective functional loss at discharge. TRIAL REGISTRATION NUMBER NCT04451694.
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Affiliation(s)
- Didier Quilliot
- Unité Transversale de Nutrition, CHRU de Nancy, Nancy, France
| | - Marine Gérard
- Unité Transversale de Nutrition, CHRU de Nancy, Nancy, France
| | - Olivier Bonsack
- Unité Transversale de Nutrition, CHRU de Nancy, Nancy, France
| | - Aurélie Malgras
- Unité Transversale de Nutrition, CHRU de Nancy, Nancy, France
| | | | | | - Roland Jaussaud
- Internal Medicine and Clinical Immunology Department, CHRU de Nancy, Nancy, France
| | - Olivier Ziegler
- Endocrinology Diabetology and Nutrition Department, CHRU de Nancy, Nancy, France
| | - Phi-Linh Nguyen-Thi
- Medical Evaluation Department, Department of Clinical Research Support PARC, University of Lorraine, CHRU de Nancy, Nancy, France
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SeyedAlinaghi S, Afsahi AM, MohsseniPour M, Behnezhad F, Salehi MA, Barzegary A, Mirzapour P, Mehraeen E, Dadras O. Late Complications of COVID-19; a Systematic Review of Current Evidence. ARCHIVES OF ACADEMIC EMERGENCY MEDICINE 2021; 9:e14. [PMID: 33681819 PMCID: PMC7927752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- SeyedAhmad SeyedAlinaghi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Masoud Afsahi
- Department of Radiology, School of Medicine, University of California, San Diego (UCSD), California, USA
| | - Mehrzad MohsseniPour
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzane Behnezhad
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Amin Salehi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Pegah Mirzapour
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Esmaeil Mehraeen
- Department of Health Information Technology, Khalkhal University of Medical Sciences, Khalkhal, Iran
| | - Omid Dadras
- Department of Global Health and Socioepidemiology, Graduate School of Medicine, Kyoto University, Kyoto. Japan
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SeyedAlinaghi S, Afsahi AM, MohsseniPour M, Behnezhad F, Salehi MA, Barzegary A, Mirzapour P, Mehraeen E, Dadras O. Late Complications of COVID-19; a Systematic Review of Current Evidence. ARCHIVES OF ACADEMIC EMERGENCY MEDICINE 2021. [PMID: 33681819 PMCID: PMC7927752 DOI: 10.22037/aaem.v9i1.1058] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- SeyedAhmad SeyedAlinaghi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Masoud Afsahi
- Department of Radiology, School of Medicine, University of California, San Diego (UCSD), California, USA
| | - Mehrzad MohsseniPour
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzane Behnezhad
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Amin Salehi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Pegah Mirzapour
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Esmaeil Mehraeen
- Department of Health Information Technology, Khalkhal University of Medical Sciences, Khalkhal, Iran
| | - Omid Dadras
- Department of Global Health and Socioepidemiology, Graduate School of Medicine, Kyoto University, Kyoto. Japan
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Oladapo BI, Ismail SO, Afolalu TD, Olawade DB, Zahedi M. Review on 3D printing: Fight against COVID-19. MATERIALS CHEMISTRY AND PHYSICS 2021; 258:123943. [PMID: 33106717 PMCID: PMC7578746 DOI: 10.1016/j.matchemphys.2020.123943] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 10/18/2020] [Accepted: 10/19/2020] [Indexed: 05/07/2023]
Abstract
The outbreak of coronavirus disease in 2019 (COVID-19) caused by the SARS-CoV-2 virus and its pandemic effects have created a demand for essential medical equipment. To date, there are no specific, clinically significant licensed drugs and vaccines available for COVID-19. Hence, mapping out COVID-19 problems and preventing the spread with relevant technology are very urgent. This study is a review of the work done till October, 2020 on solving COVID-19 with 3D printing. Many patients who need to be hospitalized because of COVID-19 can only survive on bio-macromolecules antiviral respiratory assistance and other medical devices. A bio-cellular face shield with relative comfortability made of bio-macromolecules polymerized polyvinyl chloride (BPVC) and other biomaterials are produced with 3D printers. Summarily, it was evident from this review study that additive manufacturing (AM) is a proffered technology for efficient production of an improved bio-macromolecules capable of significant COVID-19 test and personal protective equipment (PPE) to reduce the effect of COVID-19 on the world economy. Innovative AM applications can play an essential role to combat invisible killers (COVID-19) and its hydra-headed pandemic effects on humans, economics and society.
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Affiliation(s)
- Bankole I Oladapo
- School of Engineering and Sustainable Development, De Montfort University, Leicester, UK
| | - Sikiru O Ismail
- Center for Engineering Research, School of Physics, Engineering and Computer Science, University of Hertfordshire, UK
| | | | - David B Olawade
- Department of Environmental Health Sciences, University of Ibadan, Nigeria
| | - Mohsen Zahedi
- Department of Computer Engineering, University of Isfahan, Iran
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