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González-Islas D, Flores-Cisneros L, Orea-Tejeda A, Keirns-Davis C, Hernández-López N, Arcos-Pacheco LP, Zurita-Sandoval A, Albarran-López F, García-Castañeda L, Salgado-Fernández F, Hernández-López S, Jiménez-Valentín A, Pérez-García I. The Association between Body Composition Phenotype and Insulin Resistance in Post-COVID-19 Syndrome Patients without Diabetes: A Cross-Sectional, Single-Center Study. Nutrients 2024; 16:2468. [PMID: 39125348 PMCID: PMC11314085 DOI: 10.3390/nu16152468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2024] [Revised: 07/24/2024] [Accepted: 07/27/2024] [Indexed: 08/12/2024] Open
Abstract
BACKGROUND The most frequent body composition alterations in post-COVID-19 syndrome include low muscle mass, dynapenia, sarcopenia, and obesity. These conditions share interconnected pathophysiological mechanisms that exacerbate each other. The relationship between body composition phenotypes and metabolic abnormalities in post-COVID-19 syndrome remains unclear. OBJECTIVE To evaluate the association between body composition phenotypes and insulin resistance (IR) and metabolic abnormalities in non-diabetic individuals with post-COVID-19 syndrome. METHODS A cross-sectional, single-center study involving 483 subjects with post-COVID-19 syndrome following moderate to severe acute COVID-19 requiring hospitalization. Individuals with diabetes, those who declined to participate, or those who could not be contacted were excluded. Body composition phenotypes were classified as normal weight, dynapenia, sarcopenia, dynapenic obesity, and sarcopenic obesity (SO). RESULTS The average age was 52.69 ± 14.75 years; of note, 67.08% were male. The prevalence of body composition phenotypes was as follows: 13.25% were of normal weight, 9.52% had dynapenia, 9.94% had sarcopenia, 43.69% had obesity, 18.84% had dynapenic obesity, and 4.76% had SO. Additionally, 58.18% had IR. Obesity (OR: 2.98, CI95%; 1.64-5.41) and dynapenic obesity (OR: 4.98, CI95%; 1.46-6.88) were associated with IR. CONCLUSION The most common body composition phenotypes were obesity, dynapenic obesity, and dynapenia. Furthermore, obesity and dynapenic obesity were associated with IR in post-COVID-19 syndrome.
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Affiliation(s)
- Dulce González-Islas
- Heart Failure and Respiratory Distress Clinic, Instituto Nacional de Enfermedades Respiratorias “Ismael Cosío Villegas”, Mexico City 14080, Mexico; (D.G.-I.)
| | - Laura Flores-Cisneros
- Department of Epidemiological Information Analysis, General Directorate of Epidemiology, Mexico City 01480, Mexico;
| | - Arturo Orea-Tejeda
- Heart Failure and Respiratory Distress Clinic, Instituto Nacional de Enfermedades Respiratorias “Ismael Cosío Villegas”, Mexico City 14080, Mexico; (D.G.-I.)
| | - Candace Keirns-Davis
- Heart Failure and Respiratory Distress Clinic, Instituto Nacional de Enfermedades Respiratorias “Ismael Cosío Villegas”, Mexico City 14080, Mexico; (D.G.-I.)
| | - Nadia Hernández-López
- Licenciatura en Nutriología, Facultad de Estudios Superiores Zaragoza, Universidad Nacional Autónoma de México, Mexico City 09230, Mexico
| | - Laura Patricia Arcos-Pacheco
- Heart Failure and Respiratory Distress Clinic, Instituto Nacional de Enfermedades Respiratorias “Ismael Cosío Villegas”, Mexico City 14080, Mexico; (D.G.-I.)
| | - Andrea Zurita-Sandoval
- Heart Failure and Respiratory Distress Clinic, Instituto Nacional de Enfermedades Respiratorias “Ismael Cosío Villegas”, Mexico City 14080, Mexico; (D.G.-I.)
| | - Frida Albarran-López
- Heart Failure and Respiratory Distress Clinic, Instituto Nacional de Enfermedades Respiratorias “Ismael Cosío Villegas”, Mexico City 14080, Mexico; (D.G.-I.)
| | - Luis García-Castañeda
- Clinical Nutrition Department, Hospital General “Dr. Manuel Gea González”, Mexico City 14080, Mexico
| | - Fernanda Salgado-Fernández
- Licenciatura en Nutriología, Facultad de Estudios Superiores Zaragoza, Universidad Nacional Autónoma de México, Mexico City 09230, Mexico
| | - Samantha Hernández-López
- Heart Failure and Respiratory Distress Clinic, Instituto Nacional de Enfermedades Respiratorias “Ismael Cosío Villegas”, Mexico City 14080, Mexico; (D.G.-I.)
| | - Angelia Jiménez-Valentín
- Heart Failure and Respiratory Distress Clinic, Instituto Nacional de Enfermedades Respiratorias “Ismael Cosío Villegas”, Mexico City 14080, Mexico; (D.G.-I.)
| | - Ilse Pérez-García
- Heart Failure and Respiratory Distress Clinic, Instituto Nacional de Enfermedades Respiratorias “Ismael Cosío Villegas”, Mexico City 14080, Mexico; (D.G.-I.)
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Pleguezuelos E, Del Carmen A, Moreno E, Serra-Prat M, Serra-Payá N, Garnacho-Castaño MV. Telerehabilitation improves cardiorespiratory and muscular fitness and body composition in older people with post-COVID-19 syndrome. J Cachexia Sarcopenia Muscle 2024. [PMID: 38937986 DOI: 10.1002/jcsm.13530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 04/26/2024] [Accepted: 06/03/2024] [Indexed: 06/29/2024] Open
Abstract
BACKGROUND The effects of post-coronavirus disease 2019 (COVID-19) syndrome on the cardiorespiratory and muscular fitness in older people are of utmost relevance. This study aimed to evaluate the effects of a 12-week telerehabilitation programme on cardiorespiratory and muscular fitness and body composition in older patients with post-COVID-19 syndrome. METHODS One hundred twenty older patients with post-COVID-19 syndrome were randomly assigned to one of two groups: patients who carried out the telerehabilitation programme (n = 60; age: 65.0 ± 5.2; female: 14.2%) and a control group (n = 60; age: 64.3 ± 5.0; female: 24.5%). An incremental cardiopulmonary exercise testing, isokinetic strength test, and bioelectrical impedance analysis were performed to compare cardiorespiratory and muscle strength responses and body composition between telerehabilitation and control groups. RESULTS A significant increase in the cardiopulmonary exercise testing duration was found in the telerehabilitation group compared to the control group (mean difference = 88.9 s, P = 0.001). Peak oxygen uptake increased in the telerehabilitation group (mean difference = 3.0 mL·kg-1·min-1, P < 0.001) and control group (mean difference = 1.9 mL·kg-1·min-1, P < 0.001). Power output in cycle ergometer (mean difference = 25.9 watts, P < 0.001), fat free mass (mean difference = 2.1 kg, P = 0.004), soft lean mass (mean difference = 2.1 kg, P = 0.003), and skeletal muscle mass (mean difference = 1.4 kg, P = 0.003) only increased in the telerehabilitation group. A significant increase in the power output was observed in the telerehabilitation group compared with the control group in both lower limbs after isokinetic strength test of the leg extension at a speed of 60° (right: mean difference = 18.7 watts, P = 0.012; left: mean difference = 15.3 watts, P = 0.010). The peak torque of right leg extension increased only in the telerehabilitation group after isokinetic strength test at a speed of 60° (mean difference = 13.1 N·m, P < 0.001). A significant increase in the power output was observed in the telerehabilitation group compared with the control group in the left leg extension after isokinetic strength test at a speed of 180° (mean difference = 30.2 watts, P = 0.003). CONCLUSIONS The telerehabilitation programme improved cardiorespiratory and muscular fitness, and body composition in older patients with post-COVID-19 syndrome to a greater extent than a control group. The telerehabilitation programmes may be an alternative to improve the sequelae of post-COVID-19 syndrome in older patients.
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Affiliation(s)
- Eulogio Pleguezuelos
- Department of Physical Medicine and Rehabilitation, Hospital of Mataro, Barcelona, Spain
- Department of Experimental Science and Healthcare. Faculty of Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Amin Del Carmen
- Department of Physical Medicine and Rehabilitation, Hospital of Mataro, Barcelona, Spain
| | - Eva Moreno
- Department of Physical Medicine and Rehabilitation, Hospitalet General Hospital, L'Hospitalet de Llobregat, Barcelona, Spain
| | | | - Noemí Serra-Payá
- DAFNiS Research Group (Pain, Physical Activity, Nutrition and Health), Campus Docent Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
| | - Manuel Vicente Garnacho-Castaño
- DAFNiS Research Group (Pain, Physical Activity, Nutrition and Health), Campus Docent Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
- Facultad de Ciencias de la Salud, Universidad Internacional de Valencia (VIU), Valencia, Spain
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Pi Q, Xu J, Sha M, Liu X. Relationship between a body shape index and muscle strength index in Chinese university students: a cross-sectional survey. BMC Sports Sci Med Rehabil 2024; 16:48. [PMID: 38360702 PMCID: PMC10870512 DOI: 10.1186/s13102-024-00837-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 02/02/2024] [Indexed: 02/17/2024]
Abstract
BACKGROUND The problem of overweight obesity and decrease in muscle strength among university students has become an indisputable fact. In this study, a comprehensive index reflecting obesity degree a body shape index (ABSI) and a comprehensive index reflecting muscle strength muscle strength index (MSI) were studied to analyze the cross-sectional correlations existing between them. METHODS This study began recruiting participants and conducting the test survey in April 2022 and closed in July 2022. Basic condition, height, weight, waist circumference, grip strength, pull-up (boys), bent-leg sit-up (girls), and standing long jump were tested on 12,046 (boys: 6011, 49.90%) university students aged 19-22 years in China, and ABSI and MSI were calculated separately. ABSI was categorized into 5 groups according to age and sex, namely ABSI < 5th percentile (A), 5th ≤ ABSI < 25th percentile (B), 25th ≤ ABSI < 75th percentile (C), 75th ≤ ABSI < 95th percentile (D) and ABSI ≥ 95th percentile (E). The comparison of MSI between different ABSI groups was performed using effect size, and the association between them was performed by curve estimation analysis. RESULTS The association between ABSI and MSI of Chinese university students showed an inverted "U" curve. The effect of increased ABSI on MSI was greater in university girls compared to boys. The ABSI of boys was (0.080 ± 0.010) and MSI was (-0.005 ± 2.080); the ABSI of girls was (0.079 ± 0.008) and MSI was (-0.017 ± 1.867). Overall, university students ABSI was at a relatively high point for MSI between 0.050 and 0.100. The university students ABSI at 0.150 had an MSI of -1.229 for boys and - 2.779 for girls. CONCLUSION The ABSI of Chinese university students showed an inverted "U"-shaped curve relationship with MSI, and university students with low or high ABSI had lower MSI. The effect of increasing ABSI on the decrease of MSI was more obvious for girls than for boys.
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Affiliation(s)
- Qing Pi
- School of Art, Shangrao Preschool Education College, 334000, Jiangxi Shangrao, P. R. China
| | - Jiali Xu
- School of Physical Education, Shangrao Normal University, 334001, Jiangxi Shangrao, P. R. China
| | - Mian Sha
- School of Physical Education, Shangrao Normal University, 334001, Jiangxi Shangrao, P. R. China
| | - Xiangdong Liu
- Department of Physical Education, Pingxiang University, 337055, Jiangxi Shangrao, P. R. China.
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Rzepka-Cholasińska A, Ratajczak J, Michalski P, Kasprzak M, Kosobucka-Ozdoba A, Pietrzykowski Ł, Grzelakowska K, Kubica J, Kryś J, Kubica A. Gender-Related Effectiveness of Personalized Post-COVID-19 Rehabilitation. J Clin Med 2024; 13:938. [PMID: 38398252 PMCID: PMC10889393 DOI: 10.3390/jcm13040938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 01/26/2024] [Accepted: 02/05/2024] [Indexed: 02/25/2024] Open
Abstract
Background: Post-COVID-19 syndrome (PCS) may affect a substantial proportion of patients who have had COVID-19. The rehabilitation program might improve the physical capacity, functioning of the cardiopulmonary system, and mental conditions of these patients. This study aimed to investigate the effectiveness of personalized rehabilitation in patients with PCS according to gender. Methods: Adults who underwent a 6-week personalized PCS rehabilitation program were enrolled in a prospective post-COVID-19 Rehabilitation (PCR-SIRIO 8) study. The initial visit and the final visit included the hand-grip strength test, the bioimpedance analysis of body composition, and the following scales: modified Borg's scale, Modified Fatigue Impact Scale (MFIS), Functioning in Chronic Illness Scale (FCIS), modified Medical Research Council (mMRC) dyspnea scale, and tests: 30 s chair stand test (30 CST), Six-Minute Walk Test (6MWT), Short Physical Performance Battery test (SPPB)e. Results: A total of 90 patients (54% female) underwent the rehabilitation program. Rehabilitation was associated with an increase in skeletal muscle mass (24.11 kg vs. 24.37 kg, p = 0.001) and phase angle (4.89° vs. 5.01°, p = 0.001) and with a reduction in abdominal fat tissue volume (3.03 L vs. 2.85 L, p = 0.01), waist circumference (0.96 m vs. 0.95 m, p = 0.001), and hydration level (83.54% vs. 82.72%, p = 0.001). A decrease in fat tissue volume and an increase in skeletal muscle mass were observed only in females, while an increase in grip strength was noticed selectively in males. Patients' fatigue (modified Borg's scale, MFIS), physical capacity (30 CST, 6MWT), balance (SPPB), dyspnea (mMRC), and functioning (FICS) were significantly improved after the rehabilitation regardless of gender. Conclusions: Personalized rehabilitation improved the body composition, muscle strength, and functioning of patients diagnosed with PCS. The beneficial effect of rehabilitation on body composition, hydration, and phase angle was observed regardless of gender.
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Affiliation(s)
- Alicja Rzepka-Cholasińska
- Department of Cardiac Rehabilitation and Health Promotion, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, 85-094 Bydgoszcz, Poland; (J.R.); (P.M.); (A.K.-O.); (Ł.P.); (A.K.)
| | - Jakub Ratajczak
- Department of Cardiac Rehabilitation and Health Promotion, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, 85-094 Bydgoszcz, Poland; (J.R.); (P.M.); (A.K.-O.); (Ł.P.); (A.K.)
| | - Piotr Michalski
- Department of Cardiac Rehabilitation and Health Promotion, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, 85-094 Bydgoszcz, Poland; (J.R.); (P.M.); (A.K.-O.); (Ł.P.); (A.K.)
| | - Michał Kasprzak
- Department of Cardiology and Internal Medicine, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, 85-094 Bydgoszcz, Poland; (M.K.); (K.G.); (J.K.)
| | - Agata Kosobucka-Ozdoba
- Department of Cardiac Rehabilitation and Health Promotion, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, 85-094 Bydgoszcz, Poland; (J.R.); (P.M.); (A.K.-O.); (Ł.P.); (A.K.)
| | - Łukasz Pietrzykowski
- Department of Cardiac Rehabilitation and Health Promotion, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, 85-094 Bydgoszcz, Poland; (J.R.); (P.M.); (A.K.-O.); (Ł.P.); (A.K.)
| | - Klaudyna Grzelakowska
- Department of Cardiology and Internal Medicine, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, 85-094 Bydgoszcz, Poland; (M.K.); (K.G.); (J.K.)
| | - Jacek Kubica
- Department of Cardiology and Internal Medicine, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, 85-094 Bydgoszcz, Poland; (M.K.); (K.G.); (J.K.)
| | - Jacek Kryś
- Department of Health Economics, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, 85-094 Bydgoszcz, Poland;
| | - Aldona Kubica
- Department of Cardiac Rehabilitation and Health Promotion, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, 85-094 Bydgoszcz, Poland; (J.R.); (P.M.); (A.K.-O.); (Ł.P.); (A.K.)
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Dos Santos TD, Souza JA, Cardoso DM, Berni VB, Pasqualoto AS, de Albuquerque IM. Predictors of Post-COVID-19 Functional Status Scale in Hospitalized Patients Recovering From SARS-CoV-2 Infection. Am J Phys Med Rehabil 2024; 103:143-148. [PMID: 37594212 DOI: 10.1097/phm.0000000000002325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/19/2023]
Abstract
OBJECTIVE The study aimed to investigate whether peripheral and inspiratory muscle strength and architecture, functional capacity, functional mobility, fatigue, and health-related quality of life are predictors of the Post-COVID-19 Functional Status Scale score in patients with post-COVID-19 syndrome who were hospitalized. DESIGN A cross-sectional study included 69 patients (53.3 ± 13.2 yrs, 36 men) with post-COVID-19 syndrome. The following outcomes were assessed: peripheral (dynamometry) and inspiratory (manovacuometry) muscle strength, muscle architecture (ultrasound), functional capacity (six-minute walk test), functional mobility (Timed Up and Go), fatigue (Functional Assessment of Chronic Illness Therapy), health-related quality of life (36-item Short-Form Health Survey), and functional status (Post-COVID-19 Functional Status scale). RESULTS Functional mobility (β = 0.573, P < 0.001), vastus intermedius echogenicity (β = -0.491, P = 0.001), length of stay (β = 0.349, P = 0.007), and female sex (β = 0.415, P = 0.003) influenced the Post-COVID-19 Functional Status Scale. CONCLUSIONS Functional mobility, muscle quality of the vastus intermedius, length of stay, and female sex influence the Post-COVID-19 Functional Status Scale score in this population. It is noteworthy that functional mobility is an independent predictor of Post-COVID-19 Functional Status Scale.
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Affiliation(s)
- Tamires Daros Dos Santos
- From the Programa de Pós-Graduação em Distúrbios da Comunicação Humana, Universidade Federal de Santa Maria (UFSM)-Santa Maria, Brazil (TDdS); Programa de Pós-Graduação em Distúrbios da Comunicação Humana, Universidade Federal de Santa Maria (UFSM)/Hospital Universitário de Santa Maria (HUSM)-Santa Maria, Brazil (JAS); Centro de Ensino Superior Dom Alberto-Santa Cruz do Sul, Brazil (DMC); Programa de Pós-Graduação em Distúrbios da Comunicação Humana, Hospital Universitário de Santa Maria (HUSM)-Santa Maria, Brazil (VBB); Departamento de Fisioterapia e Reabilitação, Programa de Pós-Graduação em Distúrbios da Comunicação Humana, Universidade Federal de Santa Maria (UFSM)-Santa Maria, Brazil (ASP); and Departamento de Fisioterapia e Reabilitação, Programa de Pós-Graduação em Ciências do Movimento e Reabilitação, Universidade Federal de Santa Maria (UFSM)-Santa Maria, Brazil (IMdA)
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González-Islas D, Robles-Hernández R, Flores-Cisneros L, Orea-Tejeda A, Galicia-Amor S, Hernández-López N, Valdés-Moreno MI, Sánchez-Santillán R, García-Hernández JC, Castorena-Maldonado A. Association between muscle quality index and pulmonary function in post-COVID-19 subjects. BMC Pulm Med 2023; 23:442. [PMID: 37968677 PMCID: PMC10652568 DOI: 10.1186/s12890-023-02745-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 11/02/2023] [Indexed: 11/17/2023] Open
Abstract
BACKGROUND The SARS-CoV2 pandemic impacted many critically ill patients, causing sequelae, affecting lung function, and involving the musculoskeletal system. We evaluated the association between lung function and muscle quality index in severely ill post-COVID-19 patients. METHODS A cross-sectional study was conducted on a post-COVID-19 cohort at a third-level center. The study included patients who had experienced severe-to-critical COVID-19. Anthropometric measurements, such as body mass index (BMI) and handgrip strength, were obtained to calculate the muscle quality index (MQI). Additionally, spirometry, measurements of expiratory and inspiratory pressure, and an assessment of DLCO in the lungs were performed. The MQI was categorized into two groups: low-MQI (below the 50th percentile) and high-MQI (above the 50th percentile), based on sex. Group differences were analyzed, and a multivariate linear regression analysis was performed to assess the association between respiratory function and MQI. RESULTS Among the 748 patients analyzed, 61.96% required mechanical ventilation, and the median hospital stay was 17 days. In patients with a low MQI, it was observed that both mechanical respiratory function and DLCO were lower. The multivariate analysis revealed significantly lower findings in mechanical respiratory function among patients with a low MQI. CONCLUSION The Low-MQI is an independent predictor associated with pulmonary function parameters in subjects with Post-COVID-19 syndrome.
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Affiliation(s)
- Dulce González-Islas
- Heart Failure and Respiratory Distress Clinic at the Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Calzada de Tlalpan 4502 Col Sec XVI CP 14080 Del Tlalpan, Mexico City, Mexico
| | - Robinson Robles-Hernández
- Department of Research in Tobacco Smoking and COPD at the Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Mexico City, Mexico
| | - Laura Flores-Cisneros
- Department of Epidemiological Information Analysis at Dirección General de Epidemiología, Secretaría de Salud, Gobierno de México, Mexico City, 01480, Mexico
| | - Arturo Orea-Tejeda
- Heart Failure and Respiratory Distress Clinic at the Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Calzada de Tlalpan 4502 Col Sec XVI CP 14080 Del Tlalpan, Mexico City, Mexico.
| | - Susana Galicia-Amor
- Pulmonary Rehabilitation Department at the Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Mexico City, Mexico
| | - Nadia Hernández-López
- Heart Failure and Respiratory Distress Clinic at the Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Calzada de Tlalpan 4502 Col Sec XVI CP 14080 Del Tlalpan, Mexico City, Mexico
| | - Mariana I Valdés-Moreno
- Licenciatura en Nutriología Facultad de Estudios Superiores Zaragoza Universidad Nacional Autónoma de México, C.P. 09230, Mexico City, Mexico
| | - Rocío Sánchez-Santillán
- Heart Failure and Respiratory Distress Clinic at the Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Calzada de Tlalpan 4502 Col Sec XVI CP 14080 Del Tlalpan, Mexico City, Mexico
| | - Juan Carlos García-Hernández
- Pulmonary Rehabilitation Department at the Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Mexico City, Mexico
| | - Armando Castorena-Maldonado
- Direction for Medical Care in Pneumology at the Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas"|, Mexico City, Mexico
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López-Sampalo A, Cobos-Palacios L, Vilches-Pérez A, Sanz-Cánovas J, Vargas-Candela A, Mancebo-Sevilla JJ, Hernández-Negrín H, Gómez-Huelgas R, Bernal-López MR. COVID-19 in Older Patients: Assessment of Post-COVID-19 Sarcopenia. Biomedicines 2023; 11:biomedicines11030733. [PMID: 36979712 PMCID: PMC10045496 DOI: 10.3390/biomedicines11030733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 02/24/2023] [Accepted: 02/26/2023] [Indexed: 03/04/2023] Open
Abstract
(1) Background: Acute COVID-19 infections produce alterations in the skeletal muscle, leading to acute sarcopenia, but the medium- and long-term consequences are still unknown. The aim of this study was to evaluate: (1) body composition; (2) muscle strength and the prevalence of sarcopenia; and (3) the relationship between muscle strength with symptomatic and functional evolution in older patients affected by/recovered from COVID-19; (2) Methods: A prospective, longitudinal study of patients aged ≥65 years who had suffered from COVID-19 infection between 1 March and 31 May 2020, as confirmed by PCR or subsequent seroconversion. Persistent symptoms, as well as anthropometric, clinical, and analytical characteristics, were analyzed at 3 and 12 months after infection. The degree of sarcopenia was determined by dynamometry and with SARC-F; (3) Results: 106 participants, aged 76.8 ± 7 years, were included. At 3 months postinfection, a high percentage of sarcopenic patients was found, especially among women and in those with hospitalization. At 12 months postinfection, this percentage had decreased, coinciding with a functional and symptomatic recovery, and the normalization of inflammatory parameters, especially interleukin-6 (4.7 ± 11.6 pg/mL vs. 1.5 ± 2.4 pg/mL, p < 0.05). The improvement in muscle strength was accompanied by significant weight gain (71.9 ± 12.1 kg vs. 74.7 ± 12.7 kg, p < 0.001), but not by an increase in lean mass (49.6 ± 10 vs. 49.9 ± 10, p 0.29); (4) Conclusions: Older COVID-19 survivors presented a functional, clinical, and muscular recovery 12 months postinfection. Even so, it is necessary to carry out comprehensive follow-ups and assessments that include aspects of nutrition and physical activity.
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Affiliation(s)
- Almudena López-Sampalo
- Internal Medicine Department, Regional University Hospital of Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA-Plataforma Bionand), University of Málaga, Avda. Hospital Civil s/n, 29009 Málaga, Spain
| | - Lidia Cobos-Palacios
- Internal Medicine Department, Regional University Hospital of Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA-Plataforma Bionand), University of Málaga, Avda. Hospital Civil s/n, 29009 Málaga, Spain
| | - Alberto Vilches-Pérez
- Endocrinology and Nutrition Department, Virgen de la Victoria University Hospital, Instituto de Investigación Biomédica de Málaga (IBIMA-Plataforma Bionand), 29010 Málaga, Spain
| | - Jaime Sanz-Cánovas
- Internal Medicine Department, Regional University Hospital of Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA-Plataforma Bionand), University of Málaga, Avda. Hospital Civil s/n, 29009 Málaga, Spain
| | - Antonio Vargas-Candela
- Internal Medicine Department, Regional University Hospital of Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA-Plataforma Bionand), University of Málaga, Avda. Hospital Civil s/n, 29009 Málaga, Spain
| | - Juan José Mancebo-Sevilla
- Internal Medicine Department, Regional University Hospital of Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA-Plataforma Bionand), University of Málaga, Avda. Hospital Civil s/n, 29009 Málaga, Spain
| | - Halbert Hernández-Negrín
- Internal Medicine Department, Regional University Hospital of Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA-Plataforma Bionand), University of Málaga, Avda. Hospital Civil s/n, 29009 Málaga, Spain
| | - Ricardo Gómez-Huelgas
- Internal Medicine Department, Regional University Hospital of Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA-Plataforma Bionand), University of Málaga, Avda. Hospital Civil s/n, 29009 Málaga, Spain
- Ciber Fisiopatología de la Obesidad y la Nutrición, Instituto de Salud Carlos III, 28029 Madrid, Spain
- Correspondence: (R.G.-H.); (M.R.B.-L.)
| | - María Rosa Bernal-López
- Internal Medicine Department, Regional University Hospital of Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA-Plataforma Bionand), University of Málaga, Avda. Hospital Civil s/n, 29009 Málaga, Spain
- Ciber Fisiopatología de la Obesidad y la Nutrición, Instituto de Salud Carlos III, 28029 Madrid, Spain
- Correspondence: (R.G.-H.); (M.R.B.-L.)
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Prognostic Impact of Myosteatosis on Mortality in Hospitalized Patients with COVID-19. Diagnostics (Basel) 2022; 12:diagnostics12092255. [PMID: 36140656 PMCID: PMC9497568 DOI: 10.3390/diagnostics12092255] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 09/15/2022] [Accepted: 09/16/2022] [Indexed: 01/08/2023] Open
Abstract
Body composition, including sarcopenia, adipose tissue, and myosteatosis, is associated with unfavorable clinical outcomes in patients with coronavirus disease (COVID-19). However, few studies have identified the impact of body composition, including pre-existing risk factors, on COVID-19 mortality. Therefore, this study aimed to evaluate the effect of body composition, including pre-existing risk factors, on mortality in hospitalized patients with COVID-19. This two-center retrospective study included 127 hospitalized patients with COVID-19 who underwent unenhanced chest computed tomography (CT) between February and April 2020. Using the cross-sectional CT images at the L2 vertebra level, we analyzed the body composition, including skeletal muscle mass, visceral to subcutaneous adipose tissue ratio (VSR), and muscle density using the Hounsfield unit (HU). Of 127 patients with COVID-19, 16 (12.6%) died. Compared with survivors, non-survivors had low muscle density (41.9 vs. 32.2 HU, p < 0.001) and high proportion of myosteatosis (4.5 vs. 62.5%, p < 0.001). Cox regression analyses revealed diabetes (hazard ratio [HR], 3.587), myosteatosis (HR, 3.667), and a high fibrosis-4 index (HR, 1.213) as significant risk factors for mortality in patients with COVID-19. Myosteatosis was associated with mortality in hospitalized patients with COVID-19, independent of pre-existing prognostic factors.
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Köller M. [Coronavirus disease 2019 and frailty]. Z Gerontol Geriatr 2022; 55:564-568. [PMID: 36066605 PMCID: PMC9446611 DOI: 10.1007/s00391-022-02101-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/11/2022] [Indexed: 11/25/2022]
Abstract
Der Verlauf der Coronavirus disease 2019 (COVID-19) ist individuell sehr unterschiedlich. Menschen höheren Lebensalters mit Komorbiditäten sind gefährdeter, schwer zu erkranken oder zu versterben. Gebrechlichkeit (Frailty) ist ein wesentlicher Risikofaktor. Ein Fünftel der Bevölkerung in Mitteleuropa ist älter als 65 Jahre, 10–15 % davon sind als „frail“ anzusehen. Die Pandemie bringt die Gesundheitssysteme vieler Länder an deren Grenzen. Die Entscheidung, welche Patienten noch intensivmedizinisch behandelt werden, führt zu ethischen Diskussionen. Die Clinical Frailty Scale von Rockwood (CFS; CMAJ 173:489–495, 2005) wird in manchen Ländern eingesetzt, diese Entscheidungen zu unterstützen. Von COVID-19 betroffene 80-jährige Patienten haben ein fast 3,6faches Sterblichkeitsrisiko, verglichen mit der Altersgruppe von 18 bis 49 Jahren. Das Risiko gebrechlicher Patienten (CFS-Scores 6–9) ist mehr als 3fach höher als von robusten (CFS-Scores 1–3). Ein CFS-Cut-off-Wert ≥ 6 korreliert mit der Mortalität von COVID-19-Patienten über 65 Jahre. Das mittel- und längerfristige Überleben ist auch mit dem Ausmaß von „Frailty“ vor der Erkrankung und weniger mit dem Schweregrad der COVID-19 assoziiert. Besonders Patienten über 60 Jahre sind gefährdet, bei moderaten und schweren COVID-19-Verläufen rasch Muskelmasse zu verlieren. Patienten auf Intensive Care Units (ICU) verlieren innerhalb von 10 Tagen 20–30 % der Oberschenkelstreckmuskulaturmasse. Das Ausmaß der COVID-19-assoziierten Sarkopenie bestimmt wesentlich den Verlauf der Erkrankung und macht individuelle Rehabilitationsprogrammen erforderlich. Bis zu 50 % der hospitalisierten Patienten benötigen weitere Rehabilitation nach der Entlassung. Aerobes Training mit niedriger Intensität, kombiniert mit Krafttraining, sowie die Sicherstellung einer ausreichenden Energie- und Eiweißzufuhr sind unerlässlich.
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Affiliation(s)
- Marcus Köller
- Abteilung für Akutgeriatrie, Klinikum Favoriten, Kundratstr. 3, 1100, Wien, Österreich.
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