Body composition, physical capacity, and immuno-metabolic profile in community-acquired pneumonia caused by COVID-19, influenza, and bacteria: a prospective cohort study

Abstract

Background Different pathogens can cause community-acquired pneumonia (CAP); however, the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing coronavirus disease 2019 (COVID-19) has re-emphasized the vital role of respiratory viruses as a cause of CAP. The aim was to explore differences in metabolic profile, body composition, physical capacity, and inflammation between patients hospitalized with CAP caused by different etiology. Methods A prospective study of Danish patients hospitalized with CAP caused by SARS-CoV-2, influenza, or bacteria. Fat (FM) and fat-free mass (FFM) were assessed with bioelectrical impedance analysis. Physical activity and capacity were assessed using questionnaires and handgrip strength. Plasma (p)-glucose, p-lipids, hemoglobin A1c (HbA1c), p-adiponectin, and cytokines were measured. Results Among 164 patients with CAP, etiology did not affect admission levels of glucose, HbA1c, adiponectin, or lipids. Overall, 15.2% had known diabetes, 6.1% had undiagnosed diabetes, 51.3% had pre-diabetes, 81% had hyperglycemia, and 60% had low HDL-cholesterol, with no difference between groups. Body mass index, FM, and FFM were similar between groups, with 73% of the patients being characterized with abdominal obesity, although waist circumference was lower in patients with COVID-19. Physical capacity was similar between groups. More than 80% had low handgrip strength and low physical activity levels. Compared to patients with influenza, patients with COVID-19 had increased levels of interferon (IFN)-γ (mean difference (MD) 4.14; 95% CI 1.36–12.58; p = 0.008), interleukin (IL)-4 (MD 1.82; 95% CI 1.12–2.97; p = 0.012), IL-5 (MD 2.22; 95% CI 1.09–4.52; p = 0.024), and IL-6 (MD 2.41; 95% CI 1.02–5.68; p = 0.044) and increased IFN-γ (MD 6.10; 95% CI 2.53–14.71; p < 0.001) and IL-10 (MD 2.68; 95% CI 1.53–4.69; p < 0.001) compared to patients with bacterial CAP, but no difference in IL-1β, tumor necrosis factor-α, IL-8, IL-18, IL-12p70, C-reactive protein, and adiponectin. Conclusion Despite higher inflammatory response in patients with COVID-19, metabolic profile, body composition, and physical capacity were similar to patients with influenza and bacterial CAP.

Fe3O4@PDA@PEI Core-Shell Microspheres as a Novel Magnetic Sorbent for the Rapid and Broad-Spectrum Separation of Bacteria in Liquid Phase

“…Severe diseases caused by a bacterial infection or microbial contamination pose a severe threat to the public health status and are considered one of the most significant existing problems worldwide [ 1 , 2 , 3 ]. The World Health Organization (WHO) estimated that food contaminated with parasites, bacteria, viruses, toxins, or chemicals have affected more than 600 million people worldwide with 420,000 deaths, causing about $ 95 billion in productivity losses in low- and middle-income economies annually [ 4 ].…”

Kinesiophobia, Physical Activity, Depression, Anxiety and Stress Levels in Post COVID-19 Individuals: A Cross-Sectional Study

“…After the World Health Organization (WHO) declared the new coronavirus as a pandemic due to rapid transmission and higher death rates, many health problems began to appear, both in individuals who contracted SARS-CoV-2, leading to the condition COVID-19, and others who did not apparently contract the infection. 1 Although the devastating effects of COVID-19 on human health have decreased during the protracted pandemic process, health problems due to COVID-19 contact continue to emerge. 1 Low level of physical activity, decreased muscle strength, frailty and impairment in daily living activities and poor quality of life (QOL) have been reported in elderly patients with community-acquired pneumonia caused by acute COVID-19.…”

“…1 Although the devastating effects of COVID-19 on human health have decreased during the protracted pandemic process, health problems due to COVID-19 contact continue to emerge. 1 Low level of physical activity, decreased muscle strength, frailty and impairment in daily living activities and poor quality of life (QOL) have been reported in elderly patients with community-acquired pneumonia caused by acute COVID-19. 1 Moreover, mood disturbances, alterations in skeletal muscle structure, muscle weakness, pulmonary abnormalities, fatigue, and exercise intolerance have been also experienced by patients with acute or post-acute COVID-19.…”

“…1 Low level of physical activity, decreased muscle strength, frailty and impairment in daily living activities and poor quality of life (QOL) have been reported in elderly patients with community-acquired pneumonia caused by acute COVID-19. 1 Moreover, mood disturbances, alterations in skeletal muscle structure, muscle weakness, pulmonary abnormalities, fatigue, and exercise intolerance have been also experienced by patients with acute or post-acute COVID-19. [1][2][3][4][5][6][7][8] Various physical or psychological disorders persist even after the COVID-19 infection has passed.…”

“…1 Moreover, mood disturbances, alterations in skeletal muscle structure, muscle weakness, pulmonary abnormalities, fatigue, and exercise intolerance have been also experienced by patients with acute or post-acute COVID-19. [1][2][3][4][5][6][7][8] Various physical or psychological disorders persist even after the COVID-19 infection has passed. Dyspnea, decreased exercise capacity and lower limb strength, poor QOL, and worse running kinetics have been observed in post-COVID-19 individuals.…”