COVID-19: Short and Long-Term Effects of Hospitalization on Muscular Weakness in the Elderly

Abstract

The COVID-19 pandemic has recently been the cause of a global public health emergency. Frequently, elderly patients experience a marked loss of muscle mass and strength during hospitalization, resulting in a significant functional decline. This paper describes the impact of prolonged immobilization and current pharmacological treatments on muscular metabolism. In addition, the scientific evidence for an early strength intervention, neuromuscular electrical stimulation or the application of heat therapy during hospitalization to help prevent COVID-19 functional sequels is analyzed. This review remarks the need to: (1) determine which potential pharmacological interventions have a negative impact on muscle quality and quantity; (2) define a feasible and reliable pharmacological protocol to achieve a balance between desired and undesired medication effects in the treatment of this novel disease; (3) implement practical strategies to reduce muscle weakness during bed rest hospitalization and (4) develop a specific, early and safe protocol-based care of functional interventions for older adults affected by COVID-19 during and after hospitalization.

A COVID-19 Rehabilitation Prospective Surveillance Model for Use by Physiotherapists

“…For these alterations, a multimodal therapeutic exercise [ 108 ] programme that includes aerobic, strength, stretching and balance has already been effective [ 109 ]. In fact, an aerobic programme has already been recommended [ 110 ], and strength programmes are already being implemented to assess muscle weakness in COVID-19 survivors [ 111 ]. For polyneuropathy, neuralgia and neuropathic pain, an intervention of electrotherapy [ 112 ], therapeutic exercise, virtual reality and graded motor imagery (GMI) [ 113 ] is also suggested, which has been effective in other populations, as there is little information about most neuromuscular alterations in COVID-19 survivors [ 114 ].…”

An Evolving Approach to Assessing Cardiorespiratory Fitness, Muscle Function and Bone and Joint Health in the COVID-19 Era

“…A complicated medical course requiring hospitalization and immobilization can further deteriorate muscle function and bone/joint health and significantly decrease mobility and increase the risk for fall and fracture at discharge. 10 , 11 , 13 , 50 …”

COVID-19 Isolation and Risk of Death in Cyprus Elderly People

“…It is also notable that elderly people hospitalized with Covid-19 have negative short and long -term effects that impair their functionality because of the associated fatigue, muscle weakness and sarcopenia that can exacerbate frailty, dependence and disability, making this vulnerable group even more vulnerable leading to a vicious cycle of isolation and dependence ( 25 ).…”