Frailty but not sarcopenia nor malnutrition increases the risk of developing COVID-19 in older community-dwelling adults

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.

Frailty trajectories in community‐dwelling older adults during COVID‐19 pandemic: The PRESTIGE study

“… 46 Another study carried out on 241 community‐dwelling older adults from the SarcoPhAge cohort, showed that frailty, assessed by Fried criteria, was associated with seven‐time higher risk of Sars‐CoV‐2 infection. 47 Here, we found an overall incidence of COVID‐19 positivity of 12.9%, which was roughly doubled in pre‐frail/frail subjects. However, independently by Sars‐CoV‐2 infection, we observed a significant worsening of frailty condition only in those subjects who were pre‐frail/frail before COVID‐19 outbreak.…”

Nutrition Risk, Resilience and Effects of a Brief Education Intervention among Community-Dwelling Older Adults during the COVID-19 Pandemic in Alberta, Canada

“…Nutrition risk is highly prevalent among community-dwelling older adults in several countries [ 1 ], and a U.S. study showed that older age increased the risk of severe COVID-19 outcomes conferred by a history of malnutrition [ 36 ], although malnutrition per se may not increase the risk of contracting COVID-19 in older people [ 37 ]. Moreover, older adults are prone to developing frailty due to vulnerability to environmental stressors [ 9 , 10 ] such as a pandemic with mandated lockdown strategies that reduce physical contact with others and restrictions on shopping and travel.…”

The devastating trio of sarcopenia, frailty, and COVID-19 - A systematic review and meta-analysis

“…Sarcopenia was measured in 3 studies [44,46,50] using strength, assistance with walking, rising from a chair, climbing stairs, and falls (SARC-F) questionnaire. In 2 studies [63,68], sarcopenia was measured via muscle strength with a hand-held handgrip dynamometer and body composition. The percentage of older adults with sarcopenia ranged from 33% [46] to 75% [44].…”

“…The majority of the studies included hospitalized COVID-19 patients (n ¼ 33/39, 82%) [31e34,36,39e53,55e57,59e67,69], community dwelling elderly (n ¼ 2) [38,68], USA Medicare fee-for serviceeenrolled beneficiaries (n ¼ 1) [54], and long stay and care home residents (n ¼ 3) [35,37,58].…”

“…From the five studies that recorded sarcopenia [44,46,50,63,68], one study has reported a mortality rate among COVID-19 patients with sarcopenia [68], and the same study has recorded frailty as well, results indicated that frailty but not sarcopenia increases the risk of developing COVID-19 in older community-dwelling adults. In four studies, results stated that a high percentage of hospitaladmitted COVID-19 patients had a high risk of sarcopenia ranging from 33% [46] to 75% [44] of the participants in each study.…”