Handgrip strength is associated with adverse outcomes in patients hospitalized for COVID-19-associated pneumonia

Abstract

Handgrip strength (HGS), a simple tool for the evaluation of muscular strength, is independently associated with negative prognosis in many diseases. It is unknown whether HGS is prognostically relevant in COVID-19. We evaluated the ability of HGS to predict clinical outcomes in people with COVID-19-related pneumonia. 118 patients (66% men, 63 ± 12 years), consecutively hospitalized to the “Santa Maria” Terni University Hospital for COVID-19-related pneumonia and respiratory failure, underwent HGS measurement (Jamar hand-dynamometer) at ward admission. HGS was normalized to weight2/3 (nHGS) The main end-point was the first occurrence of death and/or endotracheal intubation at 14 days. Twenty-two patients reached the main end-point. In the Kaplan–Meyer analysis, the Log rank test showed significant differences between subjects with lower than mean HGS normalized to weight2/3 (nHGS) (< 1.32 kg/Kg2/3) vs subjects with higher than mean nHGS. (p = 0.03). In a Cox-proportional hazard model, nHGS inversely predicted the main end-point (hazard ratio, HR = 1.99 each 0.5 kg/Kg2/3 decrease, p = 0.03), independently from age, sex, body mass index, ratio of partial pressure arterial oxygen and fraction of inspired oxygen (PaO2/FiO2 ratio), hypertension, diabetes, estimated glomerular filtration rate and history of previous cardiovascular cardiovascular disease. These two latter also showed independent association with the main end-point (HR 1.30, p = 0.03 and 3.89, p < 0.01, respectively). In conclusion, nHGS measured at hospital admission, independently and inversely predicts the risk of poor outcomes in people with COVID-19-related pneumonia. The evaluation of HGS may be useful in early stratifying the risk of adverse prognosis in COVID-19.

Effects of l-Arginine Plus Vitamin C Supplementation on Physical Performance, Endothelial Function, and Persistent Fatigue in Adults with Long COVID: A Single-Blind Randomized Controlled Trial

“…Handgrip strength is a valid indicator of general health and a powerful predictor of disability, morbidity, and mortality across all life stages [ 51 , 52 , 53 , 54 ]. During an acute COVID-19 episode, low handgrip strength has been associated with an increased risk of hospitalization and poor outcomes [ 55 , 56 , 57 ]. In adults who survived severe COVID-19, handgrip strength values after six months of hospital discharge were significantly lower than the healthy controls [ 58 ].…”

Perfil sociodemográfico e força muscular periférica de pacientes pós Covid-19

“…Mesmo que alguns estudos (TUZUN et al, 2021;;PUCCI et al, 2022;CHEVAL et al, 2021) vêm reportando o crescimento do uso do dinamômetro manual em ambiente hospitalar, para melhor quantificação da força muscular periférica, o MRC é considerado um método válido, confiável e de fácil aplicação (TURAN; TOPALOGLU; OZYEMISCI., 2020). Independente da ferramenta a ser utilizada, avaliar a força muscular de pacientes infectados pós COVID-19 é de fundamental importância para o acompanhamento clínico e intervenção precoce, uma vez que a fraqueza muscular periférica impacta negativamente nas atividades do dia a dia e pode trazer restrições a longo prazo (KARA et al, 2021).…”

Phase Angle and Handgrip Strength as Predictors of Clinical Outcomes in Hospitalized COVID-19 Patients

“…As in most severe infections, muscle mass seems to be negatively affected in COVID-19 patients [ 25 ]. At the same time evidence suggests that limited muscle function can be associated with a higher risk of severe COVID-19 disease [ 26 ]. Moreover, results from a recent study indicated that handgrip strength (HGS) can be used as a risk predictor of future short-term adverse clinical events, such as endotracheal intubation for COVID-19 patients [ 27 ].…”