Poor nutritional status, risk of sarcopenia and nutrition related complaints are prevalent in COVID-19 patients during and after hospital admission

Wierdsma, N.J.; Kruizenga, Hinke; Konings, L; Krebbers, Daphne; Jorissen, J.; Joosten, Marie Helene I.; Aken, Loes H. van; Tan, Flora M.; Bodegraven, Ad A. van; Soeters, Maarten R.; Weijs, P.J.M.

doi:10.1016/j.clnesp.2021.03.021

Cited by 89 publications

(111 citation statements)

References 28 publications

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“…In our study, those patients who had high levels of inflammatory markers during COVID-19 had high FS. In a previous study, 35% of the hospitalised patients who suffered from COVID-19 was characterised as malnourished, mainly caused by considerable weight loss and 73% had high risk of sarcopenia ( 14 ). Immobility during hospital stay is further detrimental to skeletal muscle.…”

Section: Discussionmentioning

confidence: 99%

“…Among these the following deficiencies were noted; 19.5% hypoalbuminemia, 19.5% hypocalcemia, 34.1% anemia, 12.2% hypomagnesemia and 51.2% deficiency in vitamin D(17). Despite these problems, nutrition advise has not been given adequately to the patients ( 14 ). In our study, those patients with T2D and previous COVID-19, and high FS, showed decreased serum albumin levels.…”

Section: Discussionmentioning

confidence: 99%

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High prevalence of post COVID-19 fatigue in patients with type 2 diabetes: A case-control study

Mittal

Ghosh

Bhatt

et al. 2021

Diabetes & Metabolic Syndrome: Clinical Research & Revi

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Background Post COVID-19 syndrome (PCS) has emerged as a major roadblock in the recovery of patients infected with SARS-CoV-2. Amongst many symptoms like myalgia, headache, cough, breathless; fatigue is one of the major symptoms which makes the patient severely debilitated. Research on PCS, in particular fatigue, in patients with diabetes has not been done. Methodology In this prospective study, we included patients with type 2 diabetes (T2D) who had COVID-19 infection (mild to moderate severity), and matched T2D patients who did not suffer from COVID-19 infection. Demography, anthropometry, glycemic measures, treatment, COVID-19 infection details were recorded. Symptoms were scored using Chalder Fatigue Scale (reported as fatigue score, FS) and handgrip strength (in kg) was recorded by Jamar Hydraulic Hand Dynamometer. Results A total of 108 patients were included (cases, 52, controls, 56). Both groups were matched for age, duration of diabetes, BMI, TSH and vitamin D levels. T2D patients with COVID-19 infection had significant more fatigue when compared with patients without COVID-19 infection but comparable handgrip strength. Furthermore, patients with T2D with previous COVID-19 infection and who had FS >4 have had significant higher inflammation markers during acute illness, and post COVID-19, had increased post prandial blood glucose levels, lost more weight, had reduced physical activity and significantly lower handgrip strength as compared to those with FS <4. Conclusion Patients with T2D who had COVID-19 infection as compared to those without had significantly more fatigue after the acute illness, and those with higher fatigue score had reduced handgrip strength indicating sarcopenia. Rehabilitation of those with FS >4 after acute infection would require careful attention to nutrition, glycemic control and graduated physical activity protocol.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

High prevalence of post COVID-19 fatigue in patients with type 2 diabetes: A case-control study

Mittal

Ghosh

Bhatt

et al. 2021

Diabetes & Metabolic Syndrome: Clinical Research & Revi

View full text Add to dashboard Cite

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“…Although malnutrition and sarcopenia did not appear to be significant risk factors for the incidence of COVID-19 in the present study, the inverse relationship remains possible. Indeed, COVID-19 could be a risk factor for malnutrition due to its manifestation through gastrointestinal symptoms with nausea, vomiting, and loose bowel movement that could also cause anorexia [ 50 ]. In the same way, patients affected with COVID-19 have a decrease in their physical activity level because of isolation and fatigue, which can further accelerate the loss of muscle mass and strength and, therefore, engender sarcopenia [ 50 , 51 ].…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, COVID-19 could be a risk factor for malnutrition due to its manifestation through gastrointestinal symptoms with nausea, vomiting, and loose bowel movement that could also cause anorexia [ 50 ]. In the same way, patients affected with COVID-19 have a decrease in their physical activity level because of isolation and fatigue, which can further accelerate the loss of muscle mass and strength and, therefore, engender sarcopenia [ 50 , 51 ]. Additionally, given their well-observed impact on the progression of COVID-19 with more extended hospitalization stays and a higher risk of mortality [ 52 – 55 ], these two clinical states still represent essential factors to be considered for better prevention and management of COVID-19 outcomes.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2021

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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.

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“…In a study of 114 patients with COVID-19 infection, COVID-19 patients with higher risk of sarcopenia as assessed by the SARC-F were demonstrated to be more likely to develop severe disease than those without (68% vs. 22%, p<0.001) (59). Of the 407 patients hospitalized with COVID-19, 22% had rapid weight loss during hospitalization and 73% had a SARC-F score of 4 or higher (60). In 152 patients with acute cerebral infarction, the SARC-F was reported to be useful in predicting functional outcome 3 months after stroke onset (61).…”

Section: Clinical Significance Of the Sarc-f According To Diseasesmentioning

confidence: 99%

Screening Tools for Sarcopenia

Nishikawa

Asai

Fukunishi

et al. 2021

In Vivo

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The elderly people are characterized by multiple comorbidities, dementia, and are at risk of developing sarcopenia and frailty. Sarcopenia is defined by loss of muscle mass and muscle strength or physical decline. Sarcopenia is a main component of physical frailty. Screening tools for sarcopenia that can be easily determined in daily practice are useful and include the SARC-F screening tool. SARC-F is a questionnaire consisting of five questions: Strength (S), Assistance walking (A), Rising from a chair (R), Climbing stairs (C), and Falls (F) on a scale of 0 to 2. The recommended cutoff value is ≥4 points. The SARC-F has been shown to correlate well with clinical outcomes in the elderly and various underlying diseases, while it is also true that the SARC-F has its shortcomings such as low sensitivity for sarcopenia. In this review, we mainly outline the SARC-F and mention other screening tools for sarcopenia.The aging of Japan's population continues to accelerate (1). According to the Japanese government report, the aging rate (65 years old or older) was 15.1% of the total population in 1996, but it increased significantly to 28.4% in 2019 (2). In addition, the estimated aging rate as of January 1997 is projected to be 27.4% in 2025, but as of 2019, it has already exceeded the projection. The number of people aged 65 or older will continue to increase, and is estimated to reach 33.3% in 2036 and 38.4% in 2065. In order to improve the quality of life (QOL) of the increasing number of elderly people, efforts have been made in the fields of health, medical care, and welfare to extend healthy life expectancy (the period of time during which there are no limitations in daily life), but there are still many issues to be addressed. The elderly people are characterized by multiple comorbidities, dementia, and risk of sarcopenia and frailty (3). In 2019, the Ministry of Health, Labour and Welfare (MHLW) in Japan published the "Guidelines for Health Services Based on the Characteristics of the Elderly, Version 2", and announced the strengthening of measures against frailty, especially for elderly people aged 75 or older. The guidelines newly added the implementation of "health checkups for frailty" with the aim of integrating health guidance and care prevention. Specifically, the report has recommended the use of a "questionnaire for the elderly aged 75 or older" focusing on frailty in health checkups and other examinations conducted by municipalities since fiscal 2020. This questionnaire is expected to help prevent and raise awareness of frailty among many elderly people. Early intervention through such efforts will lead to a prolongation in healthy life expectancy. In addition, sarcopenia is a condition that forms the basis of physical frailty (4). Sarcopenia leads to decreased physical activity, and decreased physical activity leads to sarcopenia. Both are involved in frailty, forming the so-called "frailty cycle" (4). On the other hand, the number of people aged 60 or older in the world was estimated to be 600 million ...

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Poor nutritional status, risk of sarcopenia and nutrition related complaints are prevalent in COVID-19 patients during and after hospital admission

Abstract: Clinicians should consider the risks of acute malnutrition and sarcopenia in COVID-19 patients and investigate multidisciplinary treatment including dietetics during hospital stay and after discharge.

Cited by 89 publications

References 28 publications

High prevalence of post COVID-19 fatigue in patients with type 2 diabetes: A case-control study

High prevalence of post COVID-19 fatigue in patients with type 2 diabetes: A case-control study

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

Screening Tools for Sarcopenia

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