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de Godoy CG, Schmitt ACB, Ochiai GS, Gouveia E Silva EC, de Oliveira DB, da Silva EM, de Carvalho CRF, Junior CT, D'Andre A Greve JM, Hill K, Pompeu JE. Postural balance, mobility, and handgrip strength one year after hospitalization due to COVID-19. Gait Posture 2024; 114:14-20. [PMID: 39208539 DOI: 10.1016/j.gaitpost.2024.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 08/13/2024] [Accepted: 08/14/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND Symptoms such as impairment of postural balance, mobility and muscle strength can last up to 12 months post COVID-19 hospitalization, need to be better understood, as they can have repercussions in activities of daily living. RESEARCH QUESTION What happens to postural balance, mobility, and handgrip strength of COVID-19 patients after hospitalization? METHODS A prospective cohort study was conducted with patients of both sexes, aged ≥18, admitted to hospital diagnosed with COVID-19. Outcomes were assessed at 1, 4, 6, and 12 months post-discharge, including: postural balance - Brief-Balance Evaluation Systems Test, mobility - Timed "Up & Go" Test, and handgrip strength - dynamometry. Prevalence values of impaired postural balance and mobility and lower-than-expected handgrip strength were calculated by point estimate and 95 % confidence interval. Shapiro-Wilk test showed that our data did not have a normal distribution, so the Friedman Test and the test of proportions were used for the statistical analysis. RESULTS Performance on postural balance was improved after four months of hospital discharge, but the improvement in mobility and handgrip strength only occurred after six months. After six months of discharge, the proportion of individuals with impairments began to decrease. A higher prevalence of impairments in postural balance and mobility occurred at one month post-discharge, which reduced over time. However, the values of impairments for postural balance and mobility were still high after 12 months of follow-up. SIGNIFICANCE There was a high prevalence of postural balance and mobility impairment 1 month after discharge, which was still high 12 months after discharge. The prevalence of lower-than-expected handgrip strength demonstrated limited change over time. Results highlight the need for assessment of postural balance, mobility and hand grip strength in post COVID-19 related hospitalization protocols, and long-term physical therapy interventions to address these impairments when identified to improve long term outcomes.
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Affiliation(s)
- Caroline Gil de Godoy
- Department of Physical Therapy, Speech Therapy and Occupational Therapy, Medical School,University of São Paulo, 51, Cipotânea Street, São Paulo 05360-160, Brazil.
| | - Ana Carolina Basso Schmitt
- Department of Physical Therapy, Speech Therapy and Occupational Therapy, Medical School,University of São Paulo, 51, Cipotânea Street, São Paulo 05360-160, Brazil.
| | - Gabriela Sayuri Ochiai
- Department of Physical Therapy, Speech Therapy and Occupational Therapy, Medical School,University of São Paulo, 51, Cipotânea Street, São Paulo 05360-160, Brazil.
| | - Erika Christina Gouveia E Silva
- Department of Physical Therapy, Speech Therapy and Occupational Therapy, Medical School,University of São Paulo, 51, Cipotânea Street, São Paulo 05360-160, Brazil.
| | - Danielle Brancolini de Oliveira
- Department of Physical Therapy, Speech Therapy and Occupational Therapy, Medical School,University of São Paulo, 51, Cipotânea Street, São Paulo 05360-160, Brazil.
| | - Elizabeth Mendes da Silva
- Department of Physical Therapy, Speech Therapy and Occupational Therapy, Medical School,University of São Paulo, 51, Cipotânea Street, São Paulo 05360-160, Brazil.
| | - Celso Ricardo Fernandes de Carvalho
- Department of Physical Therapy, Speech Therapy and Occupational Therapy, Medical School,University of São Paulo, 51, Cipotânea Street, São Paulo 05360-160, Brazil.
| | - Carlos Toufen Junior
- Pulmonology Division of Hearth Hospital - InCor. Hospital to School of Medicine, University of São Paulo, 44, Av. Dr. Enéas de Carvalho Aguiar, São Paulo 05403-900, Brazil.
| | - Julia Maria D'Andre A Greve
- Laboratório de Estudos do Movimento, Institute of Orthopedics and Traumatology, Hospital to School of Medicine University of São Paulo, 333, R. Dr. Ovídio Pires de Campos, São Paulo 05403-010, Brazil.
| | - Keith Hill
- Monash University - Peninsula Campus, Frankston, VIC, Australia.
| | - José Eduardo Pompeu
- Department of Physical Therapy, Speech Therapy and Occupational Therapy, Medical School,University of São Paulo, 51, Cipotânea Street, São Paulo 05360-160, Brazil.
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Lizcano-Álvarez Á, Varillas-Delgado D, Cano-de-la-Cuerda R, Jiménez-Antona C, Melián-Ortiz A, Molero-Sánchez A, Laguarta-Val S. The Association of Genetic Markers Involved in Muscle Performance Responding to Lactate Levels during Physical Exercise Therapy by Nordic Walking in Patients with Long COVID Syndrome: A Nonrandomized Controlled Pilot Study. Int J Mol Sci 2024; 25:8305. [PMID: 39125881 PMCID: PMC11313616 DOI: 10.3390/ijms25158305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2024] [Revised: 07/27/2024] [Accepted: 07/29/2024] [Indexed: 08/12/2024] Open
Abstract
Several genetic markers have shown associations with muscle performance and physical abilities, but the response to exercise therapy is still unknown. The aim of this study was to test the response of patients with long COVID through an aerobic physical therapy strategy by the Nordic walking program and how several genetic polymorphisms involved in muscle performance influence physical capabilities. Using a nonrandomized controlled pilot study, 29 patients who previously suffered from COVID-19 (long COVID = 13, COVID-19 = 16) performed a Nordic walking exercise therapy program for 12 sessions. The influence of the ACE (rs4646994), ACTN3 (rs1815739), AMPD1 (rs17602729), CKM (rs8111989), and MLCK (rs2849757 and rs2700352) polymorphisms, genotyped by using single nucleotide primer extension (SNPE) in lactic acid concentration was established with a three-way ANOVA (group × genotype × sessions). For ACE polymorphism, the main effect was lactic acid (p = 0.019). In ACTN3 polymorphism, there were no main effects of lactic acid, group, or genotype. However, the posthoc analysis revealed that, in comparison with nonlong COVID, long COVID increased lactic acid concentrations in Nordic walking sessions in CT and TT genotypes (all p < 0.05). For AMPD1 polymorphism, there were main effects of lactic acid, group, or genotype and lactic acid × genotype or lactic acid × group × genotype interactions (all p < 0.05). The posthoc analysis revealed that, in comparison with nonlong COVID, long COVID increased lactic acid concentrations in Nordic walking sessions in CC and CT genotypes (all p < 0.05). Physical therapy strategy through Nordic walking enhanced physical capabilities during aerobic exercise in post-COVID19 patients with different genotypes in ACTN3 c.1729C>T and AMPD1 c.34C>T polymorphisms. These findings suggest that individuals who reported long COVID who presumably exercised less beforehand appeared to be less able to exercise, based on lactate levels, and the effect of aerobic physical exercise enhanced physical capabilities conditioned by several genetic markers in long COVID patients.
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Affiliation(s)
- Ángel Lizcano-Álvarez
- Department of Nursing and Stomatology, Faculty of Health Sciences, Universidad Rey Juan Carlos, 28922 Madrid, Spain;
| | - David Varillas-Delgado
- Exercise and Sport Science, Faculty of Health Sciences, Universidad Francisco de Vitoria, 28223 Pozuelo, Spain
| | - Roberto Cano-de-la-Cuerda
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Faculty of Health Sciences, Universidad Rey Juan Carlos, 28922 Madrid, Spain; (R.C.-d.-l.-C.); (C.J.-A.); (A.M.-S.); (S.L.-V.)
| | - Carmen Jiménez-Antona
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Faculty of Health Sciences, Universidad Rey Juan Carlos, 28922 Madrid, Spain; (R.C.-d.-l.-C.); (C.J.-A.); (A.M.-S.); (S.L.-V.)
| | - Alberto Melián-Ortiz
- Faculty of Nursing and Physiotherapy, Universidad Pontificia de Salamanca, 28015 Madrid, Spain;
| | - Alberto Molero-Sánchez
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Faculty of Health Sciences, Universidad Rey Juan Carlos, 28922 Madrid, Spain; (R.C.-d.-l.-C.); (C.J.-A.); (A.M.-S.); (S.L.-V.)
| | - Sofía Laguarta-Val
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Faculty of Health Sciences, Universidad Rey Juan Carlos, 28922 Madrid, Spain; (R.C.-d.-l.-C.); (C.J.-A.); (A.M.-S.); (S.L.-V.)
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Budelon Gonçalves JI, Lermen FM, Gonçalves JB, Zanirati G, Machado DC, Marques HM, Erwig HS, Becker BM, Wagner F, Boff MO, Rocha MG, Da Costa JC, Marinowic ED. Nutritional and Inflammatory Markers Associated with SARS-CoV-2 Infection in the Elderly. Int J Mol Sci 2024; 25:7749. [PMID: 39062991 PMCID: PMC11277511 DOI: 10.3390/ijms25147749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2024] [Revised: 07/08/2024] [Accepted: 07/11/2024] [Indexed: 07/28/2024] Open
Abstract
The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has posed unprecedented challenges to global health systems, particularly among vulnerable populations such as the elderly. Understanding the interplay between anthropometric markers, molecular profiles, and disease severity is crucial for effective clinical management and intervention strategies. We conducted a cohort study comprising 43 elderly COVID-19 patients admitted to São Lucas Hospital, PUCRS, Brazil. Anthropometric measurements, including calf circumference (CC) and abdominal circumference (AC), were assessed alongside molecular analyses of peripheral blood samples obtained within 48 h of hospital admission. Sociodemographic data were collected from electronic medical records for comprehensive analysis. Our findings revealed a possible relationship between overweight status, increased abdominal adiposity, and prolonged hospitalization duration, alongside heightened disease severity. We also found no significant correlations between BMI, vitamin D levels, and clinical outcomes. Elevated oxygen requirements were observed in both normal and overweight individuals, with the latter necessitating prolonged oxygen therapy. Molecular analyses revealed changes in the inflammatory profile regarding the outcome of the patients. Our study highlights the critical importance of both anthropometric and molecular markers in predicting disease severity and clinical outcomes in elderly individuals with COVID-19.
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Affiliation(s)
- João Ismael Budelon Gonçalves
- Brain Institute of Rio Grande do Sul (BraIns), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre 90610-000, RS, Brazil; (J.I.B.G.); (F.M.L.); (J.B.G.); (G.Z.); (D.C.M.); (H.M.M.); (H.S.E.); (B.M.B.); (F.W.); (M.O.B.); (M.G.R.); (J.C.D.C.)
| | - Fernanda Muller Lermen
- Brain Institute of Rio Grande do Sul (BraIns), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre 90610-000, RS, Brazil; (J.I.B.G.); (F.M.L.); (J.B.G.); (G.Z.); (D.C.M.); (H.M.M.); (H.S.E.); (B.M.B.); (F.W.); (M.O.B.); (M.G.R.); (J.C.D.C.)
- Graduate Program in Biomedical Gerontology, School of Medicine, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre 90619-900, RS, Brazil
| | - Júlia Budelon Gonçalves
- Brain Institute of Rio Grande do Sul (BraIns), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre 90610-000, RS, Brazil; (J.I.B.G.); (F.M.L.); (J.B.G.); (G.Z.); (D.C.M.); (H.M.M.); (H.S.E.); (B.M.B.); (F.W.); (M.O.B.); (M.G.R.); (J.C.D.C.)
| | - Gabriele Zanirati
- Brain Institute of Rio Grande do Sul (BraIns), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre 90610-000, RS, Brazil; (J.I.B.G.); (F.M.L.); (J.B.G.); (G.Z.); (D.C.M.); (H.M.M.); (H.S.E.); (B.M.B.); (F.W.); (M.O.B.); (M.G.R.); (J.C.D.C.)
| | - Denise Cantarelli Machado
- Brain Institute of Rio Grande do Sul (BraIns), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre 90610-000, RS, Brazil; (J.I.B.G.); (F.M.L.); (J.B.G.); (G.Z.); (D.C.M.); (H.M.M.); (H.S.E.); (B.M.B.); (F.W.); (M.O.B.); (M.G.R.); (J.C.D.C.)
- Graduate Program in Biomedical Gerontology, School of Medicine, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre 90619-900, RS, Brazil
| | - Helena Morsch Marques
- Brain Institute of Rio Grande do Sul (BraIns), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre 90610-000, RS, Brazil; (J.I.B.G.); (F.M.L.); (J.B.G.); (G.Z.); (D.C.M.); (H.M.M.); (H.S.E.); (B.M.B.); (F.W.); (M.O.B.); (M.G.R.); (J.C.D.C.)
| | - Helena Scartassini Erwig
- Brain Institute of Rio Grande do Sul (BraIns), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre 90610-000, RS, Brazil; (J.I.B.G.); (F.M.L.); (J.B.G.); (G.Z.); (D.C.M.); (H.M.M.); (H.S.E.); (B.M.B.); (F.W.); (M.O.B.); (M.G.R.); (J.C.D.C.)
| | - Bruno Maestri Becker
- Brain Institute of Rio Grande do Sul (BraIns), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre 90610-000, RS, Brazil; (J.I.B.G.); (F.M.L.); (J.B.G.); (G.Z.); (D.C.M.); (H.M.M.); (H.S.E.); (B.M.B.); (F.W.); (M.O.B.); (M.G.R.); (J.C.D.C.)
| | - Fernanda Wagner
- Brain Institute of Rio Grande do Sul (BraIns), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre 90610-000, RS, Brazil; (J.I.B.G.); (F.M.L.); (J.B.G.); (G.Z.); (D.C.M.); (H.M.M.); (H.S.E.); (B.M.B.); (F.W.); (M.O.B.); (M.G.R.); (J.C.D.C.)
| | - Marina Ottmann Boff
- Brain Institute of Rio Grande do Sul (BraIns), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre 90610-000, RS, Brazil; (J.I.B.G.); (F.M.L.); (J.B.G.); (G.Z.); (D.C.M.); (H.M.M.); (H.S.E.); (B.M.B.); (F.W.); (M.O.B.); (M.G.R.); (J.C.D.C.)
| | - Murilo Gomes Rocha
- Brain Institute of Rio Grande do Sul (BraIns), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre 90610-000, RS, Brazil; (J.I.B.G.); (F.M.L.); (J.B.G.); (G.Z.); (D.C.M.); (H.M.M.); (H.S.E.); (B.M.B.); (F.W.); (M.O.B.); (M.G.R.); (J.C.D.C.)
| | - Jaderson Costa Da Costa
- Brain Institute of Rio Grande do Sul (BraIns), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre 90610-000, RS, Brazil; (J.I.B.G.); (F.M.L.); (J.B.G.); (G.Z.); (D.C.M.); (H.M.M.); (H.S.E.); (B.M.B.); (F.W.); (M.O.B.); (M.G.R.); (J.C.D.C.)
| | - e Daniel Marinowic
- Brain Institute of Rio Grande do Sul (BraIns), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre 90610-000, RS, Brazil; (J.I.B.G.); (F.M.L.); (J.B.G.); (G.Z.); (D.C.M.); (H.M.M.); (H.S.E.); (B.M.B.); (F.W.); (M.O.B.); (M.G.R.); (J.C.D.C.)
- Graduate Program in Biomedical Gerontology, School of Medicine, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre 90619-900, RS, Brazil
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Mejía Alonso LA, Espinosa-Poblano E, de Regil López S, Lemus Eslava V, Serrano Sánchez JG, Paredes-Manjarrez C, Balderas-Chairéz AT, Anda-Garay JC, Miguel-Puga JA, Jáuregui-Renaud K. Malnutrition contribution to the functional status and health related quality of life after COVID-19, a correlational follow-up study. Sci Rep 2024; 14:15005. [PMID: 38951534 PMCID: PMC11217498 DOI: 10.1038/s41598-024-65698-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 06/24/2024] [Indexed: 07/03/2024] Open
Abstract
To assess malnutrition contribution to the functional status and health related quality of life after hospitalization due to COVID-19 pneumonia, 66 selected adults referred for physical rehabilitation accepted to participate in the study; none of them required oxygen supply or had history of lung/musculoskeletal/neurological/immune/rheumatic disease or trauma, or contraindication for respiratory-function tests. At three evaluations, with 3 months in-between, assessments included: self-report of functional status, the St. George's Respiratory Questionnaire, spirometry, the 6-min-walk-test, the MRC-scale, the 30-s sit-to-stand-test, the timed-up-and-go-test, nutritional status, and ultrasound imaging (vastus medialis and diaphragm). At referral, patients had nutritional deficits with protein deficiency, which gradually improved; while muscle thickness (of both vastus medialis and diaphragm) increased, along with muscle strength and mobility (ANOVA, p < 0.05). Contrarywise, the distance covered during the 6-min-walk-test decreased (ANOVA, p < 0.05), with a negative influence from excess body mass. During rehabilitation, health-related quality of life and functional status improved, with negative influence from a history of tobacco use and referral delay, respectively. After hospitalization due to COVID-19, early diagnosis of both protein deficiency and decrease of skeletal muscle thickness could be relevant for rehabilitation, while pondering the negative impact of excess body mass on submaximal exercise performance.
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Affiliation(s)
- Laura Alejandra Mejía Alonso
- Unidad de Rehabilitación, Hospital de Especialidades del Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico city, Mexico
| | - Eliseo Espinosa-Poblano
- Departamento de Inhaloterapia y Neumología, Hospital de Especialidades del Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico city, México
| | - Sarahi de Regil López
- Departamento de Nutrición y Dieta, Hospital de Especialidades del Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico city, México
| | - Verónica Lemus Eslava
- Departamento de Nutrición y Dieta, Hospital de Especialidades del Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico city, México
| | - Jesús Guadalupe Serrano Sánchez
- Departamento de Nutrición y Dieta, Hospital de Especialidades del Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico city, México
| | - Carlos Paredes-Manjarrez
- Departamento de Imagenología, Hospital de Especialidades del Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico city, México
| | - Andrés Tlacaelel Balderas-Chairéz
- Departamento de Imagenología, Hospital de Especialidades del Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico city, México
| | - Juan Carlos Anda-Garay
- Departamento de Medicina Interna, Hospital de Especialidades del Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico city, México
| | - José Adán Miguel-Puga
- Unidad de Investigación Médica en Otoneurología, Instituto Mexicano del Seguro Social, Mexico city, México
| | - Kathrine Jáuregui-Renaud
- Unidad de Investigación Médica en Otoneurología, Instituto Mexicano del Seguro Social, Mexico city, México.
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Michalas M, Katsaras S, Spetsioti S, Spaggoulakis D, Antonoglou A, Asimakos A, Katsaounou P, Christakou A. The Effect of Physiotherapy on Dyspnea, Muscle Strength and Functional Status in Patients with Long COVID Syndrome. J Pers Med 2024; 14:515. [PMID: 38793097 PMCID: PMC11121916 DOI: 10.3390/jpm14050515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Revised: 05/09/2024] [Accepted: 05/11/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND Patients who were infected with COVID-19 may experience Long COVID syndrome. We examined the effectiveness of physiotherapy on dyspnea, muscle strength, and functional status in Long COVID syndrome. METHODS The exercise group underwent an 8-week supervised physiotherapeutic program consisting of interval aerobic exercise and strengthening exercises, each lasting 30 min. The control group did not engage in any exercise. Dyspnea, muscle strength, and functional status were assessed at the beginning and end of the intervention in both groups. RESULTS No significant baseline differences were found between the two groups. The exercise group demonstrated improvements compared to baseline in dyspnea, quadriceps muscle strength, and functional status. Specifically, there was a significant increase of 3.7 lifts in the 60-s sit-to-stand test (p = 0.01), an increase of 5.86 kg in right quadriceps muscle strength (p = 0.03), an increase of 8.26 kg in left quadriceps muscle strength (p = 0.01), and a decrease in dyspnea score by 0.95 points (p = 0.02). CONCLUSIONS Similar studies have reported improvements in dyspnea, muscle strength, and functional status in the exercise group. However, further research with larger sample sizes is needed to confirm these findings.
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Affiliation(s)
- Michail Michalas
- Department of Physiotherapy, School of Health Sciences, University of Peloponnese, 23100 Sparta, Greece; (M.M.); (S.K.)
| | - Stefanos Katsaras
- Department of Physiotherapy, School of Health Sciences, University of Peloponnese, 23100 Sparta, Greece; (M.M.); (S.K.)
| | - Stavroula Spetsioti
- First Department of Critical Care Medicine, Evangelismos Hospital, Medical School, National & Kapodistrian University of Athens, 10676 Athens, Greece; (S.S.); (D.S.); (A.A.); (A.A.); (P.K.)
| | - Dimitrios Spaggoulakis
- First Department of Critical Care Medicine, Evangelismos Hospital, Medical School, National & Kapodistrian University of Athens, 10676 Athens, Greece; (S.S.); (D.S.); (A.A.); (A.A.); (P.K.)
| | - Archontoula Antonoglou
- First Department of Critical Care Medicine, Evangelismos Hospital, Medical School, National & Kapodistrian University of Athens, 10676 Athens, Greece; (S.S.); (D.S.); (A.A.); (A.A.); (P.K.)
| | - Andreas Asimakos
- First Department of Critical Care Medicine, Evangelismos Hospital, Medical School, National & Kapodistrian University of Athens, 10676 Athens, Greece; (S.S.); (D.S.); (A.A.); (A.A.); (P.K.)
| | - Paraskevi Katsaounou
- First Department of Critical Care Medicine, Evangelismos Hospital, Medical School, National & Kapodistrian University of Athens, 10676 Athens, Greece; (S.S.); (D.S.); (A.A.); (A.A.); (P.K.)
| | - Anna Christakou
- Department Physiotherapy, Lab Biomechanics, School of Health Sciences, University of Peloponnese, 23100 Sparta, Greece
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Barilaite E, Watson H, Hocaoglu MB. Understanding Patient-Reported Outcome Measures Used in Adult Survivors Experiencing Long-Term Effects After COVID-19 Infection: A Rapid Review. J Patient Cent Res Rev 2024; 11:36-50. [PMID: 38596351 PMCID: PMC11000699 DOI: 10.17294/2330-0698.2041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024] Open
Abstract
Purpose Patient-reported outcome measures (PROMs) are used in individuals experiencing long-term effects from COVID-19 infection, or Long COVID, to evaluate the quality of life and functional status of these individuals. However, little is known about which PROMs are being utilised and the psychometric properties of these PROMs. Our purpose was thus to explore which PROMs are used in Long COVID patients and to discuss the psychometric properties of the PROMs. Methods For this rapid review, a systematic literature search was performed in the PubMed, Embase, and CINAHL databases. The found studies were screened using the PRISMA flowchart. We then performed study quality appraisal and assessed the psychometric properties of the found PROMs. Results Per the systematic literature search and after removal of duplicates, 157 publications were identified for individual screening. After screening and eligibility assessment, 74 articles were selected for our review. In total, 74 PROMs were used and primarily comprised quality of life, fatigue, breathlessness, mental health, and smell/taste issues in COVID "long haulers." Five studies used newly developed, COVID-19-specific PROMs. We assessed the psychometric properties of the 10 most-used PROMs. The majority were found to be reliable and valid instruments. EQ-5D-5L was the most popular and highly rated PROM. Conclusions We assessed PROMs used in Long COVID patients and evaluated their psychometric properties. EQ-5D-5L was the most favourably rated PROM. PROMs addressing mental health issues are crucial in managing anxiety and depression in Long COVID patients. New COVID-specific PROMs assess functional status and smell/taste perception and show great utilisation potential in olfactory training at COVID smell clinics. However, many reviewed PROMs currently lack sufficient analysis of their psychometric properties. Therefore, future research needs to examine these measures.
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Affiliation(s)
- Egle Barilaite
- Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King's College London, London, United Kingdom
| | - Harry Watson
- Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King's College London, London, United Kingdom
| | - Mevhibe B Hocaoglu
- Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King's College London, London, United Kingdom
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Naidu AS, Wang CK, Rao P, Mancini F, Clemens RA, Wirakartakusumah A, Chiu HF, Yen CH, Porretta S, Mathai I, Naidu SAG. Precision nutrition to reset virus-induced human metabolic reprogramming and dysregulation (HMRD) in long-COVID. NPJ Sci Food 2024; 8:19. [PMID: 38555403 PMCID: PMC10981760 DOI: 10.1038/s41538-024-00261-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 03/15/2024] [Indexed: 04/02/2024] Open
Abstract
SARS-CoV-2, the etiological agent of COVID-19, is devoid of any metabolic capacity; therefore, it is critical for the viral pathogen to hijack host cellular metabolic machinery for its replication and propagation. This single-stranded RNA virus with a 29.9 kb genome encodes 14 open reading frames (ORFs) and initiates a plethora of virus-host protein-protein interactions in the human body. These extensive viral protein interactions with host-specific cellular targets could trigger severe human metabolic reprogramming/dysregulation (HMRD), a rewiring of sugar-, amino acid-, lipid-, and nucleotide-metabolism(s), as well as altered or impaired bioenergetics, immune dysfunction, and redox imbalance in the body. In the infectious process, the viral pathogen hijacks two major human receptors, angiotensin-converting enzyme (ACE)-2 and/or neuropilin (NRP)-1, for initial adhesion to cell surface; then utilizes two major host proteases, TMPRSS2 and/or furin, to gain cellular entry; and finally employs an endosomal enzyme, cathepsin L (CTSL) for fusogenic release of its viral genome. The virus-induced HMRD results in 5 possible infectious outcomes: asymptomatic, mild, moderate, severe to fatal episodes; while the symptomatic acute COVID-19 condition could manifest into 3 clinical phases: (i) hypoxia and hypoxemia (Warburg effect), (ii) hyperferritinemia ('cytokine storm'), and (iii) thrombocytosis (coagulopathy). The mean incubation period for COVID-19 onset was estimated to be 5.1 days, and most cases develop symptoms after 14 days. The mean viral clearance times were 24, 30, and 39 days for acute, severe, and ICU-admitted COVID-19 patients, respectively. However, about 25-70% of virus-free COVID-19 survivors continue to sustain virus-induced HMRD and exhibit a wide range of symptoms that are persistent, exacerbated, or new 'onset' clinical incidents, collectively termed as post-acute sequelae of COVID-19 (PASC) or long COVID. PASC patients experience several debilitating clinical condition(s) with >200 different and overlapping symptoms that may last for weeks to months. Chronic PASC is a cumulative outcome of at least 10 different HMRD-related pathophysiological mechanisms involving both virus-derived virulence factors and a multitude of innate host responses. Based on HMRD and virus-free clinical impairments of different human organs/systems, PASC patients can be categorized into 4 different clusters or sub-phenotypes: sub-phenotype-1 (33.8%) with cardiac and renal manifestations; sub-phenotype-2 (32.8%) with respiratory, sleep and anxiety disorders; sub-phenotype-3 (23.4%) with skeleto-muscular and nervous disorders; and sub-phenotype-4 (10.1%) with digestive and pulmonary dysfunctions. This narrative review elucidates the effects of viral hijack on host cellular machinery during SARS-CoV-2 infection, ensuing detrimental effect(s) of virus-induced HMRD on human metabolism, consequential symptomatic clinical implications, and damage to multiple organ systems; as well as chronic pathophysiological sequelae in virus-free PASC patients. We have also provided a few evidence-based, human randomized controlled trial (RCT)-tested, precision nutrients to reset HMRD for health recovery of PASC patients.
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Affiliation(s)
- A Satyanarayan Naidu
- Global Nutrition Healthcare Council (GNHC) Mission-COVID, Yorba Linda, CA, USA.
- N-terminus Research Laboratory, 232659 Via del Rio, Yorba Linda, CA, 92887, USA.
| | - Chin-Kun Wang
- Global Nutrition Healthcare Council (GNHC) Mission-COVID, Yorba Linda, CA, USA
- School of Nutrition, Chung Shan Medical University, 110, Section 1, Jianguo North Road, Taichung, 40201, Taiwan
| | - Pingfan Rao
- Global Nutrition Healthcare Council (GNHC) Mission-COVID, Yorba Linda, CA, USA
- College of Food and Bioengineering, Fujian Polytechnic Normal University, No.1, Campus New Village, Longjiang Street, Fuqing City, Fujian, China
| | - Fabrizio Mancini
- Global Nutrition Healthcare Council (GNHC) Mission-COVID, Yorba Linda, CA, USA
- President-Emeritus, Parker University, 2540 Walnut Hill Lane, Dallas, TX, 75229, USA
| | - Roger A Clemens
- Global Nutrition Healthcare Council (GNHC) Mission-COVID, Yorba Linda, CA, USA
- University of Southern California, Alfred E. Mann School of Pharmacy/D. K. Kim International Center for Regulatory & Quality Sciences, 1540 Alcazar St., CHP 140, Los Angeles, CA, 90089, USA
| | - Aman Wirakartakusumah
- International Union of Food Science and Technology (IUFoST), Guelph, ON, Canada
- IPMI International Business School Jakarta; South East Asian Food and Agriculture Science and Technology, IPB University, Bogor, Indonesia
| | - Hui-Fang Chiu
- Department of Chinese Medicine, Taichung Hospital, Ministry of Health & Well-being, Taichung, Taiwan
| | - Chi-Hua Yen
- Department of Family and Community Medicine, Chung Shan Medical University Hospital; School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Sebastiano Porretta
- Global Nutrition Healthcare Council (GNHC) Mission-COVID, Yorba Linda, CA, USA
- President, Italian Association of Food Technology (AITA), Milan, Italy
- Experimental Station for the Food Preserving Industry, Department of Consumer Science, Viale Tanara 31/a, I-43121, Parma, Italy
| | - Issac Mathai
- Global Nutrition Healthcare Council (GNHC) Mission-COVID, Yorba Linda, CA, USA
- Soukya International Holistic Health Center, Whitefield, Bengaluru, India
| | - Sreus A G Naidu
- Global Nutrition Healthcare Council (GNHC) Mission-COVID, Yorba Linda, CA, USA
- N-terminus Research Laboratory, 232659 Via del Rio, Yorba Linda, CA, 92887, USA
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Damanti S, Cilla M, Vitali G, Tiraferri V, Pomaranzi C, De Rubertis G, De Lorenzo R, Di Lucca G, Scotti R, Messina E, Dell’Acqua R, Guffanti M, Cinque P, Castagna A, Rovere-Querini P, Tresoldi M. Exploring the Association between Delirium and Malnutrition in COVID-19 Survivors: A Geriatric Perspective. Nutrients 2023; 15:4727. [PMID: 38004121 PMCID: PMC10674410 DOI: 10.3390/nu15224727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 11/06/2023] [Accepted: 11/07/2023] [Indexed: 11/26/2023] Open
Abstract
Older individuals face an elevated risk of developing geriatric syndromes when confronted with acute stressors like COVID-19. We assessed the connection between in-hospital delirium, malnutrition, and frailty in a cohort of COVID-19 survivors. Patients aged ≥65, hospitalized in a tertiary hospital in Milan for SARS-CoV-2 pneumonia, were enrolled and screened for in-hospital delirium with the 4 'A's Test (4AT) performed twice daily (morning and evening) during hospital stay. Malnutrition was assessed with the malnutrition universal screening tool (MUST) at hospital admission and with the mini-nutritional assessment short-form (MNA-SF) one month after hospital discharge. Frailty was computed with the frailty index one month after hospital discharge. Fifty patients (median age 78.5, 56% male) were enrolled. At hospital admission, 10% were malnourished. The 13 patients (26%) who developed delirium were frailer (7 vs. 4), experienced a higher in-hospital mortality (5 vs. 3), and were more malnourished one month after discharge (3 of the 4 patients with delirium vs. 6 of the 28 patients without delirium who presented at follow up). The 4AT scores correlated with the MNA-SF scores (r = -0.55, p = 0.006) and frailty (r = 0.35, p = 0.001). Frailty also correlated with MUST (r = 0.3, p = 0.04), MNA-SF (r = -0.42, p = 0.02), and hospitalization length (r = 0.44, p = 0.001). Delirium, malnutrition, and frailty are correlated in COVID-19 survivors. Screening for these geriatric syndromes should be incorporated in routine clinical practice.
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Affiliation(s)
- Sarah Damanti
- Vita Salute University, 20100 Milan, Italy; (V.T.); (C.P.); (G.D.R.); (R.D.L.); (A.C.); (P.R.-Q.)
- General Medicine and Continuity of Care Unit, IRCCS San Raffaele Hospital, 20132 Milan, Italy;
| | - Marta Cilla
- Center for Liver Disease, Division of Internal Medicine and Hepatology, IRCCS Ospedale San Raffaele, 20132 Milan, Italy;
| | - Giordano Vitali
- General Medicine and Continuity of Care Unit, IRCCS San Raffaele Hospital, 20132 Milan, Italy;
| | - Valeria Tiraferri
- Vita Salute University, 20100 Milan, Italy; (V.T.); (C.P.); (G.D.R.); (R.D.L.); (A.C.); (P.R.-Q.)
| | - Chiara Pomaranzi
- Vita Salute University, 20100 Milan, Italy; (V.T.); (C.P.); (G.D.R.); (R.D.L.); (A.C.); (P.R.-Q.)
| | - Giulia De Rubertis
- Vita Salute University, 20100 Milan, Italy; (V.T.); (C.P.); (G.D.R.); (R.D.L.); (A.C.); (P.R.-Q.)
| | - Rebecca De Lorenzo
- Vita Salute University, 20100 Milan, Italy; (V.T.); (C.P.); (G.D.R.); (R.D.L.); (A.C.); (P.R.-Q.)
| | - Giuseppe Di Lucca
- Unit of General Medicine and Advanced Care, IRCCS Ospedale San Raffaele, 20132 Milan, Italy; (G.D.L.); (R.S.); (M.T.)
| | - Raffaella Scotti
- Unit of General Medicine and Advanced Care, IRCCS Ospedale San Raffaele, 20132 Milan, Italy; (G.D.L.); (R.S.); (M.T.)
| | - Emanuela Messina
- Infectious Diseases Unit, San Raffaele Scientific Institute, 20132 Milan, Italy; (E.M.); (M.G.); (P.C.)
| | - Raffaele Dell’Acqua
- Infectious Diseases Unit, San Raffaele Scientific Institute, 20132 Milan, Italy; (E.M.); (M.G.); (P.C.)
| | - Monica Guffanti
- Infectious Diseases Unit, San Raffaele Scientific Institute, 20132 Milan, Italy; (E.M.); (M.G.); (P.C.)
| | - Paola Cinque
- Infectious Diseases Unit, San Raffaele Scientific Institute, 20132 Milan, Italy; (E.M.); (M.G.); (P.C.)
| | - Antonella Castagna
- Vita Salute University, 20100 Milan, Italy; (V.T.); (C.P.); (G.D.R.); (R.D.L.); (A.C.); (P.R.-Q.)
- Infectious Diseases Unit, San Raffaele Scientific Institute, 20132 Milan, Italy; (E.M.); (M.G.); (P.C.)
| | - Patrizia Rovere-Querini
- Vita Salute University, 20100 Milan, Italy; (V.T.); (C.P.); (G.D.R.); (R.D.L.); (A.C.); (P.R.-Q.)
- General Medicine and Continuity of Care Unit, IRCCS San Raffaele Hospital, 20132 Milan, Italy;
- Division of Immunology, Transplantation & Infectious Diseases, Università Vita-Salute San Raffaele, IRCCS Ospedale San Raffaele, 20132 Milan, Italy
| | - Moreno Tresoldi
- Unit of General Medicine and Advanced Care, IRCCS Ospedale San Raffaele, 20132 Milan, Italy; (G.D.L.); (R.S.); (M.T.)
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Tosato M, Calvani R, Ciciarello F, Galluzzo V, Martone AM, Zazzara MB, Pais C, Savera G, Robles MC, Ramirez M, Landi F. Malnutrition in COVID-19 survivors: prevalence and risk factors. Aging Clin Exp Res 2023; 35:2257-2265. [PMID: 37665556 PMCID: PMC10520154 DOI: 10.1007/s40520-023-02526-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 07/31/2023] [Indexed: 09/05/2023]
Abstract
BACKGROUND Nutritional status is a critical factor throughout COVID-19 disease course. Malnutrition is associated with poor outcomes in hospitalized COVID-19 patients. AIM To assess the prevalence of malnutrition and identify its associated factors in COVID-19 survivors. METHODS Study cohort included 1230 COVID-19 survivors aged 18-86 attending a post-COVID-19 outpatient service. Data on clinical parameters, anthropometry, acute COVID-19 symptoms, lifestyle habits were collected through a comprehensive medical assessment. Malnutrition was assessed according to Global Leadership Initiative on Malnutrition (GLIM) criteria. RESULTS Prevalence of malnutrition was 22% at 4-5 months after acute disease. Participants who were not hospitalized during acute COVID-19 showed a higher frequency of malnutrition compared to those who needed hospitalization (26% versus 19%, p < 0.01). Malnutrition was found in 25% COVID-19 survivors over 65 years of age compared to 21% younger participants (p < 0.01). After multivariable adjustment, the likelihood of being malnourished increased progressively and independently with advancing age (Odds ratio [OR] 1.02; 95% CI 1.01-1.03) and in male participants (OR 5.56; 95% CI 3.53-8.74). Malnutrition was associated with loss of appetite (OR 2.50; 95% CI 1.73-3.62), and dysgeusia (OR 4.05; 95% CI 2.30-7.21) during acute COVID-19. DISCUSSION In the present investigation we showed that malnutrition was highly prevalent in a large cohort of COVID-19 survivors at 4-5 months from acute illness. CONCLUSIONS Our findings highlight the need to implement comprehensive nutritional assessment and therapy as an integral part of care for COVID-19 patients.
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Affiliation(s)
- Matteo Tosato
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Largo Francesco Vito 1, 00168, Rome, Italy
| | - Riccardo Calvani
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Largo Francesco Vito 1, 00168, Rome, Italy.
- Department of Geriatrics, Orthopedics and Rheumatology, Università Cattolica del Sacro Cuore, 00168, Rome, Italy.
| | - Francesca Ciciarello
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Largo Francesco Vito 1, 00168, Rome, Italy
| | - Vincenzo Galluzzo
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Largo Francesco Vito 1, 00168, Rome, Italy
| | - Anna Maria Martone
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Largo Francesco Vito 1, 00168, Rome, Italy
- Department of Geriatrics, Orthopedics and Rheumatology, Università Cattolica del Sacro Cuore, 00168, Rome, Italy
| | - Maria Beatrice Zazzara
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Largo Francesco Vito 1, 00168, Rome, Italy
| | - Cristina Pais
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Largo Francesco Vito 1, 00168, Rome, Italy
| | - Giulia Savera
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Largo Francesco Vito 1, 00168, Rome, Italy
| | - Maria Camprubi Robles
- Abbott Nutrition, Research and Development, Camino de Purchil 68, 18004, Granada, Spain
| | - Maria Ramirez
- Abbott Nutrition, Research and Development, Camino de Purchil 68, 18004, Granada, Spain
| | - Francesco Landi
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Largo Francesco Vito 1, 00168, Rome, Italy
- Department of Geriatrics, Orthopedics and Rheumatology, Università Cattolica del Sacro Cuore, 00168, Rome, Italy
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10
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Treuil M, Mahmutovic M, Di Patrizio P, Nguyen-Thi PL, Quilliot D. Assessment of dynapenia and undernutrition in primary care, a systematic screening study in community medicine. Clin Nutr ESPEN 2023; 57:561-568. [PMID: 37739706 DOI: 10.1016/j.clnesp.2023.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 07/07/2023] [Accepted: 08/03/2023] [Indexed: 09/24/2023]
Abstract
Screening for sarcopenia is a growing public health issue since associated with functional alterations and an increase in morbidity and mortality. OBJECTIVE To analyze the prevalence of decreased muscle strength (dynapenia) in patients aged 18 to 74 in community medicine, as measured in the general practitioner's office, and to assess the prevalence of undernutrition in this population. METHOD Muscle strength was measured with a Hand Grip (HG) dynamometer according to European recommended thresholds and French guidelines. Malnutrition was defined according to the GLIM criteria. RESULTS Of 341 patients, 303 were evaluated (89%): mean age was 47.8 ± 17.4 years, including 51.2% women, 103 with an acute disease (AD) and 200 with a chronic disease (CD). 23.5% were below the 10th percentile threshold in the CD group and 19.4% in the AD group. For these patients, muscle age, evaluated on the median values for age, was higher by 39.3 ± 15.2 years for men and by 41.5 ± 13.6 years for women. Maximum HG values were significantly correlated with changes in International Physical Activity Questionnaire (IPAQ) score (F = 10.22; p = 0.0017) and weight changes (%) (F = 5.30; p = 0.0227) in women only, regardless of age, BMI, disease, professional status or type of work (manual or not); 19.1% suffered from malnutrition (10.9% Stage 1 and 8.3% Stage 2), with 20.0% in the CD group and 17.4% in the AD group. CONCLUSION This study highlights the feasibility of screening for sarcopenia in primary care community medicine. The prevalence of dynapenia in the studied population (nearly one in 5 patients) and the observed higher-than-expected undernutrition (17.5%) justify their screening for appropriate management care. CLINICAL TRIAL REGISTRATION NCT04451694; referred to as "observational research", "non-interventional", or « non-RIPH ».
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Affiliation(s)
- Marie Treuil
- Departement de Médecine Générale, Nancy UFR Médecine, Université de Lorraine, France
| | - Meliha Mahmutovic
- Unité Transversale de Nutrition, Hopital de Brabois, Centre Hospitalier Universitaire de Nancy, Vandoeuvre-Lès-Nancy, Université de Lorraine, France
| | - Paolo Di Patrizio
- Departement de Médecine Générale, Nancy UFR Médecine, Université de Lorraine, France; Departement Grand Est de Recherche en Soins Primaires, Nancy UFR Médicine, Université de Lorraine, France
| | - Phi-Linh Nguyen-Thi
- Unité d'Evaluation Médicale, Service d'Evaluation et Information Médicale, CHRU Nancy, France
| | - Didier Quilliot
- Unité Transversale de Nutrition, Hopital de Brabois, Centre Hospitalier Universitaire de Nancy, Vandoeuvre-Lès-Nancy, Université de Lorraine, France.
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Mills G, Daynes E, McAuley HJ, Greening NJ, Briggs-Price S, Baldwin MM, Singh SJ. Resistance Training in Post-COVID Recovery: Rationale and Current Evidence. J Frailty Sarcopenia Falls 2023; 8:188-194. [PMID: 37663156 PMCID: PMC10472035 DOI: 10.22540/jfsf-08-188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2023] [Indexed: 09/05/2023] Open
Abstract
During hospitalisation with COVID-19, individuals may experience prolonged periods of immobilisation. Combined with the inflammatory effects of the virus, this may lead to a significant reduction in both muscle mass and strength. Data from several long-term studies suggest that these symptoms may not fully resolve within one year. Owing to its effectiveness at inducing muscle fibre hypertrophy and improving neuromuscular efficiency, resistance training is of great interest in the rehabilitation of this population. This narrative review aims to identify the rationale and potential efficacy of resistance training for restoring physical function following infection with SARS-CoV-2, as well as evidence of its use in clinical practice. The studies included in this narrative review consisted mostly of multi-component rehabilitation trials. Of these, widespread improvements in muscle strength were reported using intensities of up to 80% of participants' 1-repetition-maximum. Evidence thus far indicates that resistance training may be safe and effective in patients following COVID-19, although its individual contribution is difficult to discern. Future exercise intervention studies investigating the efficacy of resistance training as a sole modality are needed.
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Affiliation(s)
- George Mills
- Centre of Exercise and Rehabilitation Science, NIHR Biomedical Research Centre – Respiratory, University Hospitals Leicester, Leicester, UK
| | - Enya Daynes
- Centre of Exercise and Rehabilitation Science, NIHR Biomedical Research Centre – Respiratory, University Hospitals Leicester, Leicester, UK
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Hamish J.C. McAuley
- Centre of Exercise and Rehabilitation Science, NIHR Biomedical Research Centre – Respiratory, University Hospitals Leicester, Leicester, UK
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Neil J. Greening
- Centre of Exercise and Rehabilitation Science, NIHR Biomedical Research Centre – Respiratory, University Hospitals Leicester, Leicester, UK
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Samuel Briggs-Price
- Centre of Exercise and Rehabilitation Science, NIHR Biomedical Research Centre – Respiratory, University Hospitals Leicester, Leicester, UK
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Molly M. Baldwin
- Centre of Exercise and Rehabilitation Science, NIHR Biomedical Research Centre – Respiratory, University Hospitals Leicester, Leicester, UK
| | - Sally J. Singh
- Centre of Exercise and Rehabilitation Science, NIHR Biomedical Research Centre – Respiratory, University Hospitals Leicester, Leicester, UK
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
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12
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Jubina LE, Locke A, Fedder KR, Slone SA, Soper MK, Kalema AG, Montgomery-Yates AA, Mayer KP. Nutrition in the intensive care unit and early recovery influence functional outcomes for survivors of critical illness: A prospective cohort study. JPEN J Parenter Enteral Nutr 2023; 47:888-895. [PMID: 37345259 PMCID: PMC11210604 DOI: 10.1002/jpen.2538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 05/26/2023] [Accepted: 06/20/2023] [Indexed: 06/23/2023]
Abstract
BACKGROUND Patients who are critically ill may receive suboptimal nutrition that leads to weight loss and increased risk of functional deficits. METHODS Our overarching hypothesis is that nutrition in the intensive care unit (ICU) and the early recovery phase associates with functional outcomes at short-term follow-up. We enrolled adult patients who attended the University of Kentucky ICU recovery clinic (ICU-RC) from November 2021 to June 2022. Patients participated in muscle and functional assessments. Nutrition intake and status during the ICU stay were analyzed. The Subjective Global Assessment and a nutrition questionnaire were used to identify changes in intake, ongoing gastrointestinal symptoms, and patient's access to food at the ICU-RC appointment. RESULTS Forty-one patients enrolled with a median hospital length of stay (LOS) of 23 days. Patients with 0 days of nil per os (NPO) status throughout hospitalization had a shorter LOS (P = 0.05), were able to complete the five times sit-to-stand test (P = 0.02), and were less likely to experience ICU-acquired weakness (P = 0.04) at short-term follow-up compared with patients with ≥1 day of NPO status. Twenty (48%) patients reported changes in nutrition intake in early recovery compared with before hospitalization. Eight (20%) patients reported symptoms leading to decreased intake and four (10%) reported access to food as a barrier to intake. CONCLUSION Barriers to nutrition exist during critical illness and persist after discharge, with almost half of patients reporting a change in intake. Inpatient nutrition intake is associated with functional outcomes and warrants further exploration.
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Affiliation(s)
- Lindsey E. Jubina
- Department of Physical Therapy, College of Health Sciences, University of Kentucky, Lexington, Kentucky, USA
| | - Alleyna Locke
- Department of Physical Therapy, College of Health Sciences, University of Kentucky, Lexington, Kentucky, USA
| | - Kelly R. Fedder
- Department of Clinical Nutrition, University of Kentucky HealthCare, Lexington, Kentucky, USA
| | - Stacey A. Slone
- Dr. Bing Zhang Department of Statistics, College of Arts & Sciences, University of Kentucky, Lexington, Kentucky, USA
| | - Melissa K. Soper
- Division of Pulmonary, Critical Care and Sleep Medicine, Internal Medicine, College of Medicine, University of Kentucky, Lexington, Kentucky, USA
| | - Anna G. Kalema
- Division of Pulmonary, Critical Care and Sleep Medicine, Internal Medicine, College of Medicine, University of Kentucky, Lexington, Kentucky, USA
- Kentucky Research Alliance for Lung Disease, Office of Research, College of Medicine, University of Kentucky, Lexington, Kentucky, USA
| | - Ashley A. Montgomery-Yates
- Division of Pulmonary, Critical Care and Sleep Medicine, Internal Medicine, College of Medicine, University of Kentucky, Lexington, Kentucky, USA
- Kentucky Research Alliance for Lung Disease, Office of Research, College of Medicine, University of Kentucky, Lexington, Kentucky, USA
| | - Kirby P. Mayer
- Department of Physical Therapy, College of Health Sciences, University of Kentucky, Lexington, Kentucky, USA
- Kentucky Research Alliance for Lung Disease, Office of Research, College of Medicine, University of Kentucky, Lexington, Kentucky, USA
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13
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Hawkings MJ, Vaselli NM, Charalampopoulos D, Brierley L, Elliot AJ, Buchan I, Hungerford D. A Systematic Review of the Prevalence of Persistent Gastrointestinal Symptoms and Incidence of New Gastrointestinal Illness after Acute SARS-CoV-2 Infection. Viruses 2023; 15:1625. [PMID: 37631968 PMCID: PMC10459193 DOI: 10.3390/v15081625] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 07/24/2023] [Accepted: 07/24/2023] [Indexed: 08/27/2023] Open
Abstract
It is known that SARS-CoV-2 infection can result in gastrointestinal symptoms. For some, these symptoms may persist beyond acute infection, in what is known as 'post-COVID syndrome'. We conducted a systematic review to examine the prevalence of persistent gastrointestinal symptoms and the incidence of new gastrointestinal illnesses following acute SARS-CoV-2 infection. We searched the scientific literature using MedLine, SCOPUS, Europe PubMed Central and medRxiv from December 2019 to July 2023. Two reviewers independently identified 45 eligible articles, which followed participants for various gastrointestinal outcomes after acute SARS-CoV-2 infection. The study quality was assessed using the Joanna Briggs Institute Critical Appraisal Tools. The weighted pooled prevalence for persistent gastrointestinal symptoms of any nature and duration was 10.8% compared with 4.9% in healthy controls. For seven studies at low risk of methodological bias, the symptom prevalence ranged from 0.2% to 24.1%, with a median follow-up time of 18 weeks. We also identified a higher risk for future illnesses such as irritable bowel syndrome, dyspepsia, hepatic and biliary disease, liver disease and autoimmune-mediated illnesses such as inflammatory bowel disease and coeliac disease in historically SARS-CoV-2-exposed individuals. Our review has shown that, from a limited pool of mostly low-quality studies, previous SARS-CoV-2 exposure may be associated with ongoing gastrointestinal symptoms and the development of functional gastrointestinal illness. Furthermore, we show the need for high-quality research to better understand the SARS-CoV-2 association with gastrointestinal illness, particularly as population exposure to enteric infections returns to pre-COVID-19-restriction levels.
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Affiliation(s)
- Michael J. Hawkings
- Department of Public Health, Policy & Systems, Institute of Population Health, University of Liverpool, Liverpool L69 3GF, UK
- National Institute for Health and Care Research Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool L69 7BE, UK; (N.M.V.)
| | - Natasha Marcella Vaselli
- National Institute for Health and Care Research Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool L69 7BE, UK; (N.M.V.)
- Department of Clinical Infection, Microbiology and Immunology, Institute of Infection, Veterinary & Ecological Sciences, University of Liverpool, Liverpool L69 7BE, UK
| | - Dimitrios Charalampopoulos
- Department of Public Health, Policy & Systems, Institute of Population Health, University of Liverpool, Liverpool L69 3GF, UK
| | - Liam Brierley
- Department of Health Data Science, Institute of Population Health, University of Liverpool, Liverpool L69 3GF, UK
| | - Alex J. Elliot
- National Institute for Health and Care Research Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool L69 7BE, UK; (N.M.V.)
- Real-Time Syndromic Surveillance Team, Field Services, Health Protection Operations, UK Health Security Agency, Birmingham B2 4BH, UK
| | - Iain Buchan
- Department of Public Health, Policy & Systems, Institute of Population Health, University of Liverpool, Liverpool L69 3GF, UK
- National Institute for Health and Care Research Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool L69 7BE, UK; (N.M.V.)
| | - Daniel Hungerford
- National Institute for Health and Care Research Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool L69 7BE, UK; (N.M.V.)
- Department of Clinical Infection, Microbiology and Immunology, Institute of Infection, Veterinary & Ecological Sciences, University of Liverpool, Liverpool L69 7BE, UK
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14
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Araya-Quintanilla F, Sepulveda-Loyola W, Cuyul-Vásquez I, Alvarez-Bustos A, Gutiérrez-Espinoza H, Suziane Probst V, Camp PG, Rodríguez-Mañas L. Recommendations and Effects of Rehabilitation Programs in Older Adults After Hospitalization for COVID-19: A Scoping Review. Am J Phys Med Rehabil 2023; 102:653-659. [PMID: 36762849 PMCID: PMC10259172 DOI: 10.1097/phm.0000000000002183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
ABSTRACT The aims of this review were to identify studies on physical rehabilitation programs and describe the potential effects on functional outcomes in patients older than 60 yrs at discharge from acute care post-COVID-19. The literature search was conducted in the MEDLINE, Cochrane CENTRAL, EMBASE, PEDro, LILACS, CINAHL, SPORTDiscus, Web of Science, and The Living OVerview of Evidence (L-OVE) COVID-19 databases. Studies with patients older than 60 yrs, hospitalized with COVID-19, and admitted to a rehabilitation program after discharge from acute care were included. Ten studies were included with a total of 572 patients. The prevalence of patients who received post-intensive care rehabilitation was 53% (95% confidence interval, 0.27-0.79; P = 0.001). The rehabilitation program included physiotherapy in nine studies, occupational therapy in three studies, and psychotherapy in two studies. The rehabilitation programs increased aerobic capacity, functional independence in basic activities of daily living, muscle strength, muscle mass, dynamic balance, physical performance, pulmonary function, quality of life, cognitive capacity and mental health. Multidisciplinary rehabilitation programs are necessary for older adults after hospitalization for COVID-19, especially those coming from intensive care units, as rehabilitation has a positive effect on important clinical outcomes.
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15
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O'Mahoney LL, Routen A, Gillies C, Ekezie W, Welford A, Zhang A, Karamchandani U, Simms-Williams N, Cassambai S, Ardavani A, Wilkinson TJ, Hawthorne G, Curtis F, Kingsnorth AP, Almaqhawi A, Ward T, Ayoubkhani D, Banerjee A, Calvert M, Shafran R, Stephenson T, Sterne J, Ward H, Evans RA, Zaccardi F, Wright S, Khunti K. Corrigendum to "The prevalence and long-term health effects of long Covid among hospitalised and non-hospitalised populations: a systematic review and meta-analysis". EClinicalMedicine 2023; 59:101959. [PMID: 37096187 PMCID: PMC10115131 DOI: 10.1016/j.eclinm.2023.101959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/26/2023] Open
Abstract
[This corrects the article DOI: 10.1016/j.eclinm.2022.101762.].
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Affiliation(s)
| | - Ash Routen
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Clare Gillies
- Diabetes Research Centre, University of Leicester, Leicester, UK
- Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Winifred Ekezie
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Anneka Welford
- Diabetes Research Centre, University of Leicester, Leicester, UK
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Alexa Zhang
- Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Urvi Karamchandani
- Faculty of Medicine, School of Public Health, Imperial College London, London, UK
| | | | - Shabana Cassambai
- Diabetes Research Centre, University of Leicester, Leicester, UK
- Department of Family and Community Medicine, College of Medicine, King Faisal University, Al Ahsa, Saudi Arabia
| | - Ashkon Ardavani
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | | | - Grace Hawthorne
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Ffion Curtis
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Andrew P Kingsnorth
- Diabetes Research Centre, University of Leicester, Leicester, UK
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Abdullah Almaqhawi
- Department of Family and Community Medicine, College of Medicine, King Faisal University, Al Ahsa, Saudi Arabia
| | - Thomas Ward
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Daniel Ayoubkhani
- Office for National Statistics, Government Buildings, Newport, UK
- Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Amitava Banerjee
- Faculty of Population Health Sciences, Institute of Health Informatics, University College London, London, UK
- Department of Population Science and Experimental Medicine, University College London, London, UK
| | - Melanie Calvert
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- NIHR Birmingham Biomedical Research Centre and NIHR Applied Research Collaboration West Midlands, University Hospital Birmingham and University of Birmingham, Birmingham, UK
- NIHR Leicester Biomedical Research Centre, Respiratory Department, University Hospitals of Leicester NHS Trust, Leicester, UK
- Birmingham Health Partners Centre for Regulatory Science and Innovation and Centre for Patient Reported Outcomes Research, University of Birmingham, Birmingham, UK
| | - Roz Shafran
- Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Terence Stephenson
- Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Jonathan Sterne
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Helen Ward
- Faculty of Medicine, School of Public Health, Imperial College London, London, UK
| | - Rachael A Evans
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
- NIHR Leicester Biomedical Research Centre, Respiratory Department, University Hospitals of Leicester NHS Trust, Leicester, UK
- Office for National Statistics, Government Buildings, Newport, UK
| | - Francesco Zaccardi
- Diabetes Research Centre, University of Leicester, Leicester, UK
- Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester, UK
| | | | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester, UK
- Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester, UK
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16
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Haines KJ, Emery KL, Berney SC. Physical therapy and nutrition therapy: synergistic, antagonistic, or independent interventions? Curr Opin Clin Nutr Metab Care 2023; 26:179-185. [PMID: 36892964 DOI: 10.1097/mco.0000000000000913] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/10/2023]
Abstract
PURPOSE OF REVIEW Physical therapy and nutrition therapy have predominantly been studied separately in the critically ill, however in clinical practice are often delivered in combination. It is important to understand how these interventions interact. This review will summarize the current science - where they are potentially synergistic, antagonistic, or independent interventions. RECENT FINDINGS Only six studies were identified within the ICU setting that combined physical therapy and nutrition therapy. The majority of these were randomized controlled trials with modest sample sizes. There was an indication of benefit in the preservation of femoral muscle mass and short-term physical quality of life - particularly with high-protein delivery and resistance exercise, in patients who were predominantly mechanically ventilated patients, with an ICU length of stay of approximately 4-7 days (varied across studies). Although these benefits did not extend to other outcomes such as reduced length of ventilation, ICU or hospital admission. No recent trials were identified that combined physical therapy and nutrition therapy in post-ICU settings and is an area that warrants investigation. SUMMARY The combination of physical therapy and nutrition therapy might be synergistic when evaluated within the ICU setting. However, more careful work is required to understand the physiological challenges in the delivery of these interventions. Combining these interventions in post-ICU settings is currently under-investigated, but may be important to understand any potential benefits to patient longitudinal recovery.
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Affiliation(s)
- Kimberley J Haines
- Department of Critical Care, School of Medicine, The University of Melbourne
- Department of Physiotherapy, Western Health
| | | | - Sue C Berney
- Department of Physiotherapy, Austin Health, Melbourne, Victoria, Australia
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17
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Ostolin TLVDP, Miranda RADR, Abdala CVM. [Evidence map on post-acute COVID-19 sequelae and rehabilitation: Update as of July 2022Mapa de evidencia sobre las secuelas y la rehabilitación tras la COVID-19 aguda: versión actualizada en julio del 2022]. Rev Panam Salud Publica 2023; 47:e30. [PMID: 36788961 PMCID: PMC9910559 DOI: 10.26633/rpsp.2023.30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 08/17/2022] [Indexed: 02/11/2023] Open
Abstract
Objective To update the evidence map on the effects of interventions for post-acute COVID-19 rehabilitation. Method The search scope was defined according to the population (patients with symptomatic COVID-19 and post-acute COVID sequelae), the context (interventions for rehabilitation), and the type of study (systematic reviews, rapid reviews, scoping reviews or overviews of reviews). Following a search in PubMed and the Virtual Health Library, two independent authors selected the articles for review. The map was updated on July 27, 2022, using the same procedures employed in the initial review. Results The initial evidence map included 22 studies (four systematic reviews, four rapid reviews, four reviews of case reports, one scoping review, and nine systematic review protocols). In the present update, an additional 10 studies were included. The analysis revealed four groups of interventions (multimodal, therapeutic, complementary, and pharmacological) and seven groups of outcomes (pathological conditions, diseases/respiratory disorders, pain, physiological and metabolic markers, mental health/quality of life, sensory function, and mortality), totaling 166 associations between interventions and outcomes. The highest number of associations was observed for complementary therapies (n = 94). Among the outcomes, the highest number of associations was observed for physiological and metabolic markers, pathological conditions, and mental health/quality of life (44, 41, and 35 associations respectively). Conclusions The map update involved the analysis of 69 associations, most notably exercise (isolated, multicomponent, or multimodal intervention), with 23 positive and four potentially positive effects) and pharmacologic and complementary therapies for sensorial functions (15 associations). The high number of systematic review protocols indicates that the literature is still incipient.
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Affiliation(s)
- Thatiane Lopes Valentim Di Paschoale Ostolin
- Universidade Federal de São Paulo (UNIFESP)Departamento de Ciências do Movimento HumanoLaboratório de Epidemiologia e Movimento Humano (EPIMOV)São Paulo (SP)BrasilUniversidade Federal de São Paulo (UNIFESP), Departamento de Ciências do Movimento Humano, Laboratório de Epidemiologia e Movimento Humano (EPIMOV), São Paulo (SP), Brasil.,
| | - Rafael Abe da Rocha Miranda
- Universidade de Brasília (UNB)Departamento de FarmáciaBrasília (DF)BrasilUniversidade de Brasília (UNB), Departamento de Farmácia, Brasília (DF), Brasil.
| | - Carmen Verônica Mendes Abdala
- Centro Latino-Americano e do Caribe de Informação em Ciências da Saúde (BIREME/OPAS/OMS)São Paulo (SP)BrasilCentro Latino-Americano e do Caribe de Informação em Ciências da Saúde (BIREME/OPAS/OMS), São Paulo (SP), Brasil.
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18
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Moretti A, Liguori S, Paoletta M, Migliaccio S, Toro G, Gimigliano F, Iolascon G. Bone fragility during the COVID-19 pandemic: the role of macro- and micronutrients. Ther Adv Musculoskelet Dis 2023; 15:1759720X231158200. [PMID: 36937822 PMCID: PMC10015293 DOI: 10.1177/1759720x231158200] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 02/01/2023] [Indexed: 03/18/2023] Open
Abstract
Bone fragility is the susceptibility to fracture due to poor bone strength. This condition is usually associated with aging, comorbidities, disability, poor quality of life, and increased mortality. International guidelines for the management of patients with bone fragility include a nutritional approach, mainly aiming at optimal protein, calcium, and vitamin D intakes. Several biomechanical features of the skeleton, such as bone mineral density (BMD), trabecular and cortical microarchitecture, seem to be positively influenced by micro- and macronutrient intake. Patients with major fragility fractures are usually poor consumers of dairy products, fruit, and vegetables as well as of nutrients modulating gut microbiota. The COVID-19 pandemic has further aggravated the health status of patients with skeletal fragility, also in terms of unhealthy dietary patterns that might adversely affect bone health. In this narrative review, we discuss the role of macro- and micronutrients in patients with bone fragility during the COVID-19 pandemic.
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Affiliation(s)
| | - Sara Liguori
- Department of Medical and Surgical Specialties
and Dentistry, University of Campania “Luigi Vanvitelli”, Naples,
Italy
| | - Marco Paoletta
- Department of Medical and Surgical Specialties
and Dentistry, University of Campania “Luigi Vanvitelli”, Naples,
Italy
| | - Silvia Migliaccio
- Department of Movement, Human and Health
Sciences, University of Rome “Foro Italico”, Rome, Italy
| | - Giuseppe Toro
- Department of Medical and Surgical Specialties
and Dentistry, University of Campania “Luigi Vanvitelli”, Naples,
Italy
| | - Francesca Gimigliano
- Department of Physical and Mental Health and
Preventive Medicine, University of Campania “Luigi Vanvitelli”, Naples,
Italy
| | - Giovanni Iolascon
- Department of Medical and Surgical Specialties
and Dentistry, University of Campania “Luigi Vanvitelli”, Naples,
Italy
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19
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He S, Wu K, Cheng Z, He M, Hu R, Fan N, Shen L, Li Q, Fan H, Tong Y. Long COVID: The latest manifestations, mechanisms, and potential therapeutic interventions. MedComm (Beijing) 2022; 3:e196. [PMID: 36514781 PMCID: PMC9732402 DOI: 10.1002/mco2.196] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 11/15/2022] [Accepted: 11/16/2022] [Indexed: 12/14/2022] Open
Abstract
COVID-19 caused by SARS-CoV-2 infection affects humans not only during the acute phase of the infection, but also several weeks to 2 years after the recovery. SARS-CoV-2 infects a variety of cells in the human body, including lung cells, intestinal cells, vascular endothelial cells, olfactory epithelial cells, etc. The damages caused by the infections of these cells and enduring immune response are the basis of long COVID. Notably, the changes in gene expression caused by viral infection can also indirectly contribute to long COVID. We summarized the occurrences of both common and uncommon long COVID, including damages to lung and respiratory system, olfactory and taste deficiency, damages to myocardial, renal, muscle, and enduring inflammation. Moreover, we provided potential treatments for long COVID symptoms manifested in different organs and systems, which were based on the pathogenesis and the associations between symptoms in different organs. Importantly, we compared the differences in symptoms and frequency of long COVID caused by breakthrough infection after vaccination and infection with different variants of concern, in order to provide a comprehensive understanding of the characteristics of long COVID and propose improvement for tackling COVID-19.
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Affiliation(s)
- Shi‐ting He
- College of Life Science and TechnologyBeijing University of Chemical TechnologyBeijingChina
| | - Kexin Wu
- College of Life Science and TechnologyBeijing University of Chemical TechnologyBeijingChina
| | - Zixuan Cheng
- College of Life Science and TechnologyBeijing University of Chemical TechnologyBeijingChina
| | - Mengjie He
- College of Life Science and TechnologyBeijing University of Chemical TechnologyBeijingChina
| | - Ruolan Hu
- College of Life Science and TechnologyBeijing University of Chemical TechnologyBeijingChina
| | - Ning Fan
- College of Life Science and TechnologyBeijing University of Chemical TechnologyBeijingChina
| | - Lin Shen
- College of Life Science and TechnologyBeijing University of Chemical TechnologyBeijingChina
| | - Qirui Li
- College of Life Science and TechnologyBeijing University of Chemical TechnologyBeijingChina
| | - Huahao Fan
- College of Life Science and TechnologyBeijing University of Chemical TechnologyBeijingChina
| | - Yigang Tong
- College of Life Science and TechnologyBeijing University of Chemical TechnologyBeijingChina
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20
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A Scoping Review on Long COVID-19: Physiological and Psychological Symptoms Post-Acute, Long-Post and Persistent Post COVID-19. Healthcare (Basel) 2022; 10:healthcare10122418. [PMID: 36553942 PMCID: PMC9778115 DOI: 10.3390/healthcare10122418] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 11/24/2022] [Accepted: 11/26/2022] [Indexed: 12/03/2022] Open
Abstract
Background: The identification of persistent symptoms of chronic/long COVID-19 is crucial in understanding the management of long haulers of post COVID-19. Methods: Pub Med (Medline) database was scoped for original articles based on a search strategy related to the objectives. The selected articles post-screening were analyzed for variables relating to chronic/long COVID-19. Results were analyzed using descriptive statistics. Results: A total of 33 studies were reviewed. A total of 60% of the studies were observational studies and most of them were from high income countries. Almost half of the studies were in phase 3 of post-COVID-19, i.e., symptoms lasting >24 weeks. Among the physiological and psychological symptoms studied, fatigue, dyspnea, cough, headache, memory loss, depression, brain fog and lack of concentration were found to be the most frequently reported symptoms. Excessive sleep, constipation and neuropathic pain were among the least reported symptoms. Prior hospitalization, the female gender was found to be a risk factor. Limitations were reported by all studies. Conclusions: The major physiological and psychological symptoms of long COVID-19 have been explained with risk factors and its impact on patients’ lifestyles. The findings of this review hope to facilitate clinicians to draw conclusions to manage the long-term effects of post/chronic COVID-19.
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21
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A Snapshot of the Experience of Dietitians during the COVID-19 Crisis in Five Arab Countries: Findings from a Regional Cross-Sectional Study. Nutrients 2022; 14:nu14224904. [PMID: 36432590 PMCID: PMC9695406 DOI: 10.3390/nu14224904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 11/13/2022] [Accepted: 11/16/2022] [Indexed: 11/22/2022] Open
Abstract
COVID-19's intimidating spread has challenged the resilience of the global health systems, causing shifts in the practices of healthcare workers, including dietitians. The current study aimed to assess the change in dietitians' practices and duties in hospitals/clinics after the commencement of COVID-19 pandemic. This cross-sectional study was conducted in five Arab countries between November 2020 and January 2021. A convenient sample of 903 dietitians filled an online self-administered questionnaire to meet the study aims. Nearly 40.0% of the dietitians experienced a change in their workload and caseload during the pandemic. Besides, 18.7% of the dietitians had been assigned additional tasks in their facilities. Nearly half the dietitians (46.9%) had started giving remote nutrition consultations, associated with a 21% drop in the number of dietitians offering in-person consultations (p = 0.001). Approximately 58.9% of the dietitians provided nutrition care to COVID-19 patients, with 48.4% having access to personal protective equipment. Moreover, 17.0% of dietitians supported COVID-19 patients with enteral and parenteral nutrition. In addition, 45.0% of dietitians reported that managing COVID-19 was challenging given that it was a newly discovered condition.
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22
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Suba Rao HR, Hamzaid NA, Ahmad MY, Hamzah N. Physiological factors affecting the mechanical performance of peripheral muscles: A perspective for long COVID patients through a systematic literature review. Front Physiol 2022; 13:958333. [PMID: 36324314 PMCID: PMC9621086 DOI: 10.3389/fphys.2022.958333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 08/31/2022] [Indexed: 11/18/2022] Open
Abstract
Background: Peripheral muscle weakness can be measured quantitatively in long COVID patients. Mechanomyography (MMG) is an alternative tool to measure muscle strength non-invasively. Objective: This literature review aims to provide evidence on the efficacy of MMG in measuring muscle strength for long COVID patients and to determine the physiological factors that may affect the use of MMG in assessing muscle performance. Methods: A systematic literature review was conducted using EBSCO’s MEDLINE Complete. A total of five out of 2,249 potential publications fulfilled the inclusion criteria. Results: The selected studies addressed muscle performance based on the physiological effects of age, gender, and physical activity level. MMG is sensitive in measuring muscle strength for long COVID patients due to its higher signal-to-noise ratio and lightweight accelerometers. Its neglectable skin impedance and low risk of influences during the recording of surface motions make MMG a reliable tool. Conclusion: Muscle performance is affected by age, gender, and physical activity level. Sensors, such as MMG, as well as the length of the muscle and the characteristics of the muscle activity, are important considerations when choosing a sensor for diagnostic evaluation. The efficacy of MMG in measuring muscle strength for long COVID patients and the physiological factors that may affect the use of MMG in assessing muscle performance are discussed.
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Affiliation(s)
- Harinivas Rao Suba Rao
- Biomechatronics and Neuroprosthetics Laboratory, Department of Biomedical Engineering, Faculty of Engineering, Universiti Malaya, Kuala Lumpur, Malaysia
- Department of Biomedical Engineering, Faculty of Engineering, Universiti Malaya, Kuala Lumpur, Malaysia
- *Correspondence: Harinivas Rao Suba Rao, ; Nur Azah Hamzaid,
| | - Nur Azah Hamzaid
- Biomechatronics and Neuroprosthetics Laboratory, Department of Biomedical Engineering, Faculty of Engineering, Universiti Malaya, Kuala Lumpur, Malaysia
- Department of Biomedical Engineering, Faculty of Engineering, Universiti Malaya, Kuala Lumpur, Malaysia
- Centre for Applied Biomechanics, Department of Biomedical Engineering, Faculty of Engineering, Universiti Malaya, Kuala Lumpur, Malaysia
- Clinic for Robotic Rehabilitation, Exercise and Advanced Universiti Malaya Medical Centre, Kuala Lumpur, Malaysia
- *Correspondence: Harinivas Rao Suba Rao, ; Nur Azah Hamzaid,
| | - Mohd Yazed Ahmad
- Department of Biomedical Engineering, Faculty of Engineering, Universiti Malaya, Kuala Lumpur, Malaysia
- Biosensor and Embedded Systems Laboratory, Department of Biomedical Engineering, Faculty of Engineering, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Norhamizan Hamzah
- Clinic for Robotic Rehabilitation, Exercise and Advanced Universiti Malaya Medical Centre, Kuala Lumpur, Malaysia
- Department of Rehabilitation Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
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23
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Figueroa-Padilla I, Rivera Fernández DE, Cházaro Rocha EF, Eugenio Gutiérrez AL, Jáuregui-Renaud K. Body Weight May Have a Role on Neuropathy and Mobility after Moderate to Severe COVID-19: An Exploratory Study. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:1401. [PMID: 36295562 PMCID: PMC9610119 DOI: 10.3390/medicina58101401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 09/21/2022] [Accepted: 10/03/2022] [Indexed: 12/01/2022]
Abstract
Background and Objectives: Among the extra-pulmonary manifestations of COVID-19, neuromuscular signs and symptoms are frequent. We aimed to assess the correlation between neuromuscular abnormalities (electrophysiological) and mobility measures (Berg Balance Scale and Timed-Up-and-Go test) twice, at least 6 weeks after hospital discharge and 6 months later, taking into account cognitive performance, nutrition, muscle strength, and submaximal exercise capacity. Materials and Methods: 43 patients (51.4 ± 9.3 years old) accepted to participate in the study; they had a dyspnea score ≤ 3 (Borg scale), and no history of neurology/neuromuscular/orthopedic disorders, but high frequency of overweight/obesity and weight loss during hospital stay. The two evaluations included physical examination, cognitive assessment, nutritional evaluation, muscle strength (hand-grip and quadriceps dynamometry), electromyography, Barthel Index, Six-Minute- Walk-Test (6MWT), Berg Balance Scale and Timed-Up-and-Go test. Bivariate and repeated measures covariance analyses were performed (significance level of 0.05). Results: Electrophysiological abnormalities were evident in 67% of the patients, which were associated with diminished performance on the 6MWT, the Berg Balance Scale and the Timed-Up-and-Go test. At each evaluation and between evaluations, scores on the Berg Balance Scale were related to the body mass index (BMI) at hospital admission and the 6MWT (MANCoVA R ≥ 0.62, p = 0.0001), while the time to perform the Timed-Up-and-Go test was related to the electrophysiological abnormalities, weight loss during hospital stay, sex, handgrip strength, and the 6MWT (MANCoVA, R ≥ 0.62, p < 0.0001). We concluded that, after hospital discharge, patients with moderate to severe COVID-19 may have neuromuscular abnormalities that can be related to BMI/weight loss, and contribute to mobility decrease. In patients with moderate to severe COVID-19 and high BMI/ large weight loss, neuromuscular and intended mobility assessments could be required to provide early rehabilitation. Apart from the 6MWT, handgrip dynamometry and the Timed-Up-and-Go test were useful tools to quickly assess fitness and mobility.
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Affiliation(s)
- Ignacio Figueroa-Padilla
- Unidad de Investigación Médica en Otoneurología, Instituto Mexicano del Seguro Social, Ciudad de México 06720, Mexico
- Hospital General Regional 72, Instituto Mexicano del Seguro Social, Tlalnepantla de Baz 54030, Mexico
| | - Dalia E. Rivera Fernández
- Hospital General Regional 72, Instituto Mexicano del Seguro Social, Tlalnepantla de Baz 54030, Mexico
| | - Erick F. Cházaro Rocha
- Hospital General Regional 72, Instituto Mexicano del Seguro Social, Tlalnepantla de Baz 54030, Mexico
| | - Alma L. Eugenio Gutiérrez
- Unidad de Investigación Médica en Otoneurología, Instituto Mexicano del Seguro Social, Ciudad de México 06720, Mexico
| | - Kathrine Jáuregui-Renaud
- Unidad de Investigación Médica en Otoneurología, Instituto Mexicano del Seguro Social, Ciudad de México 06720, Mexico
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24
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Barrea L, Vetrani C, Caprio M, Cataldi M, Ghoch ME, Elce A, Camajani E, Verde L, Savastano S, Colao A, Muscogiuri G. From the Ketogenic Diet to the Mediterranean Diet: The Potential Dietary Therapy in Patients with Obesity after CoVID-19 Infection (Post CoVID Syndrome). Curr Obes Rep 2022; 11:144-165. [PMID: 35524067 PMCID: PMC9075143 DOI: 10.1007/s13679-022-00475-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/17/2022] [Indexed: 01/08/2023]
Abstract
PURPOSE OF REVIEW This review primarily examines the evidence for areas of consensus and on-going uncertainty or controversy about diet and physical exercise approaches for in the post-CoVID. We propose an ideal dietary and physical activity approach that the patient with obesity should follow after CoVID-19 infection in order to reduce the clinical conditions associated with post-CoVID syndrome. RECENT FINDINGS The CoVID-19 disease pandemic, caused by the severe acute respiratory syndrome coronavirus-2, has spread all over the globe, infecting hundreds of millions of individuals and causing millions of death. It is also known to be is associated with several medical and psychological complications, especially in patients with obesity and weight-related disorders who in general pose a significant global public health problem, and in specific affected individuals are on a greater risk of developing poorer CoVID-19 clinical outcomes and experience a higher rate of mortality. Little is still known about the best nutritional approach to be adopted in this disease especially in the patients post-CoVID syndrome. To the best of our knowledge, no specific nutritional recommendations exist to manage in the patients post-CoVID syndrome. We report a presentation of nutritional therapeutic approach based on a ketogenic diet protocol followed by a transition to the Mediterranean diet in patients post-infection by CoVID, combined to a physical activity program to address conditions associated with post-CoVID syndrome.
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Affiliation(s)
- Luigi Barrea
- Dipartimento Di Scienze Umanistiche, Centro Direzionale, Università Telematica Pegaso, Via Porzio, isola F2, 80143, Napoli, Italy.
- Department of Clinical Medicine and Surgery, Endocrinology Unit, Centro Italiano Per La Cura E Il Benessere del Paziente Con Obesità (C.I.B.O), University Medical School of Naples, Via Sergio Pansini 5, 80131, Naples, Italy.
| | - Claudia Vetrani
- Department of Clinical Medicine and Surgery, Endocrinology Unit, Centro Italiano Per La Cura E Il Benessere del Paziente Con Obesità (C.I.B.O), University Medical School of Naples, Via Sergio Pansini 5, 80131, Naples, Italy
- Dipartimento Di Medicina Clinica E Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Massimiliano Caprio
- Laboratory of Cardiovascular Endocrinology, IRCCS San Raffaele Roma, 00166, Rome, Italy
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, 00166, Rome, Italy
| | - Mauro Cataldi
- Department of Neuroscience, Reproductive Medicine and Dentistry, Section of Pharmacology, Medical School of Naples, Federico II University, 80131, Naples, Italy
| | - Marwan El Ghoch
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, P.O. Box 11-5020, Riad El Solh, Beirut, 11072809, Lebanon
| | - Ausilia Elce
- Dipartimento Di Scienze Umanistiche, Centro Direzionale, Università Telematica Pegaso, Via Porzio, isola F2, 80143, Napoli, Italy
| | - Elisabetta Camajani
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, 00166, Rome, Italy
- PhD Programme in Endocrinological Sciences, Sapienza University of Rome, 00161, Rome, Italy
| | - Ludovica Verde
- Department of Clinical Medicine and Surgery, Endocrinology Unit, Centro Italiano Per La Cura E Il Benessere del Paziente Con Obesità (C.I.B.O), University Medical School of Naples, Via Sergio Pansini 5, 80131, Naples, Italy
- Dipartimento Di Medicina Clinica E Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Silvia Savastano
- Department of Clinical Medicine and Surgery, Endocrinology Unit, Centro Italiano Per La Cura E Il Benessere del Paziente Con Obesità (C.I.B.O), University Medical School of Naples, Via Sergio Pansini 5, 80131, Naples, Italy
- Dipartimento Di Medicina Clinica E Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Annamaria Colao
- Department of Clinical Medicine and Surgery, Endocrinology Unit, Centro Italiano Per La Cura E Il Benessere del Paziente Con Obesità (C.I.B.O), University Medical School of Naples, Via Sergio Pansini 5, 80131, Naples, Italy
- Dipartimento Di Medicina Clinica E Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131, Naples, Italy
- Cattedra Unesco "Educazione Alla Salute E Allo Sviluppo Sostenibile", University Federico II, Naples, Italy
| | - Giovanna Muscogiuri
- Department of Clinical Medicine and Surgery, Endocrinology Unit, Centro Italiano Per La Cura E Il Benessere del Paziente Con Obesità (C.I.B.O), University Medical School of Naples, Via Sergio Pansini 5, 80131, Naples, Italy
- Dipartimento Di Medicina Clinica E Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131, Naples, Italy
- Cattedra Unesco "Educazione Alla Salute E Allo Sviluppo Sostenibile", University Federico II, Naples, Italy
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Ghanem J, Passadori A, Severac F, Dieterlen A, Geny B, Andrès E. Effects of Rehabilitation on Long-COVID-19 Patient's Autonomy, Symptoms and Nutritional Observance. Nutrients 2022; 14:3027. [PMID: 35893881 PMCID: PMC9330709 DOI: 10.3390/nu14153027] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 07/14/2022] [Accepted: 07/19/2022] [Indexed: 02/06/2023] Open
Abstract
Background: Despite significant improvements in COVID-19 therapy, many patients still present with persistent symptoms and quality-of-life alterations. The aim of this study was to simultaneously investigate the long-term evolution of autonomy, malnutrition and long-lasting symptoms in people infected with COVID-19 and hospitalized in the ICU. Method: Patients’ clinical characteristics; extent of their loss of autonomy based on “Autonomie Gérontologie Groupes Iso-Ressources” (AG-GIR) classification; nutritional status while following the French and Global Leadership Initiative on Malnutrition (GLIM) recommendations; and symptom evolutions before infection, during hospitalization and rehabilitation, and up to 6 months after returning home were determined in thirty-seven patients. Results: Prior to a COVID-19 infection, all patients were autonomous, but upon admission to the rehabilitation center (CRM), 39% of them became highly dependent. After discharge from the center and 6 months after returning home, only 6 and 3%, respectively, still required considerable assistance. Of these thirty-seven patients, 11% were moderately malnourished and 81% presented with severe malnutrition, with a significant correlation being observed between malnutrition and autonomy (p < 0.05). Except for fatigue, which persisted in 70% of the patients 6 months after discharge from rehabilitation, all other symptoms decreased significantly. Conclusions: This study shows a striking decrease in autonomy associated with malnutrition after hospitalization for a COVID-19 infection and a clear beneficial effect from personalized rehabilitation. However, although almost all patients regained autonomy 6 months after returning home, they often still suffer from fatigue. Patient compliance with their nutritional recommendations deserves further improvement, preferably through personalized and persistent follow-up with the patient.
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Affiliation(s)
- Jeyniver Ghanem
- Translational Medicine Federation of Strasbourg (FMTS), Team 3072 “Mitochondria, Oxidative Stress and Muscle Protection”, Faculty of Medicine, University of Strasbourg, 67000 Strasbourg, France; (B.G.); (E.A.)
- Institut IRIMAS (7499), Institut Universitaire de Technologie, Université de Haute-Alsace, 12 Rue des Frères Lumière, 68093 Mulhouse, France;
| | - Anne Passadori
- Centre de Réadaptation de Mulhouse—CRM, 57 Rue Albert Camus, 68200 Mulhouse, France;
| | - François Severac
- Groupe Méthodes en Recherche Clinique, Service de Santé Publique, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France;
| | - Alain Dieterlen
- Institut IRIMAS (7499), Institut Universitaire de Technologie, Université de Haute-Alsace, 12 Rue des Frères Lumière, 68093 Mulhouse, France;
| | - Bernard Geny
- Translational Medicine Federation of Strasbourg (FMTS), Team 3072 “Mitochondria, Oxidative Stress and Muscle Protection”, Faculty of Medicine, University of Strasbourg, 67000 Strasbourg, France; (B.G.); (E.A.)
- Physiology and Functional Exploration Service, University Hospital of Strasbourg, 67091 Strasbourg, France
| | - Emmanuel Andrès
- Translational Medicine Federation of Strasbourg (FMTS), Team 3072 “Mitochondria, Oxidative Stress and Muscle Protection”, Faculty of Medicine, University of Strasbourg, 67000 Strasbourg, France; (B.G.); (E.A.)
- Service de Médecine Interne, Diabète et Maladies Métaboliques, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France
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26
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Özdemir Ö, Arslan Z. Issues related to post-COVID-19 syndrome. World J Methodol 2022; 12:224-234. [PMID: 36159103 PMCID: PMC9350724 DOI: 10.5662/wjm.v12.i4.224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 04/20/2022] [Accepted: 06/27/2022] [Indexed: 02/06/2023] Open
Abstract
The pandemic caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in 2019-2022 leads to a multisystem illness that results in damage to numerous organ systems. In this review, our goal was to assess current research on long-term respiratory, cardiac, neurological, digestive, rheumatological, urogenital, and dermatological system complications of coronavirus disease 2019 (COVID-19). Bibliographic searches were conducted in December 2021 using PubMed and Google Scholar, retrospectively, covering all COVID-19 literature to determine the consequences of the disease. This review may help to determine the prospects for new studies and predict the upcoming aspects requiring assessment in post-COVID-19 syndrome.
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Affiliation(s)
- Öner Özdemir
- Division of Pediatric Allergy and Immunology, Sakarya University Medical Faculty, Sakarya 54100, Turkey
| | - Zeynep Arslan
- Department of Pediatrics, Sakarya University Research and Training Hospital, Sakarya 54100, Turkey
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27
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Pires RE, Reis IGN, Waldolato GS, Pires DD, Bidolegui F, Giordano V. What Do We Need to Know About Musculoskeletal Manifestations of COVID-19?: A Systematic Review. JBJS Rev 2022; 10:01874474-202206000-00001. [PMID: 35658089 DOI: 10.2106/jbjs.rvw.22.00013] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
» COVID-19 is a disease that is challenging science, health-care systems, and humanity. An astonishingly wide spectrum of manifestations of multi-organ damage, including musculoskeletal, can be associated with SARS-CoV-2. » In the acute phase of COVID-19, fatigue, myalgia, and arthralgia are the most common musculoskeletal symptoms. » Post-COVID-19 syndrome is a group of signs and symptoms that are present for >12 weeks. The associated musculoskeletal manifestations are fatigue, arthralgia, myalgia, new-onset back pain, muscle weakness, and poor physical performance. » Data on COVID-19 complications are growing due to large absolute numbers of cases and survivors in these 2 years of the pandemic. Additional musculoskeletal manifestations encountered are falls by the elderly, increased mortality after hip fracture, reduced bone mineral density and osteoporosis, acute sarcopenia, rhabdomyolysis, Guillain-Barré syndrome, muscle denervation atrophy, fibromyalgia, rheumatological disease triggering, septic arthritis, adhesive capsulitis, myositis, critical illness myopathy, onset of latent muscular dystrophy, osteonecrosis, soft-tissue abscess, urticarial vasculitis with musculoskeletal manifestations, and necrotizing autoimmune myositis. » A wide range of signs and symptoms involving the musculoskeletal system that affect quality of life and can result in a decrease in disability-adjusted life years. This powerful and unpredictable disease highlights the importance of multimodality imaging, continuing education, and multidisciplinary team care to support preventive measures, diagnosis, and treatment.
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Affiliation(s)
- Robinson E Pires
- Departamento do Aparelho Locomotor, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.,Serviço de Ortopedia e Traumatologia, Hospital Felicio Rocho, Belo Horizonte, Brazil.,Serviço de Ortopedia e Traumatologia, Instituto Orizonti, Belo Horizonte, Brazil
| | - Igor G N Reis
- Departamento do Aparelho Locomotor, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Gustavo S Waldolato
- Serviço de Ortopedia e Traumatologia, Hospital Felicio Rocho, Belo Horizonte, Brazil.,Serviço de Ortopedia e Traumatologia, Instituto Orizonti, Belo Horizonte, Brazil
| | - Diego D Pires
- Cedimagem Medicina Diagnóstica, Grupo Alliar, Juiz de Fora, Brazil
| | - Fernando Bidolegui
- Servicio de Ortopedia y Traumatologia, Hospital Sirio-Libanes, ECICARO, Buenos Aires, Argentin
| | - Vincenzo Giordano
- Serviço de Ortopedia e Traumatologia Prof. Nova Monteiro, Hospital Municipal Miguel Couto, Rio de Janeiro, Brazil
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Gentil P, de Lira CAB, Vieira CA, Ramirez-Campillo R, Haghighi AH, Clemente FM, Souza D. Resistance Training before, during, and after COVID-19 Infection: What Have We Learned So Far? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:6323. [PMID: 35627861 PMCID: PMC9141848 DOI: 10.3390/ijerph19106323] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 02/26/2022] [Accepted: 03/02/2022] [Indexed: 02/05/2023]
Abstract
At the end of 2019, a severe acute respiratory syndrome caused by SARS-CoV-2 started a pandemic, leading to millions of deaths and many important political and social changes. Even in the absence of contamination, the mobility reduction, social distancing and closing of exercise facilities negatively affected physical activity and conditioning, which is associated with muscle atrophy, loss of muscle strength, and reductions in functional capacity. In cases of infection, it has been shown that increased physical capacity is associated with decreased hospitalization and mortality risk. Although millions of people have died from COVID-19, most contaminated individuals survived the infection, but carried different sequelae, such as the severe loss of physical function and a reduced quality of life. Among different physical exercise models that might help to prevent and treat COVID-19-related conditions, resistance training (RT) might be particularly relevant. Among its benefits, RT can be adapted to be performed in many different situations, even with limited space and equipment, and is easily adapted to an individual's characteristics and health status. The current narrative review aims to provide insights into how RT can be used in different scenarios to counteract the negative effects of COVID-19. By doing this, the authors expect to provide insights to help deal with the current pandemic and similar events the world may face in the future.
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Affiliation(s)
- Paulo Gentil
- College of Physical Education and Dance, Federal University of Goias, Goiânia 74690-900, Brazil; (C.A.B.d.L.); (C.A.V.); (D.S.)
- Hypertension League Federal University of Goias, Goiânia 74605-050, Brazil
- Instituto VIDA, Brasilia 70.000, Brazil
| | - Claudio Andre Barbosa de Lira
- College of Physical Education and Dance, Federal University of Goias, Goiânia 74690-900, Brazil; (C.A.B.d.L.); (C.A.V.); (D.S.)
| | - Carlos Alexandre Vieira
- College of Physical Education and Dance, Federal University of Goias, Goiânia 74690-900, Brazil; (C.A.B.d.L.); (C.A.V.); (D.S.)
| | - Rodrigo Ramirez-Campillo
- Exercise and Rehabilitation Sciences Laboratory, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago 7591538, Chile;
| | - Amir Hossein Haghighi
- Department of Exercise Physiology, Faculty of Sport Sciences, Hakim Sabzevari University, Sabzevar 9617976487, Iran;
| | - Filipe Manuel Clemente
- Escola Superior de Desporto e Lazer, Instituto Politécnico de Viana do Castelo, 4900-347 Viana do Castelo, Portugal;
- Research Center in Sports Performance, Recreation, Innovation and Technology (SPRINT), 4960-320 Melgaço, Portugal
- Instituto de Telecomunicações, Delegação da Covilhã, 1049-001 Lisboa, Portugal
| | - Daniel Souza
- College of Physical Education and Dance, Federal University of Goias, Goiânia 74690-900, Brazil; (C.A.B.d.L.); (C.A.V.); (D.S.)
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29
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Overweight subjects have a higher risk of malnutrition and loss of function after severe COVID infection. Clin Nutr ESPEN 2022; 49:669-670. [PMID: 35623871 PMCID: PMC9015947 DOI: 10.1016/j.clnesp.2022.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 04/13/2022] [Indexed: 11/24/2022]
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COVID-19 Disease and Outcomes among Critically Ill Patients: The Case of Medical Nutritional Therapy. Nutrients 2022; 14:nu14071416. [PMID: 35406029 PMCID: PMC9002838 DOI: 10.3390/nu14071416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 03/08/2022] [Indexed: 02/01/2023] Open
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Montes-Ibarra M, Oliveira CL, Orsso CE, Landi F, Marzetti E, Prado CM. The Impact of Long COVID-19 on Muscle Health. Clin Geriatr Med 2022; 38:545-557. [PMID: 35868672 PMCID: PMC8934728 DOI: 10.1016/j.cger.2022.03.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Levy D, Giannini M, Oulehri W, Riou M, Marcot C, Pizzimenti M, Debrut L, Charloux A, Geny B, Meyer A. Long Term Follow-Up of Sarcopenia and Malnutrition after Hospitalization for COVID-19 in Conventional or Intensive Care Units. Nutrients 2022; 14:912. [PMID: 35215562 PMCID: PMC8880495 DOI: 10.3390/nu14040912] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 02/11/2022] [Accepted: 02/16/2022] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND The post-COVID-19 condition, defined as COVID-19-related signs and symptoms lasting at least 2 months and persisting more than 3 months after infection, appears now as a public health issue in terms of frequency and quality of life alterations. Nevertheless, few data are available concerning long term evolution of malnutrition and sarcopenia, which deserve further attention. METHOD Sarcopenia was investigated prospectively, together with weight evolution, at admission and at 3 and 6 months after hospital discharge in 139 COVID-19 patients, using the European Working Group on Sarcopenia in Older People (EWGSOP2) criteria, associating both decreased muscle strength and muscle mass, assessed, respectively, with hand dynamometer and dual-energy X-ray absorptiometry. RESULTS Of the 139 patients, 22 presented with sarcopenia at 3 months; intensive care units (ICU) length of stay was the sole factor associated with sarcopenia after multivariate analysis. Although the entire group did not demonstrate significant weight change, weight decreased significantly in the sarcopenia group (Five and eight patients, showing, respectively, >5 or >10% weight decrease). Interestingly, at 6 months, 16 of the 22 patients recovered from sarcopenia and their weight returned toward baseline values. CONCLUSIONS Sarcopenia and malnutrition are frequently observed in patients hospitalized for COVID-19, even 3 months after infection occurrence, but can largely be reversed at 6 months after discharge. Enhanced patient care is needed in sarcopenic patients, particularly during long stays in an ICU.
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Affiliation(s)
- Dan Levy
- Translational Medicine Federation of Strasbourg (FMTS), Team 3072 “Mitochondria, Oxidative Stress and Muscle Protection”, Faculty of Medicine, University of Strasbourg, 67000 Strasbourg, France; (D.L.); (M.G.); (W.O.); (M.R.); (M.P.); (L.D.); (A.C.); (A.M.)
- Physiology and Functional Exploration Service, University Hospital of Strasbourg, 67091 Strasbourg, France
| | - Margherita Giannini
- Translational Medicine Federation of Strasbourg (FMTS), Team 3072 “Mitochondria, Oxidative Stress and Muscle Protection”, Faculty of Medicine, University of Strasbourg, 67000 Strasbourg, France; (D.L.); (M.G.); (W.O.); (M.R.); (M.P.); (L.D.); (A.C.); (A.M.)
- Physiology and Functional Exploration Service, University Hospital of Strasbourg, 67091 Strasbourg, France
| | - Walid Oulehri
- Translational Medicine Federation of Strasbourg (FMTS), Team 3072 “Mitochondria, Oxidative Stress and Muscle Protection”, Faculty of Medicine, University of Strasbourg, 67000 Strasbourg, France; (D.L.); (M.G.); (W.O.); (M.R.); (M.P.); (L.D.); (A.C.); (A.M.)
- Department of Anesthesiology and Surgical Critical Care, University Hospital of Strasbourg, 67091 Strasbourg, France
| | - Marianne Riou
- Translational Medicine Federation of Strasbourg (FMTS), Team 3072 “Mitochondria, Oxidative Stress and Muscle Protection”, Faculty of Medicine, University of Strasbourg, 67000 Strasbourg, France; (D.L.); (M.G.); (W.O.); (M.R.); (M.P.); (L.D.); (A.C.); (A.M.)
- Physiology and Functional Exploration Service, University Hospital of Strasbourg, 67091 Strasbourg, France
| | - Christophe Marcot
- Department of Pneumology, University Hospital of Strasbourg, 67091 Strasbourg, France;
| | - Megane Pizzimenti
- Translational Medicine Federation of Strasbourg (FMTS), Team 3072 “Mitochondria, Oxidative Stress and Muscle Protection”, Faculty of Medicine, University of Strasbourg, 67000 Strasbourg, France; (D.L.); (M.G.); (W.O.); (M.R.); (M.P.); (L.D.); (A.C.); (A.M.)
| | - Lea Debrut
- Translational Medicine Federation of Strasbourg (FMTS), Team 3072 “Mitochondria, Oxidative Stress and Muscle Protection”, Faculty of Medicine, University of Strasbourg, 67000 Strasbourg, France; (D.L.); (M.G.); (W.O.); (M.R.); (M.P.); (L.D.); (A.C.); (A.M.)
| | - Anne Charloux
- Translational Medicine Federation of Strasbourg (FMTS), Team 3072 “Mitochondria, Oxidative Stress and Muscle Protection”, Faculty of Medicine, University of Strasbourg, 67000 Strasbourg, France; (D.L.); (M.G.); (W.O.); (M.R.); (M.P.); (L.D.); (A.C.); (A.M.)
- Physiology and Functional Exploration Service, University Hospital of Strasbourg, 67091 Strasbourg, France
| | - Bernard Geny
- Translational Medicine Federation of Strasbourg (FMTS), Team 3072 “Mitochondria, Oxidative Stress and Muscle Protection”, Faculty of Medicine, University of Strasbourg, 67000 Strasbourg, France; (D.L.); (M.G.); (W.O.); (M.R.); (M.P.); (L.D.); (A.C.); (A.M.)
- Physiology and Functional Exploration Service, University Hospital of Strasbourg, 67091 Strasbourg, France
| | - Alain Meyer
- Translational Medicine Federation of Strasbourg (FMTS), Team 3072 “Mitochondria, Oxidative Stress and Muscle Protection”, Faculty of Medicine, University of Strasbourg, 67000 Strasbourg, France; (D.L.); (M.G.); (W.O.); (M.R.); (M.P.); (L.D.); (A.C.); (A.M.)
- Physiology and Functional Exploration Service, University Hospital of Strasbourg, 67091 Strasbourg, France
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Impact of COVID-19 Infection and Persistent Lingering Symptoms on Patient Reported Indicators of Nutritional Risk and Malnutrition. Nutrients 2022; 14:nu14030642. [PMID: 35277001 PMCID: PMC8839070 DOI: 10.3390/nu14030642] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 01/27/2022] [Accepted: 01/27/2022] [Indexed: 01/09/2023] Open
Abstract
Persistent malnutrition after COVID-19 infection may worsen outcomes, including delayed recovery and increased risk of rehospitalization. This study aimed to determine dietary intakes and nutrient distribution patterns after acute COVID-19 illness. Findings were also compared to national standards for intake of energy, protein, fruit, and vegetables, as well as protein intake distribution recommendations. Participants (≥18 years old, n = 92) were enrolled after baseline visit at the Post-COVID Recovery Clinic. The broad screening battery included nutritional assessment and 24-h dietary recall. Participants were, on average, 53 years old, 63% female, 69% non-Hispanic White, and 59% obese/morbidly obese. Participants at risk for malnutrition (48%) experienced significantly greater symptoms, such as gastric intestinal issues, loss of smell, loss of taste, or shortness of breath; in addition, they consumed significantly fewer calories. Most participants did not meet recommendations for fruit or vegetables. Less than 39% met the 1.2 g/kg/day proposed optimal protein intake for recovery from illness. Protein distribution throughout the day was skewed; only 3% met the recommendation at all meals, while over 30% never met the threshold at any meal. Our findings highlight the need for nutritional education and support for patients to account for lingering symptoms and optimize recovery after COVID-19 infection.
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