Department of Thoracic Surgery, Peking University People's Hospital, Beijing, China.
Department of Thoracic Surgical Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Nutrition. 2021 Apr;84:111104. doi: 10.1016/j.nut.2020.111104. Epub 2020 Dec 5.
The role of skeletal muscle mass in modulating immune response and supporting metabolic stress has been increasingly confirmed. Patients with sarcopenia, characterized by reduced muscle mass and muscle strength, were reported to have poor immune response and metabolic stress when facing acute infection, major surgeries, and other attacks. Based on empirical data, patients with sarcopenia are speculated to have increased infection rates and dismal prognoses amid the current 2019 novel coronavirus disease (COVID-19) epidemic. COVID-19 infection also aggravates sarcopenia because of the increased muscle wasting caused by systematic inflammation and the reduced physical activity and inadequate nutrient intake caused by social isolation. Notably, the interventions targeting skeletal muscle are anticipated to break the vicious circle and benefit the treatment of both conditions. We recommend sarcopenia assessment for populations with advanced age, inactivity, chronic disease, cancers, and nutritional deficiency. Patients with sarcopenia and COVID-19 infection need intensive care and aggressive treatments. The provision of at-home physical activities together with protein supplementation is anticipated to reverse sarcopenia and promote the prevention and treatment of COVID-19. The recommended protocols on nutritional support and physical activities are provided in detail.
骨骼肌质量在调节免疫反应和支持代谢应激方面的作用已得到越来越多的证实。患有肌少症的患者,其特征是肌肉质量和肌肉力量下降,据报道,在面临急性感染、大手术和其他侵袭时,他们的免疫反应和代谢应激较差。基于经验数据,人们推测在当前的 2019 年新型冠状病毒病(COVID-19)流行期间,肌少症患者的感染率更高,预后更差。COVID-19 感染也会加重肌少症,因为系统性炎症会导致肌肉消耗增加,社交隔离会导致体力活动减少和营养摄入不足。值得注意的是,针对骨骼肌的干预措施有望打破恶性循环,有利于这两种疾病的治疗。我们建议对年龄较大、不活动、患有慢性疾病、癌症和营养缺乏的人群进行肌少症评估。患有肌少症和 COVID-19 感染的患者需要重症监护和积极治疗。预计在家中进行体育活动和补充蛋白质将有助于逆转肌少症,并促进 COVID-19 的预防和治疗。详细提供了关于营养支持和体育活动的推荐方案。