Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Research and Development, Abbott Nutrition, Granada, Spain.
J Cachexia Sarcopenia Muscle. 2022 Aug;13(4):1974-1982. doi: 10.1002/jcsm.12931. Epub 2022 Jun 14.
Severe clinical pictures and sequelae of COVID-19 disease are immune mediated and characterized by a 'cytokine storm'. Skeletal muscle has emerged as a potent regulator of immune system function. The aim of the present study is to define the prevalence of sarcopenia among COVID-19 survivors and the negative impact of sarcopenia on the post-acute COVID-19 syndrome and its related risk factors.
A total of 541 subjects recovered from COVID-19 disease were enrolled in the Gemelli Against COVID-19 Post-Acute Care between April 2020 and February 2021. They underwent a multidisciplinary clinical evaluation and muscle strength and physical performance assessment.
Mean age was 53.1 years (SD 15.2, range from 18 to 86 years), and 274 (51%) were women. The prevalence of sarcopenia was 19.5%, and it was higher in patients with a longer hospital stay and lower in patients who were more physically active and had higher levels of serum albumin. Patients with sarcopenia had a higher number of persistent symptoms than non-sarcopenic patients (3.8 ± 2.9 vs. 3.2 ± 2.8, respectively; P = 0.06), in particular fatigue, dyspnoea, and joint pain.
Sarcopenia identified according to the EWGSOP2 criteria is high in patients recovered from COVID-19 acute illness, particularly in those who had experienced the worst clinical picture reporting the persistence of fatigue and dyspnoea. Our data suggest that sarcopenia, through the persistence of inflammation, could be the biological substrate of long COVID-19 syndrome. Physical activity, especially if associated with adequate nutrition, seems to be an important protective factor.
COVID-19 疾病的严重临床表现和后遗症是免疫介导的，其特征是“细胞因子风暴”。骨骼肌已成为免疫系统功能的有力调节剂。本研究的目的是确定 COVID-19 幸存者中肌少症的患病率，以及肌少症对急性 COVID-19 后综合征及其相关危险因素的负面影响。
2020 年 4 月至 2021 年 2 月期间，共有 541 名 COVID-19 康复患者入组 Gemelli Against COVID-19 急性后护理。他们接受了多学科临床评估以及肌肉力量和身体表现评估。
平均年龄为 53.1 岁（标准差 15.2，范围 18-86 岁），274 名（51%）为女性。肌少症的患病率为 19.5%，住院时间较长的患者中患病率较高，而身体活动较多且血清白蛋白水平较高的患者中患病率较低。与非肌少症患者相比，肌少症患者有更多持续症状（分别为 3.8±2.9 与 3.2±2.8；P=0.06），尤其是疲劳、呼吸困难和关节疼痛。
根据 EWGSOP2 标准确定的肌少症在 COVID-19 急性疾病康复患者中发生率较高，尤其是那些经历过最严重临床表现并报告持续疲劳和呼吸困难的患者。我们的数据表明，肌少症通过持续的炎症可能是长 COVID-19 综合征的生物学基础。身体活动，尤其是与充足营养相结合，似乎是一个重要的保护因素。
