Massari Maria Chiara, Bimonte Viviana Maria, Falcioni Lavinia, Moretti Antimo, Baldari Carlo, Iolascon Giovanni, Migliaccio Silvia
Department of Experimental Medicine, Section of Medical Pathophysiology, Endocrinology and Food Sciences, University Sapienza of Rome, Rome, Italy.
Department of Movement, Human and Health Sciences, University Foro Italico of Rome, Rome, Italy.
Ther Adv Musculoskelet Dis. 2023 Feb 13;15:1759720X231152648. doi: 10.1177/1759720X231152648. eCollection 2023.
'Frailty' has been described as 'a state of increased vulnerability of the individual caused by an impairment of homeostasis as a result of endogenous or exogenous stress'. Frail individuals are depicted by a dramatic change in health status following an apparently minor insult and a higher risk of adverse health-related outcomes such as osteoporosis and sarcopenia, falls and disability, and fragility fractures. Frailty is a condition of increasing importance due to the global ageing of the population during the last decades. Central to the pathophysiology of frailty is a mechanism that is partially independent of ageing, but most likely evolves with ageing: the cumulative level of molecular and cellular damage in every subject. Furthermore, an uncorrected nutrition and a sedentary behaviour play a pivotal role in worsening the syndrome. In January 2020, a cluster of a genus of the family Coronaviridae was isolated as the pathogen of the new coronavirus disease (COVID-19). Since then, this infection has spread worldwide causing one of the most dramatic pandemics of the modern era, with more than 500 million confirmed cases all over the world. The clinical spectrum of SARS-CoV-2 severity ranges from asymptomatic conditions to mild symptoms, such as fever, cough, ageusia, anosmia and asthenia, up to most severe conditions, such as acute respiratory distress syndrome (ARDS) and multi-organ failure leading to death. Primary evidence revealed that the elderly frail subjects were more susceptible to the disease in its most intense form and were at greater risk of developing severe COVID-19. Factors contributing to the severity of COVID-19, and the higher mortality rate, are a poor immune system activity and long-standing inflammatory status of the frail subjects compared with the general population. Further recent research also suggested a potential role of sedentary behaviour, metabolic chronic disorders linked to it and uncorrected nutritional status. Thus, the aim of this review was to evaluate the different studies and evidence related to COVID-19 pandemic, both nutritional status and physical activity, and, also, to provide further information on the correct nutritional approach in this peculiar pathological condition.
“衰弱”被描述为“由于内源性或外源性应激导致体内稳态受损，个体易损性增加的一种状态”。衰弱个体的特点是在遭受看似轻微的损伤后，健康状况会发生显著变化，且出现与健康相关的不良后果的风险更高，如骨质疏松症、肌肉减少症、跌倒和残疾以及脆性骨折。由于过去几十年全球人口老龄化，衰弱这一状况的重要性日益增加。衰弱病理生理学的核心是一种部分独立于衰老，但很可能随衰老而演变的机制：每个个体分子和细胞损伤的累积水平。此外，营养未得到纠正和久坐不动的行为在使该综合征恶化方面起着关键作用。2020年1月，一种冠状病毒科的毒株被分离出来，成为新型冠状病毒病（COVID-19）的病原体。从那时起，这种感染在全球范围内传播，引发了现代最严重的大流行之一，全球确诊病例超过5亿例。SARS-CoV-2严重程度的临床谱范围从无症状状态到轻微症状，如发热、咳嗽、味觉丧失、嗅觉丧失和乏力，直至最严重的状态，如急性呼吸窘迫综合征（ARDS）和多器官衰竭导致死亡。初步证据表明，年老体弱的受试者更容易感染这种最严重形式的疾病，且患重症COVID-19的风险更高。与普通人群相比，导致COVID-19严重程度和更高死亡率的因素包括免疫系统活动不佳以及体弱受试者长期存在的炎症状态。最近的进一步研究还表明了久坐行为、与之相关的慢性代谢紊乱以及未得到纠正的营养状况可能起到的作用。因此，本综述的目的是评估与COVID-19大流行相关的不同研究和证据，包括营养状况和身体活动，并且还提供关于这种特殊病理状况下正确营养方法的更多信息。
