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老年患者的新冠病毒病:新冠后肌肉减少症评估

COVID-19 in Older Patients: Assessment of Post-COVID-19 Sarcopenia.

作者信息

López-Sampalo Almudena, Cobos-Palacios Lidia, Vilches-Pérez Alberto, Sanz-Cánovas Jaime, Vargas-Candela Antonio, Mancebo-Sevilla Juan José, Hernández-Negrín Halbert, Gómez-Huelgas Ricardo, Bernal-López María Rosa

机构信息

Internal Medicine Department, Regional University Hospital of Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA-Plataforma Bionand), University of Málaga, Avda. Hospital Civil s/n, 29009 Málaga, Spain.

Endocrinology and Nutrition Department, Virgen de la Victoria University Hospital, Instituto de Investigación Biomédica de Málaga (IBIMA-Plataforma Bionand), 29010 Málaga, Spain.

出版信息

Biomedicines. 2023 Feb 28;11(3):733. doi: 10.3390/biomedicines11030733.

Abstract

(1) Background: Acute COVID-19 infections produce alterations in the skeletal muscle, leading to acute sarcopenia, but the medium- and long-term consequences are still unknown. The aim of this study was to evaluate: (1) body composition; (2) muscle strength and the prevalence of sarcopenia; and (3) the relationship between muscle strength with symptomatic and functional evolution in older patients affected by/recovered from COVID-19; (2) Methods: A prospective, longitudinal study of patients aged ≥65 years who had suffered from COVID-19 infection between 1 March and 31 May 2020, as confirmed by PCR or subsequent seroconversion. Persistent symptoms, as well as anthropometric, clinical, and analytical characteristics, were analyzed at 3 and 12 months after infection. The degree of sarcopenia was determined by dynamometry and with SARC-F; (3) Results: 106 participants, aged 76.8 ± 7 years, were included. At 3 months postinfection, a high percentage of sarcopenic patients was found, especially among women and in those with hospitalization. At 12 months postinfection, this percentage had decreased, coinciding with a functional and symptomatic recovery, and the normalization of inflammatory parameters, especially interleukin-6 (4.7 ± 11.6 pg/mL vs. 1.5 ± 2.4 pg/mL, < 0.05). The improvement in muscle strength was accompanied by significant weight gain (71.9 ± 12.1 kg vs. 74.7 ± 12.7 kg, < 0.001), but not by an increase in lean mass (49.6 ± 10 vs. 49.9 ± 10, p 0.29); (4) Conclusions: Older COVID-19 survivors presented a functional, clinical, and muscular recovery 12 months postinfection. Even so, it is necessary to carry out comprehensive follow-ups and assessments that include aspects of nutrition and physical activity.

摘要

(1)背景:新型冠状病毒肺炎(COVID-19)急性感染会导致骨骼肌改变,引发急性肌肉减少症,但中长期后果仍不明确。本研究的目的是评估:(1)身体成分;(2)肌肉力量和肌肉减少症的患病率;(3)在感染COVID-19/从COVID-19中康复的老年患者中,肌肉力量与症状及功能演变之间的关系;(2)方法:对年龄≥65岁、在2020年3月1日至5月31日期间感染COVID-19(经PCR或后续血清学转换确诊)的患者进行一项前瞻性纵向研究。在感染后3个月和12个月分析持续症状以及人体测量、临床和分析特征。通过握力测量法和SARC-F量表确定肌肉减少症的程度;(3)结果:纳入106名年龄为76.8±7岁的参与者。感染后3个月时,发现肌肉减少症患者的比例很高,尤其是在女性和住院患者中。感染后12个月时,这一比例有所下降,同时伴有功能和症状的恢复以及炎症参数的正常化,尤其是白细胞介素-6(4.7±11.6 pg/mL对1.5±2.4 pg/mL,P<0.05)。肌肉力量的改善伴随着体重显著增加(71.9±12.1 kg对74.7±12.7 kg,P<0.001),但瘦体重没有增加(49.6±10对49.9±10,P=0.29);(4)结论:感染COVID-19的老年幸存者在感染后12个月出现了功能、临床和肌肉方面的恢复。即便如此,仍有必要进行包括营养和身体活动等方面的全面随访和评估。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a17b/10045496/e85aa97dbbe0/biomedicines-11-00733-g001.jpg

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