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Volume 9, Issue 5, September 2020, Page: 132-137
Assessment of Muscle Function in Severe and Malnourished COVID-19 Patients
Marine Gerard, Transversal Unit of Nutrition, Department of Endocrinology, Diabetology and Nutrition, University of Lorraine, CHRU Nancy, Brabois Hospital, Nancy, France
Phi-Linh Nguyen-Thi, Medical Evaluation Department, Department of Clinical Research Support PARC, University of Lorraine, CHU Nancy, France
Aurelie Malgras, Transversal Unit of Nutrition, Department of Endocrinology, Diabetology and Nutrition, University of Lorraine, CHRU Nancy, Brabois Hospital, Nancy, France
Thomas Bermand, Internal Medicine and Clinical Immunology Department, Nancy University Hospital, Nancy, France
Roland Jaussaud, Internal Medicine and Clinical Immunology Department, Nancy University Hospital, Nancy, France
Didier Quilliot, Transversal Unit of Nutrition, Department of Endocrinology, Diabetology and Nutrition, University of Lorraine, CHRU Nancy, Brabois Hospital, Nancy, France
Received: Nov. 3, 2020;       Accepted: Nov. 13, 2020;       Published: Nov. 23, 2020
DOI: 10.11648/j.ijnfs.20200905.12      View  125      Downloads  61
Abstract
COVID-19 is a disease at high risk of muscle failure and undernutrition. In this setting, systematic screenings are necessary to assess muscle deficit during hospitalization and after discharge. Objective: To analyze the interest of a self-assessment of muscle strength (SES) to evaluate the evolution of muscle strength during COVID-19 and to assess the agreement between SES and the handgrip test. Methods: Prospective cohort study including all inpatients diagnosed with COVID-19 admitted in a non-ICU unit, until the required number of subjects is reached. Handgrip test and SES were recorded at admission and every two days during hospitalization and at Day30 post-discharge. Sarcopenic screening test (SARC-F) and International Physical Activity Questionnaire (IPAQ-SF) were administered before admission and on Day30. Nutritional status was recorded at admission, at discharge and at Day30 post-discharge. Evolution effects were analyzed using ANOVA for repeated measures and Pearson's chi-square test (p< 0.05). Results: Handgrip and SES progression were significantly correlated (p=0.004), SES <7 enabled detecting 95% of patients with progression in muscle strength. Muscle failure incidence was lower at discharge (73% to 42% for handgrip and 69% to 42% for SES (p=0.0035)). At admission, 61% had ≥30% reduction in food intake which was higher in the presence of anosmia and inflammation; 73% presented malnutrition and 19% necessitated tube feeding due to severe malnutrition as well as insufficient nutrition intake. Weight loss kinetics decreased significantly during hospitalization (-0.4±1.6% vs. -5.4±6.3% pre-admission, p=0.0016). At Day 30, 17% had a severe muscle failure (SES<7 and/or SARC-F>6) and 32% had persistent severe malnutrition. Conclusion: The present study showed that three quarters of COVID-19 patients admitted in a non-ICU setting presented malnutrition as well as sarcopenia as assessed by hand strength. Screening for malnutrition and muscle failure should be initiated immediately at the onset of care, with the aim of improving nutritional status as well as maintaining muscle mass and physical performance. During hospitalization, grip strength measured by a handheld dynamometer is inexpensive and easy to administer, even in a COVID unit. On the other hand, the 10-point verbal or visual analogue scales (SES) could prove useful in assessing the long-term progression of muscle strength.
Keywords
COVID-19, Sarcopenia, Muscle Failure, Malnutrition, Handgrip, Self-Evaluation
To cite this article
Marine Gerard, Phi-Linh Nguyen-Thi, Aurelie Malgras, Thomas Bermand, Roland Jaussaud, Didier Quilliot, Assessment of Muscle Function in Severe and Malnourished COVID-19 Patients, International Journal of Nutrition and Food Sciences. Vol. 9, No. 5, 2020, pp. 132-137. doi: 10.11648/j.ijnfs.20200905.12
Copyright
Copyright © 2020 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Reference
[1]
Liu H, Chen S, Liu M, Nie H, Lu H. Comorbid Chronic Diseases are Strongly Correlated with Disease Severity among COVID-19 Patients: A Systematic Review and Meta-Analysis. Aging Dis. 2020; 11: 668-78.
[2]
Tong JY, Wong A, Zhu D, Fastenberg JH, Tham T. The Prevalence of Olfactory and Gustatory Dysfunction in COVID-19 Patients: A Systematic Review and Meta-analysis. Otolaryngol Head Neck Surg. 2020; 163: 3-11.
[3]
Roos DS, Oranje OJM, Freriksen AFD, Berendse HW, Boesveldt S. Flavor perception and the risk of malnutrition in patients with Parkinson's disease. J Neural Transm (Vienna). 2018; 125: 925-30.
[4]
Bruyère O, Beaudart C, Reginster J, Buckinx F, Schoene D, Hirani V, Cooper C, Kanis J, Rizzoli R, McCloskey E, Cederholm T, Cruz-Jentoft A, Freiberger E. Assessment of muscle mass, muscle strength and physical performance in clinical practice: An international survey. Eur Geriatr Med. 2016; 7: 243-246.
[5]
Beaudart C, Rolland Y, Cruz-Jentoft AJ, Bauer JM, Sieber C, Cooper C, et al. Assessment of Muscle Function and Physical Performance in Daily Clinical Practice: A position paper endorsed by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO). Calcif Tissue Int. 2019; 105: 1-14.
[6]
Cederholm T, Jensen GL, Correia M, Gonzalez MC, Fukushima R, Higashiguchi T, et al. GLIM criteria for the diagnosis of malnutrition - A consensus report from the global clinical nutrition community. Clin Nutr. 2019; 38: 1-9.
[7]
Woo J, Leung J, Morley JE. Validating the SARC-F: a suitable community screening tool for sarcopenia? J Am Med Dir Assoc. 2014; 15: 630-4.
[8]
Bouette G, Esvan M, Apel K, Thibault R. A visual analogue scale for food intake as a screening test for malnutrition in the primary care setting: Prospective non-interventional study. Clin Nutr. 2020.
[9]
Thibault R, Goujon N, Le Gallic E, Clairand R, Sebille V, Vibert J, et al. Use of 10-point analogue scales to estimate dietary intake: a prospective study in patients nutritionally at-risk. Clin Nutr. 2009; 28: 134-40.
[10]
Criteria N-. https://www.mdcalc.com/nutrition-risk-screening-2002-nrs-2002.
[11]
Thibault R, Quilliot D, Seguin P, Tamion F, Schneider S, Déchelotte P. Nutritional care at hospital during the Covid-19 viral epidemic: Expert opinion from the French-speaking Society for Clinical Nutrition and Metabolism (SFNCM). Nut Clin et Métab. 2020; 34: 97-104.
[12]
https://www.uhs.nhs.uk/Media/Southampton-Clinical-Research/Procedures/BRCProcedures/Procedure-for-measuring-gripstrength-using-the-JAMAR-dynamometer.pdf.
[13]
Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyere O, Cederholm T, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019; 48: 16-31.
[14]
Krznaric Z, Bender DV, Laviano A, Cuerda C, Landi F, Monteiro R, et al. A simple remote nutritional screening tool and practical guidance for nutritional care in primary practice during the COVID-19 pandemic. Clin Nutr. 2020; 39: 1983-7.
[15]
Craig CL, Marshall AL, Sjostrom M, Bauman AE, Booth ML, Ainsworth BE, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003; 35: 1381-95.
[16]
Barazzoni R, Bischoff SC, Breda J, Wickramasinghe K, Krznaric Z, Nitzan D, et al. ESPEN expert statements and practical guidance for nutritional management of individuals with SARS-CoV-2 infection. Clin Nutr. 2020; 39: 1631-8.
[17]
Herridge MS, Chu LM, Matte A, Tomlinson G, Chan L, Thomas C, et al. The RECOVER Program: Disability Risk Groups and 1-Year Outcome after 7 or More Days of Mechanical Ventilation. Am J Respir Crit Care Med. 2016; 194: 831-44.
[18]
Msigwa SS, Wang Y, Li Y, Cheng X. The neurological insights of the emerging coronaviruses. J Clin Neurosci. 2020; 78: 1-7.
[19]
Chiappetta S, Sharma AM, Bottino V, Stier C. COVID-19 and the role of chronic inflammation in patients with obesity. Int J Obes (Lond). 2020; 44: 1790-2.
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