Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Feb 6;7(1):103-114.
doi: 10.1002/agm2.12287. eCollection 2024 Feb.

Navigating sarcopenia in COVID-19 patients and survivors: Understanding the long-term consequences, transitioning from hospital to community with mechanisms and interventions for future preparedness

Affiliations
Review

Navigating sarcopenia in COVID-19 patients and survivors: Understanding the long-term consequences, transitioning from hospital to community with mechanisms and interventions for future preparedness

Mohammad Reza Shadmand Foumani Moghadam et al. Aging Med (Milton). .

Abstract

The coronavirus disease 2019 (COVID-19) pandemic has caused widespread devastation, with millions of confirmed cases and deaths worldwide. Although there were efforts made to develop treatments and vaccines for COVID-19, the coexistence of sarcopenia, a muscle disorder, has been largely overlooked. It is while new variants of this disease (eg, BA.2.86) are challenging the current protocols. Sarcopenia is associated with increased mortality and disability, and shares common mechanisms with COVID-19, such as inflammation, hormonal changes, and malnutrition. This can worsen the effects of both conditions. Furthermore, survived patients with COVID-19 who have elevated risk, as well as aging, which increases the process of sarcopenia. Therefore, addressing sarcopenia in patients with COVID-19 and surviving individuals can be crucial for improving outcomes and preventing long-term disability. During hospital stays, assessing sarcopenia through indicators like muscle wasting and malnutrition is important. Nutritional interventions, such as malnutrition screening and enteral feeding, play a critical role in preventing sarcopenia in hospitals. Mental health and physical activity evaluations and interventions are also necessary. Even after recovering from COVID-19, there is a risk of developing sarcopenia, requiring continued monitoring. Nutrition and physical activity considerations are vital for prevention and management, necessitating tailored training programs and diet therapy. Mental health should not be overlooked, with regular screening, and community-based interventions. Infrastructure should support physical activity, and mental health services must become more accessible. Community engagement through support groups and peer networks can foster resilience and social connection. Efforts are needed to promote healthy diets and ensure access to nutritious foods.

Keywords: COVID‐19; SARS‐CoV‐2; mechanism; nutrition; sarcopenia.

PubMed Disclaimer

Conflict of interest statement

There is none to declare.

Figures

FIGURE 1
FIGURE 1
There are several factors that are associated with an increased risk of developing sarcopenia during COVID‐19 hospitalization and post‐hospitalization. Furthermore, it is crucial to consider the self‐generating process of sarcopenia, specifically the interaction between muscle and fat, as it can lead to the progression of severe sarcopenic conditions. COVID‐19, coronavirus disease 2019.
FIGURE 2
FIGURE 2
The development of sarcopenia during COVID‐19 infection may potentially increase the susceptibility of patients to a higher risk of mortality, particularly during hospitalization. Blue factors represent the primary causes contributing to the occurrence of sarcopenia, whereas gray factors depict the potential outcomes resulting from sarcopenia. Moreover, white factors typically represent the secondary outcomes of other elements that have an impact on sarcopenia. COVID‐19, coronavirus disease 2019.
FIGURE 3
FIGURE 3
Represents the stages of developing sarcopenia risk factors and the necessary interventions for patients with COVID‐19 both during and after their hospitalization. The stages of hospitalization are stratified by color, with green representing the during‐hospitalization stage and purple representing the post‐hospitalization stage. Additionally, certain interventions are recommended to be continued even after full recovery for a specified period of time. The different elements in the figure are denoted by specific colors: black represents sarcopenia monitoring tools, blue represents COVID‐19 outcomes that increase the risk of sarcopenia, and salmon represents the required interventions. BDI‐13, Beck Depression Inventory‐13; COVID‐19, coronavirus disease 2019; DASS‐21, Depression Anxiety Stress Scales‐21; EN, enteral nutrition.
FIGURE 4
FIGURE 4
The summarized steps of community interventions within people who survived COVID‐19 in post‐COVID areas. The annual monitoring of sarcopenia is the first orbit of this progress. The preparation phase including providing facilities by national or regional governments follows next, and the supporting phase (for people at elevated risk of sarcopenia) and intervention (for people with sarcopenia) are the next phases to control sarcopenia in this group population. COVID‐19, coronavirus disease 2019; EWGSOP2, European Working Group on Sarcopenia in Older People 2; SARC‐F, strength, assistance with walking, rising from a chair, climbing stairs, and falls.

Similar articles

References

    1. Rothan HA, Byrareddy SN. The epidemiology and pathogenesis of coronavirus disease (COVID‐19) outbreak. J Autoimmun. 2020;109:102433. doi:10.1016/j.jaut.2020.102433 - DOI - PMC - PubMed
    1. Wu SY, Yau HS, Yu MY, et al. The diagnostic methods in the COVID‐19 pandemic, today and in the future. Expert Rev Mol Diagn. 2020;20(9):985‐993. doi:10.1080/14737159.2020.1816171 - DOI - PubMed
    1. Looi M‐K. Covid‐19: scientists sound alarm over new BA.2.86 “Pirola” variant. Br Med J. 2023;382:p1964. doi:10.1136/bmj.p1964c - DOI - PubMed
    1. Cruz‐Jentoft AJ, Sayer AA. Sarcopenia. Lancet. 2019;393:2636‐2646. doi:10.1016/S0140-6736(19)31138-9 - DOI - PubMed
    1. Dent E, Morley J, Cruz‐Jentoft A, et al. International clinical practice guidelines for sarcopenia (ICFSR): screening, diagnosis and management. J Nutr Health Aging. 2018;22(10):1148‐1161. doi:10.1007/s12603-018-1139-9 - DOI - PubMed
-