Muscle strength and muscle mass as predictors of hospital length of stay in patients with moderate to severe COVID‐19: a prospective observational study
Abstract Background Strength and muscle mass are predictors of relevant clinical outcomes in critically ill patients, but in hospitalized patients with COVID‐19, it remains to be determined. In this prospective observational study, we investigated whether muscle strength or muscle mass are predictiv...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2021-12-01
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| Series: | Journal of Cachexia, Sarcopenia and Muscle |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/jcsm.12789 |
| _version_ | 1797203935292817408 |
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| author | Saulo Gil Wilson Jacob Filho Samuel Katsuyuki Shinjo Eduardo Ferriolli Alexandre Leopold Busse Thiago Junqueira Avelino‐Silva Igor Longobardi Gersiel Nascimento deOliveira Júnior Paul Swinton Bruno Gualano Hamilton Roschel The HCFMUSP COVID‐19 Study Group |
| author_facet | Saulo Gil Wilson Jacob Filho Samuel Katsuyuki Shinjo Eduardo Ferriolli Alexandre Leopold Busse Thiago Junqueira Avelino‐Silva Igor Longobardi Gersiel Nascimento deOliveira Júnior Paul Swinton Bruno Gualano Hamilton Roschel The HCFMUSP COVID‐19 Study Group |
| author_sort | Saulo Gil |
| collection | DOAJ |
| description | Abstract Background Strength and muscle mass are predictors of relevant clinical outcomes in critically ill patients, but in hospitalized patients with COVID‐19, it remains to be determined. In this prospective observational study, we investigated whether muscle strength or muscle mass are predictive of hospital length of stay (LOS) in patients with moderate to severe COVID‐19 patients. Methods We evaluated prospectively 196 patients at hospital admission for muscle mass and strength. Ten patients did not test positive for SARS‐CoV‐2 during hospitalization and were excluded from the analyses. Results The sample comprised patients of both sexes (50% male) with a mean age (SD) of 59 (±15) years, body mass index of 29.5 (±6.9) kg/m2. The prevalence of current smoking patients was 24.7%, and more prevalent coexisting conditions were hypertension (67.7%), obesity (40.9%), and type 2 diabetes (36.0%). Mean (SD) LOS was 8.6 days (7.7); 17.0% of the patients required intensive care; 3.8% used invasive mechanical ventilation; and 6.6% died during the hospitalization period. The crude hazard ratio (HR) for LOS was greatest for handgrip strength comparing the strongest versus other patients (1.47 [95% CI: 1.07–2.03; P = 0.019]). Evidence of an association between increased handgrip strength and shorter hospital stay was also identified when handgrip strength was standardized according to the sex‐specific mean and standard deviation (1.23 [95% CI: 1.06–1.43; P = 0.007]). Mean LOS was shorter for the strongest patients (7.5 ± 6.1 days) versus others (9.2 ± 8.4 days). Evidence of associations were also present for vastus lateralis cross‐sectional area. The crude HR identified shorter hospital stay for patients with greater sex‐specific standardized values (1.20 [95% CI: 1.03–1.39; P = 0.016]). Evidence was also obtained associating longer hospital stays for patients with the lowest values for vastus lateralis cross‐sectional area (0.63 [95% CI: 0.46–0.88; P = 0.006). Mean LOS for the patients with the lowest muscle cross‐sectional area was longer (10.8 ± 8.8 days) versus others (7.7 ± 7.2 days). The magnitude of associations for handgrip strength and vastus lateralis cross‐sectional area remained consistent and statistically significant after adjusting for other covariates. Conclusions Muscle strength and mass assessed upon hospital admission are predictors of LOS in patients with moderate to severe COVID‐19, which stresses the value of muscle health in prognosis of this disease. |
| first_indexed | 2024-04-24T08:27:14Z |
| format | Article |
| id | doaj.art-b5dace3a24014ac38383943881219246 |
| institution | Directory Open Access Journal |
| issn | 2190-5991 2190-6009 |
| language | English |
| last_indexed | 2024-04-24T08:27:14Z |
| publishDate | 2021-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Cachexia, Sarcopenia and Muscle |
| spelling | doaj.art-b5dace3a24014ac383839438812192462024-04-16T21:54:09ZengWileyJournal of Cachexia, Sarcopenia and Muscle2190-59912190-60092021-12-011261871187810.1002/jcsm.12789Muscle strength and muscle mass as predictors of hospital length of stay in patients with moderate to severe COVID‐19: a prospective observational studySaulo Gil0Wilson Jacob Filho1Samuel Katsuyuki Shinjo2Eduardo Ferriolli3Alexandre Leopold Busse4Thiago Junqueira Avelino‐Silva5Igor Longobardi6Gersiel Nascimento deOliveira Júnior7Paul Swinton8Bruno Gualano9Hamilton Roschel10The HCFMUSP COVID‐19 Study GroupApplied Physiology & Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculdade de Medicina FMUSP Universidade de Sao Paulo São Paulo SP BrazilLaboratorio de Investigacao Medica em Envelhecimento (LIM‐66), Servico de Geriatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina Universidade de Sao Paulo Sao Paulo BrazilRheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina FMUSP Universidade de Sao Paulo Sao Paulo BrazilLaboratorio de Investigacao Medica em Envelhecimento (LIM‐66), Servico de Geriatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina Universidade de Sao Paulo Sao Paulo BrazilLaboratorio de Investigacao Medica em Envelhecimento (LIM‐66), Servico de Geriatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina Universidade de Sao Paulo Sao Paulo BrazilLaboratorio de Investigacao Medica em Envelhecimento (LIM‐66), Servico de Geriatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina Universidade de Sao Paulo Sao Paulo BrazilApplied Physiology & Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculdade de Medicina FMUSP Universidade de Sao Paulo São Paulo SP BrazilApplied Physiology & Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculdade de Medicina FMUSP Universidade de Sao Paulo São Paulo SP BrazilSchool of Health Sciences Robert Gordon University Aberdeen UKApplied Physiology & Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculdade de Medicina FMUSP Universidade de Sao Paulo São Paulo SP BrazilApplied Physiology & Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculdade de Medicina FMUSP Universidade de Sao Paulo São Paulo SP BrazilAbstract Background Strength and muscle mass are predictors of relevant clinical outcomes in critically ill patients, but in hospitalized patients with COVID‐19, it remains to be determined. In this prospective observational study, we investigated whether muscle strength or muscle mass are predictive of hospital length of stay (LOS) in patients with moderate to severe COVID‐19 patients. Methods We evaluated prospectively 196 patients at hospital admission for muscle mass and strength. Ten patients did not test positive for SARS‐CoV‐2 during hospitalization and were excluded from the analyses. Results The sample comprised patients of both sexes (50% male) with a mean age (SD) of 59 (±15) years, body mass index of 29.5 (±6.9) kg/m2. The prevalence of current smoking patients was 24.7%, and more prevalent coexisting conditions were hypertension (67.7%), obesity (40.9%), and type 2 diabetes (36.0%). Mean (SD) LOS was 8.6 days (7.7); 17.0% of the patients required intensive care; 3.8% used invasive mechanical ventilation; and 6.6% died during the hospitalization period. The crude hazard ratio (HR) for LOS was greatest for handgrip strength comparing the strongest versus other patients (1.47 [95% CI: 1.07–2.03; P = 0.019]). Evidence of an association between increased handgrip strength and shorter hospital stay was also identified when handgrip strength was standardized according to the sex‐specific mean and standard deviation (1.23 [95% CI: 1.06–1.43; P = 0.007]). Mean LOS was shorter for the strongest patients (7.5 ± 6.1 days) versus others (9.2 ± 8.4 days). Evidence of associations were also present for vastus lateralis cross‐sectional area. The crude HR identified shorter hospital stay for patients with greater sex‐specific standardized values (1.20 [95% CI: 1.03–1.39; P = 0.016]). Evidence was also obtained associating longer hospital stays for patients with the lowest values for vastus lateralis cross‐sectional area (0.63 [95% CI: 0.46–0.88; P = 0.006). Mean LOS for the patients with the lowest muscle cross‐sectional area was longer (10.8 ± 8.8 days) versus others (7.7 ± 7.2 days). The magnitude of associations for handgrip strength and vastus lateralis cross‐sectional area remained consistent and statistically significant after adjusting for other covariates. Conclusions Muscle strength and mass assessed upon hospital admission are predictors of LOS in patients with moderate to severe COVID‐19, which stresses the value of muscle health in prognosis of this disease.https://doi.org/10.1002/jcsm.12789COVID‐19HandgripHospital staySkeletal muscle |
| spellingShingle | Saulo Gil Wilson Jacob Filho Samuel Katsuyuki Shinjo Eduardo Ferriolli Alexandre Leopold Busse Thiago Junqueira Avelino‐Silva Igor Longobardi Gersiel Nascimento deOliveira Júnior Paul Swinton Bruno Gualano Hamilton Roschel The HCFMUSP COVID‐19 Study Group Muscle strength and muscle mass as predictors of hospital length of stay in patients with moderate to severe COVID‐19: a prospective observational study Journal of Cachexia, Sarcopenia and Muscle COVID‐19 Handgrip Hospital stay Skeletal muscle |
| title | Muscle strength and muscle mass as predictors of hospital length of stay in patients with moderate to severe COVID‐19: a prospective observational study |
| title_full | Muscle strength and muscle mass as predictors of hospital length of stay in patients with moderate to severe COVID‐19: a prospective observational study |
| title_fullStr | Muscle strength and muscle mass as predictors of hospital length of stay in patients with moderate to severe COVID‐19: a prospective observational study |
| title_full_unstemmed | Muscle strength and muscle mass as predictors of hospital length of stay in patients with moderate to severe COVID‐19: a prospective observational study |
| title_short | Muscle strength and muscle mass as predictors of hospital length of stay in patients with moderate to severe COVID‐19: a prospective observational study |
| title_sort | muscle strength and muscle mass as predictors of hospital length of stay in patients with moderate to severe covid 19 a prospective observational study |
| topic | COVID‐19 Handgrip Hospital stay Skeletal muscle |
| url | https://doi.org/10.1002/jcsm.12789 |
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