Effect of COVID-19 Pandemic on the Change in Skeletal Muscle Mass in Older Patients with Type 2 Diabetes: A Retrospective Cohort Study.

Yuka Hasegawa,Chihiro Munekawa,Naoko Nakanishi,Emi Ushigome,Yoshitaka Hashimoto,Masahide Hamaguchi,Hiroshi Okada,Fuyuko Takahashi,Takuro Okamura,Takafumi Senmaru,Saori Majima,Yukako Hosomi,Masahiro Yamazaki,Michiaki Fukui

doi:10.3390/ijerph18084188

Abstract

Background: The aim of this study was to investigate the effect of the coronavirus disease (COVID-19) pandemic restrictions on the change in muscle mass in older patients with type 2 diabetes (T2D), who were not infected with COVID-19. Methods: In this retrospective cohort study, data were obtained from outpatients who underwent bioelectrical impedance analysis at least twice before April 2020 and at least once thereafter. Skeletal muscle mass index (SMI, kg/m2) was calculated as appendicular muscle mass (kg) divided by height squared (m2). Change in SMI (kg/m2/year) was calculated as (follow-up SMI—baseline SMI/follow-up period). The differences between the changes in SMI before and after the start of the COVID-19 pandemic were evaluated using paired t test. Results: This study recruited 56 patients, with a mean (SD) age of 75.2 (7.1) years. SMI changed from 6.7 (0.9) to 6.8 (0.9) kg/m2 before the COVID-19 pandemic, whereas SMI changed from 6.8 (0.9) to 6.6 (0.9) kg/m2 after the start of the COVID-19 pandemic. SMI decreased after the start of the COVID-19 pandemic compared with before the pandemic (−0.117 (0.240) vs. 0.005 (0.289) kg/m2/year, p = 0.049). This decrease was observed in men (−0.159 (0.257) vs. 0.031 (0.325) kg/m2/year, p = 0.038), patients with poor glycemic control (−0.170 (0.264) vs. 0.031 (0.285) kg/m2/year, p = 0.042), and those with a long diabetes duration (−0.153 (0.229) vs. 0.082 (0.291) kg/m2, p = 0.049). Conclusions: The COVID-19 pandemic restrictions caused muscle mass loss in older patents with T2D. Actions, including recommendation of exercise and adequate diet intake, are needed to prevent loss of muscle mass.

Highlights

The coronavirus disease (COVID-19) pandemic has had a severe impact on public health worldwide [1]
The data of patients who answered the questions about changes in stress levels and lifestyle due to the COVID-19 pandemic were summarized, and we investigated the differences in the changes in SMI before and after the start of the pandemic using the paired t test according to patient stress levels and exercise status
Among 538 patients with type 2 diabetes (T2D) who participated in the KAMOGAWA-DM cohort study, we extracted data on 105 patients who had undergone bioelectrical impedance analysis (BIA) at least three times

Summary

Introduction

The coronavirus disease (COVID-19) pandemic has had a severe impact on public health worldwide [1]. 1.8 million deaths due to COVID-19 had been reported in 222 countries [2]. In response to the pandemic, several countries, such as Italy and France, implemented city lockdowns [3]. The aim of this study was to investigate the effect of the coronavirus disease (COVID-19) pandemic restrictions on the change in muscle mass in older patients with type 2 diabetes (T2D), who were not infected with COVID-19. Skeletal muscle mass index (SMI, kg/m2 ). The differences between the changes in SMI before and after the start of the COVID-19 pandemic were evaluated using paired t test. SMI decreased after the start of the COVID-19 pandemic compared with before the pandemic

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Discussion

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