Abstract
Although the numbers of aged populations have risen considerably in the last few decades, the current coronavirus disease 2019 (COVID-19) has revealed an extensive vulnerability among these populations. Sarcopenia is an age-related disorder that increases hospitalization, dependencies, and mortality in older adults. It starts to develop in midlife or even earlier as a result of unbalanced diet/poor nutrition and low levels of physical activity, in addition to chronic disorders such as obesity and diabetes mellitus. Given that social isolation is adopted as the most protective measure against COVID-19, the level of physical activity and the intake of adequate diet have considerably declined, especially among older adults—denoting an increased possibility for developing sarcopenia. Research also shows a higher vulnerability of sarcopenic people to COVID-19 as well as the development of wasting disorders such as sarcopenia and cachexia in a considerable proportion of symptomatic and recovering COVID-19 patients. Muscular wasting in COVID-19 is associated with poor prognosis. Accordingly, early detection and proper management of sarcopenia and wasting conditions in older adults and COVID-19 patients may minimize morbidity and mortality during the current COVID-19 crisis. This review explored different aspects of screening for sarcopenia, stressing their relevance to the detection of altered muscular structure and performance in patients with COVID-19. Current guidelines recommend prior evaluation of muscle strength by simple measures such as grip strength to identify individuals with proven weakness who then would be screened for muscle mass loss. The latter is best measured by MRI and CT. However, due to the high cost and radiation risk entailed by these techniques, other simpler and cheaper techniques such as DXA and ultrasound are given preference. Muscle loss in COVID-19 patients was measured during the acute phase by CT scanning of the pectoralis muscle simultaneously during a routine check for lung fibrosis, which seems to be an efficient evaluation of sarcopenia among those patients with no additional cost. In recovering patients, muscle strength and physical performance have been evaluated by electromyography and traditional tests such as the six-minute walk test. Effective preventive and therapeutic interventions are necessary in order to prevent muscle loss and associated physical decline in COVID-19 patients.
Highlights
Aging involves deterioration of cellular processes, inability to maintain homeostasis, and increased vulnerability to stressors [1,2,3,4]. is condition is known as frailty
Frailty is closely linked to comorbidity, poor cognition, functional dependence, institutionalization, and hospitalization [3, 75]. erefore, it is recommended to screen for sarcopenia in people with recent functional decline, recent history of reduced appetite that resulted in poor food intake, unintentional weight loss of more than 5% per month, low muscle mass, repeated falls, depression, cognitive decline, and chronic wasting disorders such as chronic heart failure, chronic obstructive pulmonary disease, diabetes mellitus, chronic kidney disease, connective tissue disease, and tuberculosis [14, 76, 77]
Sarcopenia and related conditions are widespread in aged and diseased populations; they are major risk factors for SARS-COV-2 infection. ey contribute to the severity of COVID-19 by potentiating cytokine storms and respiratory failure. e detection of sarcopenia in vulnerable groups, mainly older adults and persons with chronic noncommunicable diseases, should proceed from the evaluation of muscle strength by simple measures such as grip strength to the evaluation of muscle mass in those with proven weakness
Summary
Aging involves deterioration of cellular processes, inability to maintain homeostasis, and increased vulnerability to stressors [1,2,3,4]. is condition is known as frailty. Sarcopenia is an age-bound condition that entails a progressive loss of skeletal muscle mass along with declines in muscle strength and physical performance [3, 7]. Because muscle wasting in hospitalized patients is associated with serious adverse effects including premature death [37, 38], researchers emphasize the importance of screening hospitalized COVID-19 patients, especially older adults, for wasting disorders such as sarcopenia and cachexia [3, 45, 49]. This review sheds light on conditions in which the assessment of skeletal muscle damage may be necessary It provides a detailed illustration of different measures used for detecting sarcopenia, with a focus on measures appropriate for use among patients struck by COVID-19
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