Skeletal Muscle Mass, Sarcopenia and Rehabilitation Outcomes in Post-Acute COVID-19 Patients.

Michele Gobbi,Paolo Capodaglio,Giulia Trotti,Emanuela Bezzoli,Veronica Cimolin,Valentina Aspesi,Stefano Cortellezzi,Ionathan Seitanidis,Marco Arreghini,Francesca Meneguzzo,Francesco Ismelli,Paolo Fanari,Amelia Brunani

doi:10.3390/jcm10235623

Abstract

The relationship between skeletal muscle mass at the beginning of the post-acute rehabilitation phase and rehabilitation outcomes has been scarcely investigated. The aim of this study was to investigate the impact of the existence of sarcopenia upon admission to a post-acute COVID-19 patient rehabilitation unit on body composition and functional and respiratory capacity at discharge. Thirty-four post-acute COVID-19 patients were referred to our Rehabilitation Unit from different COVID Hospitals in northern Italy. Body weight loss, body composition, handgrip strength, functional parameters, oxygen saturation and related perception of dyspnea in several positions were measured before and after a 28-day multidisciplinary rehabilitation program. Spirometry was performed only upon admission. The intervention included psychiatric support, cognitive behavioral therapy, nutritional therapy and physiotherapy, including aerobic and resistance training. Training volume was 45 min/session, 6 sessions/week. Upon admission, the prevalence of sarcopenia among our patients was 58%. In all of the 34 patients, we observed a trend of improvement in all of the respiratory, body composition, muscle strength and functional parameters considered. Monitoring muscle mass and strength in post-acute COVID-19 patients appears to be a key predictor of rehabilitation outcomes. Early diagnosis of sarcopenia therefore appears to be of paramount importance in the management of post-acute COVID-19 patients.

Highlights

COVID-19 is an infectious disease caused by SARS-CoV-2, leading to a severe acute respiratory syndrome and multi-organ failure [1]
The number of patients admitted to the intensive care unit in the previous hospitalization was 8/20 based on the clinical records
The number of patients admitted to the intensive care unit in the previous hospitalization was 3/14

Summary

Introduction

COVID-19 is an infectious disease caused by SARS-CoV-2, leading to a severe acute respiratory syndrome and multi-organ failure [1]. COVID-19 patients may develop acute respiratory, nervous and musculoskeletal symptoms, leading to difficulty in verticalization [2,3]. COVID-19 patients require intensive rehabilitation aimed at restoring independence in basic daily activities. Some patients may develop post-viral fatigue syndrome or “long COVID” [3]. Rehabilitation guidelines for post-COVID-19 patients have been released by the World Health Organization [4] and different countries [5]. To update the rehabilitation community on the growing evidence for the role of rehabilitation in management of COVID-19 patients, Cochrane Rehabilitation launched

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