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Editorial
. 2021 Feb;12(1):9-13.
doi: 10.1002/jcsm.12674. Epub 2020 Dec 31.

Weight loss, malnutrition, and cachexia in COVID-19: facts and numbers

Markus S Anker  1   2   3 , Ulf Landmesser  1   3   4 , Stephan von Haehling  5   6 , Javed Butler  7 , Andrew J S Coats  8 , Stefan D Anker  2   3   9
Affiliations
Editorial

Weight loss, malnutrition, and cachexia in COVID-19: facts and numbers

Markus S Anker et al. J Cachexia Sarcopenia Muscle. 2021 Feb.

Abstract

Patients with COVID-19 disease are prone to develop significant weight loss and clinical cachexia. Three reports with altogether 589 patients that reported on weight loss and cachexia in COVID-19 were identified. Disease severity of patients and the timing of the assessment during the disease course in these patients were variable-65 patients (11%) were intensive care treated at the time of assessment, and 183 (31%) were cared for in sub-intensive or intermediate care structures. The frequency of weight loss ≥5% (that defines cachexia) was 37% (range 29-52%). Correlates of weight loss occurrence were reported to be raised C-reactive protein levels, impaired renal function status, and longer duration of COVID-19 disease. Underweight status by WHO criteria (BMI < 18.5 kg/m2 ) was only observed in 4% of patients analysing data from seven studies with 6661 patients. Cachexia assessment in COVID-19 needs assessment of weight loss. COVID-19 associated cachexia is understood to affect muscle and fat tissue as is also seen in many other chronic illness-associated forms of cachexia. There are many factors that can contribute to body wasting in COVID-19, and they include loss of appetite and taste, fever and inflammation, immobilization, as well as general malnutrition, catabolic-anabolic imbalance, endocrine dysfunction, and organ-specific complications of COVID-19 disease such as cardiac and renal dysfunction. Treatment of COVID-19 patients should include a focus on nutritional support and rehabilitative exercise whenever possible. Specific anti-cachectic therapies for COVID-19 do not exist, but constitute a high medical need to prevent long-term disability due to acute COVID-19 disease.

Keywords: COVID-19; Cachexia; Epidemiology; Malnutrition; Weight loss.

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Conflict of interest statement

M.S.A. reports personal fees from Servier, outside the submitted work.

U.L. reports personal lecture or advisory fees from Amgen, Novartis, Sanofi, Bayer, Abbott, Böhringer, Daichy Sankyo, and NovoNordisk.

S.v.H. reports received personal fees from AstraZeneca, Bayer, Boehringer Ingelheim, BRAHMS, Chugai, Grünenthal, Helsinn, Hexal, Novartis, Respicardia, Roche, Sorin, and Vifor. SvH reports research support from Amgen, AstraZeneca, Boehringer Ingelheim, IMI, and the German Center for Cardiovascular Research (DZHK), all outside the submitted work.

J.B. serves as a consultant for Abbott, Adrenomed, Amgen, Applied Therapeutics, Array, Astra Zeneca, Bayer, BerlinCures, Boehringer Ingelheim, CVRx, G3 Pharmaceutical, Impulse Dynamics, Innolife, Janssen, LivaNova, Luitpold, Medtronic, Merck, Novartis, NovoNordisk, Relypsa, Sequana Medical, V‐Wave Limited, and Vifor.

A.J.C. has received personal fees from Astra Zeneca, Bayer, Boehringer Ingelheim, Menarini, Novartis, Nutricia, Servier, Vifor, Abbott, Actimed, Arena, Cardiac Dimensions, Corvia, CVRx, Enopace, ESN Cleer, Faraday, WL Gore, Impulse Dynamics, and Respicardia, all outside the submitted work.

S.D.A. reports grants from Vifor Int and Abbott and personal fees from Vifor, Bayer, Boehringer Ingelheim, Novartis, Servier, Abbott, Actimed, Cardiac Dimensions, and Impulse Dynamics, all outside the submitted work.

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References

    1. Morley JE, Kalantar‐Zadeh K, Anker SD. COVID‐19: a major cause of cachexia and sarcopenia? J Cachexia Sarcopenia Muscle 2020;11:863–865. - PMC - PubMed
    1. Zeng F, Huang Y, Guo Y, Yin M, Chen X, Xiao L, et al. Association of inflammatory markers with the severity of COVID‐19: a meta‐analysis. Int J Infect Dis 2020;96:467–474. - PMC - PubMed
    1. Jin Y, Yang H, Ji W, Wu W, Chen S, Zhang W, et al. Virology, epidemiology, pathogenesis, and control of COVID‐19. Viruses 2020;12:372. - PMC - PubMed
    1. Virgens IPA, Santana NM, Lima SCVC, Fayh APT. Can COVID‐19 be a risk for cachexia for patients during intensive care? Narrative review and nutritional recommendations. Br J Nutr 2020;5:1–9. - PMC - PubMed
    1. Li T, Zhang Y, Gong C, Wang J, Liu B, Shi L, et al. Prevalence of malnutrition and analysis of related factors in elderly patients with COVID‐19 in Wuhan, China. Eur J Clin Nutr 2020;74:871–875. - PMC - PubMed

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