Poor Nutritional Status and Dynapenia Are Highly Prevalent in Post-Acute COVID-19

Francesco de Blasio; Luca Scalfi; Bianca Castellucci; Anna Maria Sacco; Giulia Miracco Berlingieri; Ludovica Capitelli; Paola Alicante; Alessandro Sanduzzi; Marialuisa Bocchino

doi:10.3389/fnut.2022.888485

Poor Nutritional Status and Dynapenia Are Highly Prevalent in Post-Acute COVID-19

Front Nutr. 2022 Jun 3:9:888485. doi: 10.3389/fnut.2022.888485. eCollection 2022.

Authors

Francesco de Blasio¹, Luca Scalfi², Bianca Castellucci¹, Anna Maria Sacco², Giulia Miracco Berlingieri¹, Ludovica Capitelli³, Paola Alicante², Alessandro Sanduzzi³, Marialuisa Bocchino³

Affiliations

¹ Respiratory Medicine and Pulmonary Rehabilitation, Clinic Center, Private Hospital, Naples, Italy.
² Department of Public Health, Federico II University, Naples, Italy.
³ Respiratory Medicine Unit, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy.

Abstract

Poor nutritional status is common (estimated prevalence 5-69%) in acute coronavirus disease-2019 (COVID-19), and has been associated with hospitalization, the need for intensive care, and mortality. Body composition (BC) and muscle function have also been related in such patients to poor disease outcomes. As the evidence in the literature is limited, a cross-sectional study was carried out to determine the frequency of malnutrition in a cohort of post-acute COVID-19 patients referred to a rehabilitation center after hospital discharge. BC and muscle strength were assessed and the differences between bedridden and not bedridden patients were specifically evaluated. The study sample was composed of 144 post-acute COVID-19 patients (mean age 64.8 years; males = 95), 37% of whom were bedridden (males = 60%). Nutritional status was evaluated with Mini-Nutritional Assessment (MNA) and Controlling Nutritional status (CONUT). Fat-free mass (FFM) and skeletal muscle mass (SM) were estimated using bioelectrical impedance analysis (BIA). Raw BIA variables (phase angle = PhA and impedance ratios = IRs) were also determined and handgrip strength (HGS) was measured. Dynapenia was identified according to the 2019 EWGSOP criteria. According to MNA, 18% (n. 26) of patients were malnourished and 62% (n. 89) were at risk of malnutrition. As for CONUT, 21% (n. 31) of cases had moderate-severe malnutrition and 58% (n. 83) had light malnutrition. Abnormalities of raw BIA variables (low PhA and high IRs) and low HGS were more common in bedridden patients, in those who were malnourished, or had low FFM or SM. Dynapenic patients were 65% men and 47% women. In conclusion, malnutrition, BC alterations, and low HGS occur in post-acute COVID-19 patients and are more common in bedridden patients. Further studies are needed to identify reliable algorithms for assessing nutritional status in post-acute COVID-19 patients undergoing rehabilitation.

Keywords: dynapenia; handgrip strength; malnutrition; phage angle; post-acute COVID-19.