Influence of body composition during hospitalization on lung function and inspiratory muscle strength in patients with COVID 19: cross-sectional study
DOI:
https://doi.org/10.33233/fb.v24i1.5345Keywords:
COVID-19, body composition, respiratory function testAbstract
Introduction: Approximately 31% of hospitalized patients with COVID-19 lose more than 5% of their initial weight, leading to muscle weakness. Therefore, body composition has become the focus of investigation, to estimate pulmonary impairment, inspiratory muscle strength, and mortality. Objectives: To investigate whether weight loss and body composition of patients hospitalized with COVID-19 have any influence on lung function and inspiratory muscle strength after hospital discharge. Methods: Cross-sectional study. Adult patients were assessed after hospitalization due to COVID-19. Outcomes evaluated were lung function, maximal inspiratory pressure (MIP), body composition, and mortality. Correlations between the variables were estimated by Pearson's Correlation Coefficient. Results: Forced Vital Capacity (FVC) was correlated with weight loss, skeletal muscle mass, lean mass, left leg, and fat-free mass; Forced expiratory volume in the first second (FEV1) was correlated only with weight loss; and MIP was correlated with skeletal muscle mass, lean mass, left leg, right leg, and fat-free mass. Conclusion: A moderate correlation was observed between FVC and the analyzed body composition variables, except lean mass of left leg; between FEV1 and weight loss; and between MIP and the analyzed body composition variables, except weight loss.
References
Di Filippo L, De Lorenzo R, D'Amico M, Sofia V, Roveri L, Mele R, et al. COVID-19 is associated with clinically significant weight loss and risk of malnutrition, independent of hospitalisation: A post-hoc analysis of a prospective cohort study. Clin Nutr. 2021;40(4):2420-6. doi: 10.1016/j.clnu.2020.10.043
Gao M, Wang Q, Piernas C, Astbury NM, Jebb SA, Holmes MV, et al. Associations between body composition, fat distribution and metabolic consequences of excess adiposity with severe COVID-19 outcomes: observational study and Mendelian randomisation analysis. Int J Obes. 2022;46:943-950. doi: 10.1038/s41366-021-01054-3
Anker MS, Landmesser U, Haehling SV, Butler J, Coats AJS, Anker SD. Weight loss, malnutrition, and cachexia in COVID-19: facts and numbers. Journal of Cachexia, Sarcopenia and Muscle. 2021;12(1):9-13. doi: 10.1002/jcsm.12674
Albarrán-Sánchez A, Ramírez-Rentería C, Anda-Garay JC, Noyola-García ME, Alberti-Minutti P, Flores-Padilla G, et al. Differences in mortality rate among patients hospitalized with severe COVID-19 according to their body mass index. Obes Sci Pract. 2021;8(4):423-432. doi: 10.1002/osp4.584
Donnelly JP, Wang XQ, Iwashyna TJ, Prescott HC. Readmission and death after initial hospital discharge among patients with COVID-19 in a large multihospital system. JAMA. 2020;325(3):304-306. https://doi:10.1001/jama.2020.21465
Ballvé A, Llauradó A, Palasí A, Quintana M, Martínez-Sáez E, Laínez E, et al. Weakness as a complication of COVID-19 in critically ill patients: clinical features and prognostic factors in a case series. Rev Neurol. 2021;73(1):10-16. doi: 10.33588/rn.7301.2021042
Plaza M, Sevilla GGP. Respiratory muscle sequelae in young university students infected by coronavirus disease 2019: an observational study. Rev Assoc Med Bras. 2022;68(2):245-249. doi: 10.1590/1806-9282.20211040
Zhang S, Bai W, Yue J, Qin L, Zhang C, Xu S, et al. Eight months follow-up study on pulmonary function, lung radiographic, and related physiological characteristics in COVID-19 survivors. Scientific Reports. 2021;13854:1-13. doi: 10.1038/s41598-021-93191-y
Carod-Artal FJ. Post-COVID-19 syndrome: epidemiology, diagnostic criteria and pathogenic mechanisms involved. Rev Neurol. 2021;72(11):384-396. doi: 10.33588/rn.7211.2021230
Freuer D, Linseisen J, C. Meisinger. Impact of body composition on COVID-19 susceptibility and severity: A two-sample multivariable Mendelian randomization study. Metabolism. 2021;118:154732. doi: 10.1016/j.metabol.2021.154732
Polese J, Sant'Ana L, Moulaz IR, Lara IC, Bernardi JM, Lima MD, et al. Pulmonary function evaluation after hospital discharge of patients with severe COVID-19. Clinics. 2021;76:e2848. doi: 10.6061/clinics/2021/e2848
Morgenthau AS, Levin MA, Freeman R, Reich DL, Klang E. Moderate or severe impairment in pulmonary function is associated with mortality in sarcoidosis patients infected with SARS-CoV-2. Lung. 2020;198:771-775. doi: 10.1007/s00408-020-00392-9
Mancuzo EV, Marinho CC, Machado-Coelho GLL, Batista AP, Oliveira JF, Andrade BH, et al. Lung function of patients hospitalized with COVID-19 at 45 days after hospital discharge: first report of a prospective multicenter study in Brazil. J Bras Pneumol. 2021;47(6):e20210162. doi: 10.36416/1806-3756/e20210162
Thomas M, OJ Price, JH Hull. Pulmonary function and COVID-19. Physiol Curr Opin. 2021;21:29-35. doi: 10.1016/j.cophys.2021.03.005
Allard L, E Ouedraogo, Molleville J, Bihan H,Giroux-Leprieur B, Sutton A, et al. Malnutrition: percentage and association with prognosis in patients hospitalized for coronavirus disease 2019. Nutrients. 2020;12(12):E3679. doi: 10.3390/nu12123679
Pironi L, Sasdelli AS, Ravaioli F, Baracco B, Battaiola C, Bocedi G, et al. Malnutrition and nutritional therapy in patients with SARS-CoV-2 disease. Clin Nutr. 2021;40(3):1330-7. doi: 10.1016/j.clnu.2020.08.021
Elm EV, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol. 2008;61(4):344-9. doi: 10.1016/j.jclinepi.2007.11.008
Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, et al. Standardisation of spirometry. Eur Respir J. 2005;26(2):319-38. doi: 10.1183/09031936.05.00034805
Sociedade Brasileira de Pneumologia e Tisiologia. Diretrizes para Testes de Função Pulmonar. J Pneumol [Internet]. 2002 [cited 2023 Jan 13];28(Suppl 3):S1-S238. Available from : https://www.jornaldepneumologia.com.br/details-supp/45
American Thoracic Society/European Respiratory. ATS/ERS Statement on respiratory muscle testing. Am J Respir Crit Care Med. 2002;166(4):518-24. doi: 10.1164/rccm.166.4.518
Neder JA, Andreoni S, Lerario MC, Nery LE. Reference values for lung function tests. II. Maximal respiratory pressures and voluntary ventilation. Braz J Med Biol Res. 1999;32(6):719-27. doi: 10.1590/S0100-879X1999000600007
Thluiz RR, Magnanini MMF. The logic of sample determination in epidemiological research. Cad Health Collect [Internet]. 2000 [cited 2023 Jan 13];8(2):9-28. Available from: https://pesquisa.bvsalud.org/portal/resource/pt/lil-326604
Banerjee J, Canamar CP, Voyageur C, Tangpraphaphorn S, Lemus A, Jr CC, et al. Mortality and readmission rates among patients with COVID-19 after discharge from acute care setting with supplemental oxygen. JAMA. 2021;4(4):e213990. https://doi:10.1001/jamanetworkopen.2021.3990
Akoglu H. User's guide to correlation coefficients. Turk J Emerg Med. 2018;18(3):91–3. doi: 10.1016/j.tjem.2018.08.001
Ayres M, Ayres JR, Ayres DL, Santos AS. BioEstat 5.3: Statistical applications in the areas of Biological and Medical Sciences. Belém: Mamirauá Civil Society Publishing House; 2011. p. 364.
Anastasio F, Barbuto S, Scarnecchia E, Cosma P, Fugagnoli A, Rossi G. Medium-term impact of COVID-19 on pulmonary function, functional capacity and quality of life. Eur Respir J. 2021;58(3):2004015. doi: 10.1183/13993003.04015-2020
Huang Y, Tan C, Wu J, Chen M, Wang Z, Luo L, et al. Impact of coronavirus disease 2019 on pulmonary function in early convalescence phase. Respir Res. 2020;21(1):163. doi: 10.1186/s12931-020-01429-6
Gobbi M, Bezzoli E, Ismelli F, Trotti G, Cortellezzi S, Meneguzzo F, et al. Skeletal muscle mass, sarcopenia and rehabilitation outcomes in post-acute COVID-19 patients. J Clin Med. 2021;10(23):5623. doi: 10.3390/jcm10235623
Park CH, Yi Y, Do JG, Lee YT, Yoon KJ. Relationship between skeletal muscle mass and lung function in Korean adults without clinically apparent lung disease. Medicine (Baltimore). 2018;97(37):e12281. doi: 10.1097%2FMD.0000000000012281
Tieland M, Trouwborst I, Clark BC. Skeletal muscle performance and ageing. J Cachexia Sarcopenia Muscle. 2018;9(1):3-19. doi: 10.1002/jcsm.12238
Bone AE, Hepgul N, Kon S, Maddocks M. Sarcopenia and frailty in chronic respiratory disease. Chron Respir Dis. 2017;14(1):85-99. doi: 10.1177/1479972316679664
Alonso AC, Silva-Santos PR, Quintana MSL, Silva VC, Brech GC, Barbosa LG, et al. Physical and pulmonary capacities of individuals with severe coronavirus disease after hospital discharge: A preliminary cross-sectional study based on cluster analysis. Clinics. 2021;76:e3540. doi: 10.6061/clinics/2021/e3540
Moonen HPFX, Zanten FJLV, Driessen L, Smet V, Slingerland-Boot R, Mensink M, et al. Association of bioelectric impedance analysis body composition and disease severity in COVID-19 hospital ward and ICU patients: The BIAC-19 study. Clin Nutr. 2021;40(4):2328-36. doi: 10.1016%2Fj.clnu.2020.10.023
Kellnar A, Hoppe JM, Brunner S, Stremmel C. Hospitalization for COVID-19 is associated with significant changes in body composition. Clin Nutr. ESPEN 2021;45:499-502. doi: 10.1016/j.clnesp.2021.07.033
Published
Issue
Section
License
Copyright (c) 2023 Juliano Giorgio Rosa Luccas, Larissa de Magalhães Doebeli Matias, Hiago Vinicius Costa Silva, Charlys Victor Sousa Aguiar, João Paulo Rodrigues Pacheco, Everton Teles Rodrigues, Juliana Ribeiro Fonseca Franco de Macedo, Adriana Claudia Lunardi, Elinaldo da Conceição dos Santos
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors are authorized for non-exclusive distribution of the version of the work published in this journal (eg, publishing in an institutional repository or as a book chapter), with acknowledgment of authorship and initial publication in this journal.
