Muscle strength is associated with COVID‐19 hospitalization in adults 50 years of age or older
Journal of Cachexia, Sarcopenia and Muscle, doi:10.1002/jcsm.12738
Background Weak muscle strength has been associated with a wide range of adverse health outcomes. Yet, whether individuals with weaker muscle strength are more at risk for hospitalization due to severe COVID-19 is still unclear. The objective of this study was to investigate the independent association between muscle strength and COVID-19 hospitalization. Methods Data from adults 50 years of age or older were analysed using logistic models adjusted for several chronic conditions, body-mass index, age, and sex. Hand-grip strength was repeatedly measured between 2004 and 2017 using a handheld dynamometer. COVID-19 hospitalization during the lockdown was self-reported in summer 2020 and was used as an indicator of COVID-19 severity.
Results The study was based on the Survey of Health, Ageing and Retirement in Europe (SHARE) and included 3600 older adults (68.8 ± 8.8 years, 2044 female), among whom 316 were tested positive for the severe acute respiratory syndrome coronavirus 2 (8.8%), and 83 (2.3%) were hospitalized due to COVID-19. Results showed that higher grip strength was associated with a lower risk of COVID-19 hospitalization [adjusted odds ratio (OR) per increase of 1 standard deviation in grip strength = 0.64, 95% confidence interval (95% CI) = 0.45-0.87, P = 0.015]. Results also showed that age (OR for a 10 -year period = 1.70, 95% CI = 1.32-2.20, P < 0.001) and obesity (OR = 2.01, 95% CI = 1.00-3.69, P = 0.025) were associated with higher risk of COVID-19 hospitalization. Sensitivity analyses using different measurements of grip strength as well as robustness analyses based on rare-events logistic regression and a different sample of participants (i.e. COVID-19 patients) were consistent with the main results. Conclusions Muscle strength is an independent risk factor for COVID-19 severity in adults 50 years of age or older.
Author contributions All the authors designed the study. S. S. cleaned the data. B. C. analysed the data. B. C. and M. P. B. drafted the manuscript. All authors critically appraised the manuscript, worked on its content, and approved its submitted version.
Conflict of interest All authors declare that they have no conflict of interests.
Ethical approval This study was part of the SHARE study, approved by the relevant research ethics committees in the participating countries.
Informed consent All participants provided written informed consent.
Online supplementary material Additional supporting information may be found online in the Supporting Information section at the end of the article. Table S1 . Cumulative proportion of COVID-19 cases. Table S2 . Results based on average muscle strength (2004-2017). Table S3 . Results based on muscle strength assessed in wave 7. Table S4 . Results adjusted for the country of residence. Table S5 . Results based on the rare events logistic regression with a tau of 84/100,00. Table S6 . Results in COVID-19 patients (N = 289).
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