Frailty but not sarcopenia nor malnutrition increases the risk of developing COVID-19 in older community-dwelling adults
Lengelé et al.
, Frailty but not sarcopenia nor malnutrition increases the risk of developing COVID-19 in older..
, Aging Clinical and Experimental Research, doi:10.1007/s40520-021-01991-z
Analysis of 241 adults >65yo in Belgium, showing lower risk of COVID-19 with a history of physical activity.
risk of case, 73.6% lower, RR 0.26, p = 0.03, high activity levels 23 of 229 (10.0%), low activity levels 4 of 12 (33.3%), NNT 4.3, inverted to make RR<1 favor high activity levels, odds ratio converted to relative risk.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Lengelé et al., 23 Oct 2021, prospective, Belgium, peer-reviewed, median age 75.6, 8 authors, study period March 2020 - April 2021.
Abstract: Aging Clinical and Experimental Research (2022) 34:223–234
Frailty but not sarcopenia nor malnutrition increases the risk
of developing COVID‑19 in older community‑dwelling adults
Laetitia Lengelé1 · Médéa Locquet1 · Michel Moutschen2 · Charlotte Beaudart1,3 · Jean‑François Kaux3,4 ·
Sophie Gillain5 · Jean‑Yves Reginster1 · Olivier Bruyère1,3,4
Received: 16 July 2021 / Accepted: 25 September 2021 / Published online: 23 October 2021
© The Author(s), under exclusive licence to Springer Nature Switzerland AG 2021
Background The identification of coronavirus disease 2019 (COVID-19) risk factors is requested to implement prevention
Aim To explore the associations between the COVID-19 incidence and malnutrition, sarcopenia, and frailty, identified as
potential risk factors in previous cross-sectional studies.
Methods Malnutrition, sarcopenia, and frailty were assessed at the last available follow-up from the Sarcopenia and Physical Impairments with Advancing Age (SarcoPhAge) cohort (i.e., the fifth year that ended in 2019) according to the MiniNutritional Assessment short-form, the European Working Group on Sarcopenia in Older People (EWGSOP2), and the Fried
criteria, respectively. Information regarding the COVID-19 was gathered by phone calls interviews in April 2021 to measure
its self-declared incidence. Adjusted Cox regressions and Kaplan–Meier curves were performed.
Results The present study included 241 participants [median age 75.6 (73.0–80.6) years, 63.1% women]. Among them, 27
participants (11.2%) developed the non-fatal Covid-19. No significant increased risks of COVID-19 were observed in patients
with malnutrition [adjusted HR 1.14 (0.26–5.07)] and sarcopenia [adjusted HR 1.25 (0.35–4.42)]. Nevertheless, the incidence
of COVID-19 was significantly higher in frail (44.4%) than in robust participants (8.5%) [Adjusted HR 7.01 (2.69–18.25)],
which was confirmed by the Kaplan–Meier curves (p < 0.001). Among the frailty syndrome components, a low physical
activity level was the only one significantly associated with an increased risk of COVID-19 [adjusted HR 5.18 (1.37–19.54)].
Conclusion Despite some limitations in the methodology of this study (i.e., limited sample size, COVID-19 incidence selfreported and not assessed systematically using objective measurements) requiring careful consideration, an increased risk
to develop COVID-19 was observed in the presence of the frailty syndrome. Further investigations are needed to elaborate
on our findings.
Keywords Malnutrition · Sarcopenia · Frailty · COVID-19 · SarcoPhAge
* Laetitia Lengelé
Division of Public Health, Epidemiology and Health
Economics, WHO Collaborating Centre for Public Health
Aspects of Musculoskeletal Health and Aging, University
of Liège, CHU-Sart Tilman, Quartier Hôpital, Avenue
Hippocrate 13 (Bât. B23), 4000 Liège, Belgium
Physical, Rehabilitation Medicine and Sports Traumatology,
SportS2, University Hospital of Liège, 4000 Liège, Belgium
Department of Sport Rehabilitation Sciences, University
of Liège, 4000 Liège, Belgium
Geriatrics Department, University Hospital of Liège, Liège,
Department of Infectious Diseases and General Internal
Medicine, CHU Sart-Tilman, University of Liège,
4000 Liège, Belgium
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