☆ 4.4 Article

Handgrip strength is associated with adverse outcomes in patients hospitalized for COVID-19-associated pneumonia

INTERNAL AND EMERGENCY MEDICINE (2022)

Journal

INTERNAL AND EMERGENCY MEDICINE

Volume 17, Issue 7, Pages 1997-2004

Publisher

SPRINGER-VERLAG ITALIA SRL

DOI: 10.1007/s11739-022-03060-3

Keywords

COVID-19; Respiratory failure; Handgrip strength; Sarcopenia; Muscular wasting; Obesity; Sarcopenic obesity

Funding

Universita degli Studi di Perugia within the CRUI-CARE

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Abstract

Handgrip strength (HGS), measured by Jamar hand-dynamometer, can predict the risk of poor outcomes in patients with COVID-19-related pneumonia. Normalized handgrip strength (nHGS) inversely predicts the occurrence of death and/or endotracheal intubation within 14 days.

Handgrip strength (HGS), a simple tool for the evaluation of muscular strength, is independently associated with negative prognosis in many diseases. It is unknown whether HGS is prognostically relevant in COVID-19. We evaluated the ability of HGS to predict clinical outcomes in people with COVID-19-related pneumonia. 118 patients (66% men, 63 +/- 12 years), consecutively hospitalized to the Santa Maria Terni University Hospital for COVID-19-related pneumonia and respiratory failure, underwent HGS measurement (Jamar hand-dynamometer) at ward admission. HGS was normalized to weight(2/3) (nHGS) The main end-point was the first occurrence of death and/or endotracheal intubation at 14 days. Twenty-two patients reached the main end-point. In the Kaplan-Meyer analysis, the Log rank test showed significant differences between subjects with lower than mean HGS normalized to weight(2/3) (nHGS) (< 1.32 kg/Kg(2/3)) vs subjects with higher than mean nHGS. (p = 0.03). In a Cox-proportional hazard model, nHGS inversely predicted the main end-point (hazard ratio, HR = 1.99 each 0.5 kg/Kg(2/3) decrease, p = 0.03), independently from age, sex, body mass index, ratio of partial pressure arterial oxygen and fraction of inspired oxygen (PaO2/FiO(2) ratio), hypertension, diabetes, estimated glomerular filtration rate and history of previous cardiovascular cardiovascular disease. These two latter also showed independent association with the main end-point (HR 1.30, p = 0.03 and 3.89, p < 0.01, respectively). In conclusion, nHGS measured at hospital admission, independently and inversely predicts the risk of poor outcomes in people with COVID-19-related pneumonia. The evaluation of HGS may be useful in early stratifying the risk of adverse prognosis in COVID-19.

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Sarcopenic obesity by the ESPEN/EASO criteria for predicting mortality in advanced non-small cell lung cancer

Jinqiu Zhou, Li Luo, Lingling Xie, Song Hu, Lingling Tan, Xiaozhen Lei, Xiaozhen Luo, Ming Yang

Summary: The ESPEN and EASO have released the international consensus on the diagnostic criteria for sarcopenic obesity (SO), recommending skeletal muscle mass adjusted for body weight (SMM/W) for determining low muscle mass. This study aimed to evaluate the agreement between different diagnostic criteria for SO and to compare their predictive abilities for mortality in patients with advanced NSCLC. The results showed that SOESPEN, SOESPEN-M, and SOAWGS were significantly associated with mortality, while SOCT and SOFM were not.

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