Frailty but not sarcopenia nor malnutrition increases the risk of developing COVID-19 in older community-dwelling adults

Laetitia Lengelé; Médéa Locquet; Michel Moutschen; Charlotte Beaudart; Jean-François Kaux; Sophie Gillain; Jean-Yves Reginster; Olivier Bruyère

doi:10.1007/s40520-021-01991-z

Frailty but not sarcopenia nor malnutrition increases the risk of developing COVID-19 in older community-dwelling adults

Aging Clin Exp Res. 2022 Jan;34(1):223-234. doi: 10.1007/s40520-021-01991-z. Epub 2021 Oct 23.

Authors

Laetitia Lengelé¹, Médéa Locquet², Michel Moutschen³, Charlotte Beaudart^{2

4}, Jean-François Kaux^{4

5}, Sophie Gillain⁶, Jean-Yves Reginster², Olivier Bruyère^{2

4

5}

Affiliations

¹ 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. llengele@uliege.be.
² 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.
³ Department of Infectious Diseases and General Internal Medicine, CHU Sart-Tilman, University of Liège, 4000, Liège, Belgium.
⁴ Physical, Rehabilitation Medicine and Sports Traumatology, SportS2, University Hospital of Liège, 4000, Liège, Belgium.
⁵ Department of Sport Rehabilitation Sciences, University of Liège, 4000, Liège, Belgium.
⁶ Geriatrics Department, University Hospital of Liège, Liège, Belgium.

Abstract

Background: The identification of coronavirus disease 2019 (COVID-19) risk factors is requested to implement prevention strategies.

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 Mini-Nutritional 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 self-reported 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: COVID-19; Frailty; Malnutrition; SarcoPhAge; Sarcopenia.

MeSH terms

Aged
COVID-19*
Female
Frail Elderly
Frailty* / epidemiology
Geriatric Assessment
Humans
Independent Living
Male
Malnutrition* / complications
Malnutrition* / epidemiology
SARS-CoV-2
Sarcopenia* / epidemiology