Sarcopenia and frailty assessments’ predictive value in elderly patients with COVID-19

Article: Factors associated with mortality in hospitalised, non-severe, older COVID-19 patients – the role of sarcopenia and frailty assessment

Dynapenia is characterised by an age-related loss of muscle strength. When coupled with low muscle mass, it is instead diagnosed as sarcopenia according to the European Working Group on Sarcopenia in Older People revised guidelines (EWGSOP2).

The SARS-CoV-2 infection is accompanied by severe inflammation and increased catabolism, which may significantly impact infected patients’ skeletal muscle structure and function. These impacts may be detrimental to elderly patients, who are disproportionately affected and already highly burdened by the disease. Recent studies have suggested that sarcopenia at the time of hospital admission may shape older patients’ length of stay and increase mortality in those with moderate to severe COVID-19.

The aim of this study was to examine the association between simple clinical biomarkers, including those for the assessment of muscle function and frailty, and the risk of poor survival as well as increased length of hospital stay in older patients with COVID-19. Sarcopenia was screened using SARC-F, while frailty was assessed in accordance with the Rockwood Clinical Frailty Scale.

Key learnings:

Both SARC-F and the Rockwood Clinical Frailty Scale were found to be significantly related to mortality. A 1 score increase in SARC-F was associated with a 34% greater risk of death and a longer hospital stay. Probable sarcopenia was further associated with a significantly greater (441%) risk of death.

Similarly, a 1 score increase in Rockwood was associated with an 86% greater risk of death but was found to be unrelated to the length of hospital stay.

Furthermore, while hand grip strength and dynapenia were found to be unrelated to mortality, the latter was found to be associated with a longer hospital stay. These findings are significant as they underscore the clinical value of using the SARC-F and Rockwood assessments for outcome predictions in elderly patients with COVID-19.

Reviewed by: S. Duarte

Authors: Piotrowicz K, Rys M, Perera I et al.

Published in: BMC Geriatrics 2022