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Review
. 2023 Mar 9:18:359-373.
doi: 10.2147/CIA.S398386. eCollection 2023.

Sarcopenia and COVID-19 Outcomes

Yuhan Wang  1 , Shuwen Tan  1 , Qihui Yan  1 , Ying Gao  1
Affiliations
Review

Sarcopenia and COVID-19 Outcomes

Yuhan Wang et al. Clin Interv Aging. .

Abstract

Coronavirus disease 2019 (COVID-19) spread rapidly and became a severe global public health threat. Older adults have a high risk of COVID-19 and its associated mortality. Sarcopenia has emerged as a predictor of poor outcomes in COVID-19 patients, including lengthy hospital stays, mortality, intensive care unit admission, need for invasive mechanical ventilation, and poor rehabilitation outcomes. Chronic inflammation, immune dysfunction, respiratory muscle dysfunction, and swallowing dysfunction may underlie the association between sarcopenia and the poor outcomes of COVID-19 patients. Interleukin 6 receptor blockers (tocilizumab or sarilumab) are recommended for treating patients with severe COVID-19, and their therapeutic effects on sarcopenia are of great interest. This review aimed to analyze the current reports on the association between sarcopenia and COVID-19 and provide an update on the contribution of sarcopenia to the severity and adverse outcomes of COVID-19 and its underlying mechanisms. We also aimed to explore the different screening tools for sarcopenia concurrent with COVID-19, and advocate for early diagnosis and treatment of sarcopenia. Given that the fight against the COVID-19 pandemic may be long-term, further research into understanding the effects of sarcopenia in patients infected with the Omicron variant is necessary.

Keywords: COVID-19; IL-6; inflammation; sarcopenia; skeletal muscle.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
The potential mechanisms underlying the association between sarcopenia and poor COVID-19 outcomes are chronic inflammation, immune dysfunction, respiratory muscle dysfunction, and swallowing dysfunction. A low-grade chronic inflammatory state (elevated concentrations of IL-6, TNF-α, and CRP) related to sarcopenia may be associated with an increased risk of a cytokine storm in patients with severe COVID-19. A key mechanism underlying impaired immunity in sarcopenic individuals is the abnormal expression of IL-15. IL-15 can regulate the activation, proliferation, and survival of CD8 T and NK cells. A lack of IL-15 signaling may lead to poor immune responses against COVID-19.
See this image and copyright information in PMC

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Supplementary concepts