Low handgrip strength is associated with worse functional outcomes in long-Covid

Abstract

Abstract The diagnosis of long-Covid is troublesome, even when functional limitations are present. Dynapenia is a decrease in muscle strength and power production and may explain in part these limitations. This study aimed to identify the distribution and possible association of dynapenia with functional assessment in patients with long-Covid. A total of 113 inpatients with COVID-19 were evaluated by functional assessment 120 days post-acute severe disease. Body composition, respiratory muscle strength, spirometry, six-minute walk test (6MWT) and hand-grip strength (HGS) were assessed. Dynapenia was defined as HGS < 30kg/f (men), and < 20kg/f (women). Twenty-five (22%) participants were dynapenic, presenting lower muscle mass (p < 0.001), worse forced expiratory volume in the first second (FEV1) (p = 0.0001), lower forced vital capacity (p < 0.001), and inspiratory (p = 0.007) and expiratory (p = 0.002) peek pressures, as well as worse 6MWT performance (p < 0.001). Dynapenia was associated with worse FEV1, MEP, and 6MWT, independent of age (p < 0.001). Patients with dynapenia had higher ICU admission rates (p = 0.01) and need for invasive mechanical ventilation (p = 0.007) during hospitalization. The HGS is a simple, reliable, and low-cost measurement that can be performed in outpatient clinics in low- and middle-income countries. Thus, HGS may be used as a proxy indicator of functional impairment in this population.