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Review

Physical Frailty/Sarcopenia as a Key Predisposing Factor to Coronavirus Disease 2019 (COVID-19) and Its Complications in Older Adults

1
Department of Behavioral Medicine, National Center of Neurology and Psychiatry, National Institute of Mental Health, Tokyo 187-8553, Japan
2
Department of Psychiatric Nursing and Mental Health, Faculty of Nursing, Alexandria University, Alexandria 21527, Egypt
3
Department of Psychiatry, Teikyo University School of Medicine, Tokyo 173-8605, Japan
4
Department of Mental Disorder Research, National Center of Neurology and Psychiatry, National Institute of Neuroscience, Tokyo 187-8502, Japan
*
Author to whom correspondence should be addressed.
Academic Editor: Marc Poirot
Received: 18 May 2021 / Revised: 13 July 2021 / Accepted: 23 July 2021 / Published: 29 July 2021
The tremendously rising numbers of aged populations are associated with a heightened risk for motor and functional declines. Sarcopenia is an active age-related process that involves progressive losses of skeletal muscle mass, muscle strength, and muscle function. Muscle failure is a major cause of frailty, disability, falls, hospitalization, dependency, institutionalization, and low quality of life in older seniors. Therefore, sarcopenia considerably heightens the annual cost of care worldwide. This narrative review elaborates on sarcopenia as a deleterious condition in old age while spotting the light on its association with the coronavirus disease 2019 (COVID-19). It discusses its pathophysiology and the most possible options for preventing and treating sarcopenia. The literature shows that the dynamic of sarcopenia is complex, involving multifaceted physiological alterations relevant to aging, unhealthy behaviors (e.g., undernutrition or inadequate dietary intake and physical inactivity/immobility or sedentary lifestyle), and multiple pathogenic conditions such as metabolic, inflammatory, and endocrinal disorders. Frail individuals express nutritional deficiencies, immune deficit, oxidative stress, metabolic alterations, gut microbial alterations, neurological insult, etc. Such physiological dysfunctions are closely linked to increased vulnerability to COVID-19 among older adults and people with non-communicable diseases such as diabetes mellitus, cardiovascular disorders, and obesity. Available studies report higher occurrence of severe COVID-19 and COVID-19-related complications (ICU admission, mechanical ventilation, and in-hospital mortality) among frail compared with non-frail and prefrail individuals. Effective pharmacological treatments of sarcopenia are not currently available. However, physical activity and nutritional interventions (e.g., fast digestive proteins, vitamin D, and natural products such as bee products) may prevent the development of sarcopenia in early stages of the disease or limit disease progress. Such interventions may also lower vulnerability to COVID-19. View Full-Text
Keywords: coronavirus disease 2019; COVID-19; severe acute respiratory syndrome; SARS-CoV-2; sarcopenia; dynapenia; frailty; cachexia; malnutrition; obesity; sarcopenic obesity; aging; dietary interventions; neuromuscular; muscle; skeletal; muscle wasting; muscle mass; muscle strength; gut-muscle axis; physical performance; body composition; lean body mass; insulin resistance; mitochondrial dysfunction; satellite stem cells coronavirus disease 2019; COVID-19; severe acute respiratory syndrome; SARS-CoV-2; sarcopenia; dynapenia; frailty; cachexia; malnutrition; obesity; sarcopenic obesity; aging; dietary interventions; neuromuscular; muscle; skeletal; muscle wasting; muscle mass; muscle strength; gut-muscle axis; physical performance; body composition; lean body mass; insulin resistance; mitochondrial dysfunction; satellite stem cells
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MDPI and ACS Style

Ali, A.M.; Kunugi, H. Physical Frailty/Sarcopenia as a Key Predisposing Factor to Coronavirus Disease 2019 (COVID-19) and Its Complications in Older Adults. BioMed 2021, 1, 11-40. https://0-doi-org.brum.beds.ac.uk/10.3390/biomed1010002

AMA Style

Ali AM, Kunugi H. Physical Frailty/Sarcopenia as a Key Predisposing Factor to Coronavirus Disease 2019 (COVID-19) and Its Complications in Older Adults. BioMed. 2021; 1(1):11-40. https://0-doi-org.brum.beds.ac.uk/10.3390/biomed1010002

Chicago/Turabian Style

Ali, Amira M., and Hiroshi Kunugi. 2021. "Physical Frailty/Sarcopenia as a Key Predisposing Factor to Coronavirus Disease 2019 (COVID-19) and Its Complications in Older Adults" BioMed 1, no. 1: 11-40. https://0-doi-org.brum.beds.ac.uk/10.3390/biomed1010002

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