Muscle strength is associated with COVID‐19 hospitalization in adults 50 years of age or older
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Abstract
Background
Weak muscle strength has been associated with a wide range of adverse health outcomes. Yet, whether individuals with weaker muscle strength are more at risk for hospitalization due to severe COVID‐19 is still unclear. The objective of this study was to investigate the independent association between muscle strength and COVID‐19 hospitalization.
Methods
Data from adults 50 years of age or older were analysed using logistic models adjusted for several chronic conditions, body‐mass index, age, and sex. Hand‐grip strength was repeatedly measured between 2004 and 2017 using a handheld dynamometer. COVID‐19 hospitalization during the lockdown was self‐reported in summer 2020 and was used as an indicator of COVID‐19 severity.
Results
The study was based on the Survey of Health, Ageing and Retirement in Europe (SHARE) and included 3600 older adults (68.8 ± 8.8 years, 2044 female), among whom 316 were tested positive for the severe acute respiratory syndrome coronavirus 2 (8.8%), and 83 (2.3%) were hospitalized due to COVID‐19. Results showed that higher grip strength was associated with a lower risk of COVID‐19 hospitalization [adjusted odds ratio (OR) per increase of 1 standard deviation in grip strength = 0.64, 95% confidence interval (95% CI) = 0.45–0.87, P = 0.015]. Results also showed that age (OR for a 10 ‐year period = 1.70, 95% CI = 1.32–2.20, P < 0.001) and obesity (OR = 2.01, 95% CI = 1.00–3.69, P = 0.025) were associated with higher risk of COVID‐19 hospitalization. Sensitivity analyses using different measurements of grip strength as well as robustness analyses based on rare‐events logistic regression and a different sample of participants (i.e. COVID‐19 patients) were consistent with the main results.
Conclusions
Muscle strength is an independent risk factor for COVID‐19 severity in adults 50 years of age or older.
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SciScore for 10.1101/2021.02.02.21250909: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement IRB: SHARE was approved by the Ethics Committee of the University of Mannheim (waves 1-4) and the Ethics Council of the Max Plank Society (waves 4-7). Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:However, potential limitations should be noted. First, the established risk factors were …
SciScore for 10.1101/2021.02.02.21250909: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement IRB: SHARE was approved by the Ethics Committee of the University of Mannheim (waves 1-4) and the Ethics Council of the Max Plank Society (waves 4-7). Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:However, potential limitations should be noted. First, the established risk factors were assessed with self-reported questionnaires, which may have reduced measurement validity. Second, the latest assessment of these factors was in 2017, that is two years before participants’ potential infection to COVID-19. Therefore, participants may have contracted a disease between the assessment of these heath conditions and the COVID-19 pandemic, which may have resulted in a misclassification bias. Third, COVID-19 severity was inferred by COVID-19 hospitalization. However, this measure lacks sensitivity. For example, the questionnaire did not assess the lengths of hospitalization or whether the patients have to be transferred to intensive cate unit, which would have allowed to assess with a finer grained COVID-19 severity. Similarly, our sample did not included participants who were hospitalized during the data collection (except when the information can be extract from the spouse or partners) and participants who died due to COVID-19. These limitations may explain the absence of statistical evidence supporting the effect of established risk factors for COVID-19 hospitalization (34, 35).
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
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