Fatigue in Covid-19 survivors: The potential impact of a nutritional supplement on muscle strength and function

Vincenzo Galluzzo, Maria Beatrice Zazzara, Francesca Ciciarello, Giulia Savera, Cristina Pais, Riccardo Calvani, Anna Picca, Emanuele Marzetti, Francesco Landi, Matteo Tosato, Steering Committee, Elisa Gremese, Coordination, Roberto Bernabei, Massimo Fantoni, Antonio Gasbarrini, Field Investigators, Gastroenterology Team, Serena Porcari, Carlo Romano SettanniGeriatric Team, Francesca Benvenuto, Giulia Bramato, Vincenzo Brandi, Angelo Carfì, Sofia Fabrizi, Maria Rita Lo Monaco, Anna Maria Martone, Carmen Napolitano, Francesco Cosimo Pagano, Sara Rocchi, Elisabetta Rota, Andrea Salerno, Andrea Maria Salerno, Marcello Tritto, Lucio Catalano, Francesco Paolo Damiano, Alessandra Rocconi, Alessandro Galliani, Giovanni Spaziani, Salvatore Tupputi, Camilla Cocchi, Flavia Pirone, Federica D'Ignazio, Stefano Cacciatore, Infectious Disease Team, Roberto Cauda, Enrica Tamburrini, A. Borghetti, Alberto Borghetti, Simona Di Gianbenedetto, Rita Murri, Antonella Cingolani, Giulio Ventura, E. Taddei, D. Moschese, A. Ciccullo, A. Dusina, Internal Medicine Team, Leonardo Stella, Giovanni Addolorato, Francesco Franceschi, Gertrude Mingrone, Geltrude Mingrone, M. A. Zocco, Maria Assunta Zocco, Microbiology Team, Maurizio Sanguinetti, Simona Marchetti, Brunella Posteraro, M. Sali, Michela Sali, Neurology Team, Alessandra Bizzarro, Alessandra Lauria, Ophthalmology Team, Stanislao Rizzo, Maria Cristina Savastano, G. Gambini, Gloria Gambini, G. M. Cozzupoli, C. Culiersi, Carola Culiersi, Otolaryngology Team, Giulio Cesare Passali, Gaetano Paludetti, Jacopo Galli, F. Crudo, G. Di Cintio, Y. Longobardi, Ylenia Longobardi, L. Tricarico, Laura Tricarico, M. Santantonio, Pediatric Team, Danilo Buonsenso, Piero Valentini, D. Pata, D. Sinatti, Dario Sinatti, C. De Rose, Cristina De Rose, Pneumology Team, Luca Richeldi, Francesco Lombardi, A. Calabrese, Anna Chiara Calabrese, Paolo Maria Leone, Maria Rosaria Calvello, Enrica Intini, Giuliano Montemurro, Psychiatric Team, Gabriele Sani, Delfina Janiri, Alessio Simonetti, G. Giuseppin, M. Molinaro, M. Odica, Radiology Team, Luigi Natale, Anna Rita Larici, Riccardo Marano, Rheumatology Team, Annamaria Paglionico, Luca Petricca, Luca Gigante, Lavinia Gigante, G. Natalello, A. L. Fedele, Anna Laura Fedele, M. M. Lizzio, Marco Maria Lizzio, B. Tolusso, Barbara Tolusso, Clara Di Mario, Stefano Alivernini, Vascular Team, Angelo Santoliquido, Luca Santoro, Angela Di Giorgio, Antonio Nesci, V. Popolla, Valentina Popolla

Research output: Contribution to journalArticle

Abstract

Background: Fatigue with reduced tolerance to exercise is a common persistent long-lasting feature amongst COVID-19 survivors. The assessment of muscle function in this category of patients is often neglected. Aim.: To evaluate the potential impact of a daily supplementation based on amino acids, minerals, vi- tamins, and plant extracts (Apportal®) on muscle function, body composition, laboratory parameters and self-rated health in a small group of COVID-19 survivors affected by fatigue. Methods: Thirty participants were enrolled among patients affected by physical fatigue during or after acute COVID-19 and admitted to the post-COVID-19 outpatient service at Fondazione Policlinico Gemelli in Rome between 1st March 2021 and 30th April 2021. All participants were evaluated at first visit (t0) and at control visit (t1), after taking a daily sachet of Apportal® for 28 days. Muscle function was analyzed using hand grip strength test, exhaustion strength time and the number of repetitions at one- minute chair stand test. Body composition was assessed with bioelectrical impedance analysis (BIA). Laboratory parameters, including standard blood biochemistry and ferritin levels, were evaluated at the first visit and during the control visit. A quick evaluation of self-rated health, before COVID-19, at t0 and t1, was obtained through a visual analogue scale (VAS). Results: Participants aged 60 years and older were 13 (43%). Females represented the 70% of the study sample. Participants hospitalized for COVID-19 with low-flow oxygen supplementation represented the 43.3% of the study sample while 3.3% received noninvasive ventilation (NIV) or invasive ventilation. Hand grip strength improved from 26.3 Kg to 28.9 Kg (p < 0.05) at t1 as compared to t0. The mean time of strength exhaustion increased from 31.7 s (sec) at t0 to 47.5 s at t1 (p < 0.05). Participants performed a higher number of repetitions (28.3 vs. 22.0; p < 0.05) during the one-minute chair stand test at t1 as compared to t0. A trend, although not significant, in reduction of ferritin levels was found after nutri- tional supplementation (94.4 vs. 84.3, respectively; p ¼ 0.01). The self-rated health status increased by at least 13 points (t0, mean 57.6 ± 5.86; t1, mean 71.4 ± 6.73; p < 0.05). Conclusions: After 28 days of nutritional supplementation with Apportal® in COVID-19 survivors affected by fatigue with reduced tolerance to exercise, we found a significant improvement in means of muscle strength and physical performance, associated with enhancement of self-rated health status between t0 and t.
Original languageEnglish
Pages (from-to)215-221
Number of pages7
JournalClinical Nutrition ESPEN
Volume51
DOIs
Publication statusPublished - 2022

Keywords

  • Covid-19

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