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BACKGROUND: The most frequent body composition alterations in post-COVID-19 syndrome include low muscle mass, dynapenia, sarcopenia, and obesity. These conditions share interconnected pathophysiological mechanisms that exacerbate each other. The relationship between body composition phenotypes and metabolic abnormalities in post-COVID-19 syndrome remains unclear. OBJECTIVE: To evaluate the association between body composition phenotypes and insulin resistance (IR) and metabolic abnormalities in non-diabetic individuals with post-COVID-19 syndrome. METHODS: A cross-sectional, single-center study involving 483 subjects with post-COVID-19 syndrome following moderate to severe acute COVID-19 requiring hospitalization. Individuals with diabetes, those who declined to participate, or those who could not be contacted were excluded. Body composition phenotypes were classified as normal weight, dynapenia, sarcopenia, dynapenic obesity, and sarcopenic obesity (SO). RESULTS: The average age was 52.69 ± 14.75 years; of note, 67.08% were male. The prevalence of body composition phenotypes was as follows: 13.25% were of normal weight, 9.52% had dynapenia, 9.94% had sarcopenia, 43.69% had obesity, 18.84% had dynapenic obesity, and 4.76% had SO. Additionally, 58.18% had IR. Obesity (OR: 2.98, CI95%; 1.64-5.41) and dynapenic obesity (OR: 4.98, CI95%; 1.46-6.88) were associated with IR. CONCLUSION: The most common body composition phenotypes were obesity, dynapenic obesity, and dynapenia. Furthermore, obesity and dynapenic obesity were associated with IR in post-COVID-19 syndrome.

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BACKGROUND: Patients with chronic obstructive pulmonary disease (COPD) have alterations in body composition, such as low cell integrity, body cell mass, and disturbances in water distribution evidenced by higher impedance ratio (IR), low phase angle (PhA), as well as low strength, low muscle mass, and sarcopenia. Body composition alterations are associated with adverse outcomes. However, according to the European Working Group on Sarcopenia in Older People 2 (EWGSOP2), the impact of these alterations on mortality in COPD patients is not well-established. Our aims were to evaluate whether low strength, low muscle mass, and sarcopenia impacted mortality in COPD patients. METHODS: A prospective cohort study performance was conducted with COPD patients. Patients with cancer, and asthma were excluded. Body composition was assessed by bioelectrical impedance analysis. Low strength and muscle mass, and sarcopenia were defined according to EWGSOP2. RESULTS: 240 patients were evaluated, of whom 32% had sarcopenia. The mean age was 72.32 ± 8.24 years. The factors associated with lower risk of mortality were handgrip strength (HR:0.91, CI 95%; 0.85 to 0.96, p = 0.002), PhA (HR:0.59, CI 95%; 0.37 to 0.94, p = 0.026) and exercise tolerance (HR:0.99, CI 95%; 0.992 to 0.999, p = 0.021), while PhA below the 50th percentile (HR:3.47, CI 95%; 1.45 to 8.29, p = 0.005), low muscle strength (HR:3.49, CI 95%; 1.41 to 8.64, p = 0.007) and sarcopenia (HR:2.10, CI 95%; 1.02 to 4.33, p = 0.022) were associated with a higher risk of mortality. CONCLUSION: Low PhA, low muscle strength, and sarcopenia are independently associated with poor prognosis in COPD patients.

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BACKGROUND: Post-COVID-19 syndrome is characterized by diverse symptoms and abnormalities that persist beyond 12 weeks from the onset of acute COVID-19. Severity disease has been associated with more musculoskeletal alterations such as muscle weakness, dyspnea, and distance walking. The aim was to evaluate the impact of invasive mechanical ventilation (IMV) on body composition and investigate risk factors associated with sarcopenia in post-COVID-19 patients three months after moderate or severe COVID-19 infections. METHODS: Cross-sectional study. 530 patients with PCR-confirmed diagnoses of moderate to severe COVID-19, > 18 years old, oxygen saturation ≤ 93%, PaO2/FiO2 ratio < 300, who required hospitalization and were discharged were included. We excluded those who died before the follow-up visit, declined to participate, or could not be contacted. RESULTS: The mean age was 53.79 ± 12.90 years. IMV subjects had lower phase angle and handgrip strength and higher impedance index, frequency of low muscle mass, and low muscle strength than those without IMV. The risk factors of sarcopenia were > 60 years of age, diabetes, obesity, IMV, and prolonged hospital stay. The multivariate model showed that age > 60 years (OR: 4.91, 95% CI: 2.26-10.63), obesity (OR: 3.73, 95% CI: 1.21-11.54), and interaction between prolonged length of hospital stay and IMV (OR: 2.92; 95% CI: 1.21-7.02) were related to a higher risk of sarcopenia. CONCLUSION: Obesity and the interaction between prolonged length of hospital stay and IMV are associated with a higher risk of sarcopenia at 3 months after severe or moderate COVID-19 infection.

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BACKGROUND: Heart Failure (HF) patients developed changes in body composition as overhydration, muscle-skeletal wear and cardiac cachexia (CC). The possible factors involved in the development of CC in Right Heart Failure (RHF) patients are venous congestion, nutrient malabsorption. However, in HF, the overhydration obscure the loss of fat-free mass and difficult the body composition assessment. Bioelectrical impedance vectorial analysis (BIVA) is a method validated and used for hydration status and body composition assessment in HF. The aim of this study was to investigate the body compositions changes assessment by BIVA in the subjects with and without RHF and evaluate the risk factors for devolvement CC in HF subjects. MATERIAL AND METHODS: Prospective cohort study. Subjects with confirmed diagnoses of HF, >18 years old without CC according to BIVA criteria were included. Subjects with congenital heart disease, cancer, HIV, and end-stage renal disease were excluded. Body composition was an assessment by BIVA. 288 HF patients were evaluated. RHF subjects had an impedance vector reduction (9.26 dR/H and -1.92 dXc/H, T2=14.9, D = 0.45, p<0.001), while subjects without RHF no-showed statistically significant changes (7.57 dR/H and 0.72 dXc/H, T2=3, D = 0.17, p = 0.200). The risks factors to development CC were age, RHF, phase angle < 5°, total body water were risks factors while handgrip strength was a protector factor. CONCLUSIONS: RHF has greater disturbances in body composition and is a risk factor to development CC.

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