By Dr. Sushama R. Chaphalkar, PhD. Jan 26 2024 Reviewed by Lily Ramsey, LLM
In a recent longitudinal study published in Scientific Reports, researchers from Brazil investigated the potential association between dynapenia (loss of muscle strength and power) with functional outcomes in patients with long coronavirus disease 2019 (COVID-19).
They found that in patients with long COVID, low handgrip strength (HGS) is associated with worse functional outcomes. They further suggested the potential use of low HGS to indicate functional impairment in long COVID patients.
Study: Low handgrip strength is associated with worse functional outcomes in long COVID . Image Credit: Ralf Liebhold/Shutterstock.com Background
Long COVID, characterized by persistent symptoms after infection with severe acute respiratory syndrome coronavirus 2 (SARS-VoV-2), poses a significant public health challenge. Symptoms include post-exertional malaise, fatigue, and neurocognitive and gastrointestinal issues.
The estimated global prevalence of the condition is 43%, with an even higher prevalence in hospitalized individuals. Vulnerable populations, including middle-aged, female, Hispanic/Latino, and economically constrained groups, are at a higher risk of developing the disease.
Despite its impact, long COVID lacks a consensus definition and a standard biomarker or diagnostic tool. This often leads to potential underdiagnosis, particularly in low-and-middle-income countries (LMICs).
HGS is an indicator of dynapenia and is shown to be associated with various health outcomes, including cognitive disabilities, bone mineral density, depression, functional health, and mortality. In acute COVID-19, decreased HGS is an independent risk factor.
Using HGS as a simple, low-cost indicator could aid in identifying functional impairment, especially in LMICs lacking complex assessment tools.
Researchers in the present study aimed to investigate if individuals with a persistently low HGS after hospital discharge (following severe COVID-19 in early 2020) showed greater respiratory and functional impairments at 120 days. About the studyTop of Form
The present longitudinal study was conducted at a hospital in Brazil from April to October 2020. It followed unvaccinated, adult COVID-19 patients of both sexes who tested positive for SARS-CoV-2 by reverse transcription-quantitative polymerase chain reaction (RT-qPCR) during hospitalization. A total of 113 patients with a mean age of 48 years were included in the study, 54% of whom were female. Related StoriesLong COVID's impact on cardiovascular health: what we do and do not knowEffects of varying COVID-19 vaccination rates on population-level health outcomes across variant waves in the U.S.mRNA COVID-19 vaccines highly effective in preventing hospitalizations among adolescents in Nordic study
At the 120-day (D120) follow-up post-hospitalization, participants underwent assessments including functional capacity test, body composition, HGS, pulmonary function test, and respiratory muscle strength (RMS).
HGS and dynapenia (defined as HGS < 30 Kgf for males and < 20 Kgf for females) were measured using a hand-held digital dynamometer. Spirometry assessed pulmonary function, and RMS was evaluated with a digital manometer.
Outcomes were measured in terms of forced vital capacity (FEV), forced expiratory capacity at the first second of exhalation (FEV1), maximum inspiratory pressure (MIP), and maximum expiratory pressure (MEP).
Functional capacity was assessed using the 6-minute walk test (6MWT), and body composition was determined through bioimpedance analysis.
Data were recorded electronically and analyzed for associations between HGS, respiratory function, and functional capacity. Statistical analysis included the Shapiro–Wilk test, Mann–Whitney test, Chi-square test, Spearman's test, and a regression model. Results and discussion
Out of the 113 long COVID patients, 22% exhibited dynapenia at D120 post-acute severe disease. Dynapenic individuals had lower muscle mass, reduced HGS, higher rates of intensive care unit admission and invasive ventilation during hospitalization, and higher BMI.
A greater proportion of dynapenic individuals showed a history of smoking and diabetes. Additionally, muscle mass between day one and D120 of dynapenic individuals was found to be reduced significantly (30.7 kg to 19.9 kg, p<0.001).
Dynapenia was also associated with worse respiratory function (FEV1, FVC, MIP, MEP), significantly diminished walking distance and a lower percentage of predicted walking distance on the 6MWT. Correlation and regression analyses confirmed the association between HGS and functional outcomes, independent of age.
The study's limitations include a relatively small sample size and a short-term follow-up, preventing comprehensive longitudinal comparisons of HGS and other functional outcomes.
Additionally, the single-center design and the specific timeframe of individuals infected with SARS-CoV-2 in the early 2020s may limit the direct applicability of the results to individuals infected with more recent virus variants and with long-term health outcomes. Conclusion
In conclusion, low HGS in long COVID patients, indicative of dynapenia, is linked to adverse health outcomes such as changes in pulmonary function, respiratory muscle strength, and exercise capacity.
A simple, cost-effective HGS measurement can be a practical biomarker for functional impairment in outpatient and primary care settings.
Recognizing dynapenia's association with in-hospital outcomes months later enables timely patient stratification and risk prevention, potentially reducing comorbidities, delaying functional decline, improving prognosis, and expediting the return to daily activities.
This approach is particularly relevant for LMICs, enhancing healthcare accessibility, facilitating early screening, and managing long-term COVID patients. Journal reference: Amaral, C.M.S.S.B. et al. (2024) Low handgrip strength is associated with worse functional outcomes in long COVID, Scientific Reports, 14, 2049. doi: https://doi.org/10.1038/s41598-024-52401-z. https://www.nature.com/articles/s41598-024-52401-z
US House Speaker Mike Johnson has said he will “strongly request” a report into allegations of sex trafficking against Matt Gaetz, who is the president-elect’s choice of attorney general, should not be released.
Mr Johnson said he was against publishing the House Ethics Committee report on Mr Gaetz, 42, who if approved by the Senate will become the nation’s top prosecutor once Donald Trump is sworn in as president on 20 January.
That’s despite Mr Gaetz having previously faced a nearly three-year Justice Department investigation into sex trafficking allegations involving a 17-year-old girl. He denies the allegations and has not faced criminal charges.
Mr Gaetz has also never worked as a prosecutor and has only worked in law for a few years at a local level.
He stepped down from Congress after Mr Trump announced him as his attorney general pick.
His resignation brought the investigation by the House Ethics Committee to an end – two days before it had been expected to release its report into the trafficking claims.
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Why is Matt Gaetz a controversial pick?
House Speaker Mr Johnson, a Louisiana Republican, said of the probe: “I’m going to strongly request that the Ethics Committee not issue the report, because that is not the way we do things in the House.”
Politicians of both parties on the Senate Judiciary Committee have said they want to see the report on Mr Gaetz, as part of a Senate confirmation process for cabinet nominees that would start next year with public hearings.
Democrats have described the MAGA loyalist as “a gonzo agent of chaos” and his appointment a “red alert moment for our democracy”, while some Republican senators have also raised doubts about his suitability for the role.
Mr Johnson said he planned to urge House Ethics Committee chairman Michael Guest not to provide the report to the Senate Judiciary Committee.
“The rules of the House have always been that a former member is beyond the jurisdiction of the Ethics Committee,” said Mr Johnson, who returned on Friday morning from meeting Mr Trump at the president-elect’s Mar-a-Lago resort in Florida.
“I think it’s a terrible breach of protocol and tradition and the spirit of the rule,” he added. “I think that would be a terrible precedent to set.”
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YouTuber-turned-boxer Jake Paul is taking on one of boxing’s greatest-ever fighters tonight in former undisputed world champion Mike Tyson.
The heavyweight bout is being labelled by some as Paul’s toughest test yet, despite the 30-year age gap between him and Tyson.
The fight was originally scheduled for 20 July, but was delayed after Tyson fell ill on a flight due to an ulcer flare up in May.
It’s going to be a co-main event alongside a highly-anticipated rematch between undisputed super lightweight champion Katie Taylor and unified featherweight champion Amanda Serrano.
Here’s everything you need to know about the hotly anticipated fight and how to watch.
Who are the fighters?
Jake Paul, 27, is an American YouTube star who made a name for himself on social media platform Vine. He made his professional boxing debut in 2020.
“The Problem Child” has since defeated former UFC contender Nate Diaz, professional boxer Andre August, former Gold Gloves champion Ryan Bourland and most recently MMA fighter Mike Perry to earn himself a boxing record of 10-1.
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“Iron Mike” Tyson, 58, retired from professional boxing in 2005 with a 50-6 record and as a former undisputed heavyweight champion.
The legendary fighter, who knocked out 44 opponents during his career, returned to the ring after 15 years in 2020 for a bout against fellow boxing icon Roy Jones, which ended in an unofficial draw.
Tyson’s fighting skills place him among the best heavyweight boxers of all time, but the age gap between him and Paul along with some potential ring rust are expected to level the playing field.
When is the fight and where will it be?
The bout is due to take place at the AT&T Stadium in Arlington, Texas, on Friday 15 November. The 80,000-seat capacity stadium is home of the Dallas Cowboys and is the biggest NFL stadium in the US.
The event is set to begin at 1am GMT on 16 November, with Taylor v Serrano scheduled for 3am GMT and Tyson v Paul at 4am GMT.
How can I watch it?
It will be aired on Netflix in what will be the first live fight ever on the streaming platform.
Jake Paul, who co-founded Most Valuable Promotions (MVP) in 2021, said his company signed with Netflix because it is “the biggest streaming platform in the world”.
Fellow MVP co-founder Nakisa Bidarian added: “Partnering with Netflix for this deal presents an unparalleled opportunity to bring Jake Paul v Mike Tyson to the world on an unprecedented scale.”
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Some good news for Netflix users; there is no additional cost for the streaming platform’s subscribers.
It’s not a pay-per-view event, but you won’t be able to watch it unless you have a Netflix account, which costs between £4.99 and £17.99 depending on what sort of plan you subscribe to.
Can I buy tickets?
Tickets are still available throughout the stadium via SeatGeek, with prices for regular seats ranging from $60 (£47.32) to about $7,400 (£5,914).
What are the rules?
The Texas Athletic Commission has sanctioned it as a professional fight which will count on the pair’s boxing records, but it has put some sanctions in place due to Tyson’s age.
There will be eight rounds lasting a maximum of two minutes rather than three, and both boxers will wear 14-ounce gloves, heavier than the usual 10-ounce.
What you need to know about Taylor v Serrano
Taylor and Serrano produced an epic when they became the first ever women fighters to headline at Madison Square Garden back in 2022, with the former edging a split decision that could have arguably fallen either way after 10 rounds.
Now over two years on from one of the greatest fights in the history of female boxing, undisputed super-lightweight world champion Taylor, 38, will put her belts on the line against unified featherweight champion Serrano, 36.
The contest will mark a step in three weight classes from Serrano’s usual featherweight division as she seeks the biggest win of her glittering career.
Taylor will enter 23-1 having avenged her loss to Chantelle Cameron in May last year by winning November’s rematch via majority decision to become undisputed super-lightweight champion and a two-weight undisputed champion.
Serrano is meanwhile 46-2-1 having won all four of her fights since losing to Taylor, most recently beating Danila Ramos via unanimous decision after their 12-rounder in October.
Who is on the undercard?
There are five other fights on the bill besides the two co-main events – and two of them will see titles on the line. Here’s how it looks:
Mario Barrios v Abel Ramos – WBC welterweight title
Shadasia Green v Melinda Watpool – WBO super-middleweight title
Lucas Bahdi v Corey Marksman – lightweight
Bruce Carrington v Dana Coolwell – featherweight
Neeraj Goyat v Whindersson Nunes – middleweight
‘The fight of a lifetime’
Paul is not typically known for showing respect to his opponents. In the lead-up to his last fight against Tommy Fury, which he lost on points, Paul said Tyson Fury’s brother “boxes because he was told to do so by his dad”.
“He doesn’t have that real heart, that real fighter inside of him,” he added.
Few, however, would question Mike Tyson’s credentials, with Paul having adopted a more respectful approach to promoting the fight so far.
“My sights are set on becoming a world champion, and now I have a chance to prove myself against the greatest heavyweight champion ever – the baddest man on the planet and the most dangerous boxer of all time,” he said, adding: “This will be the fight of a lifetime.”
In a face-to-face posted on his YouTube channel on 10 November, Paul said winning would be “bittersweet” due to the respect he has for Tyson, but said it was “my time to shine”.
‘I plan to finish him’
Critics of the fight have said there is simply too big of an age gap between the two, with Tyson falling ill in May stoking talks over the fight being a mistake for the 58-year-old.
But the veteran has insisted he still has fuel left in the tank, claiming his body is “in better overall shape than it has been since the 1990s”.
“I’m very much looking forward to stepping into the ring with Jake Paul,” Tyson said – promising to “finish him” and his boxing career.
During the face-to-face, Tyson warned: “I’m not going to lose. I can’t even fathom losing.
“I think he thinks this is going to be a very easy night. It’s not going to be an easy night.”
BALTIMORE — The Orioles are ready to adjust their wall in left field again.
The team moved the wall at Camden Yards back and made it significantly taller before the 2022 season. General manager Mike Elias said Friday the team “overcorrected” and will try to find a “happier medium” before the 2025 season.
The team sent out a rendering of changes showing the wall moved farther in — particularly in left-center field near the bullpens — and reduced in height.