Muscle mass and strength are associated with lower scores of Long COVID symptoms
DOI:
https://doi.org/10.33448/rsd-v14i3.48578Keywords:
Rehabilitation; Body composition; Post-Acute COVID-19 Syndrome; Muscle strength.Abstract
Introduction: Long COVID refers to the persistence of symptoms even after acute recovery from COVID-19. However, the association of anthropometric and functional variables with Long COVID symptoms requires clarification. Objective: to correlate body weight, body fat, muscle mass, muscle strength and function with a score of Long COVID symptom’s prevalence and severity. Methods: This is a Cross-sectional study. Seventeen adult participants (29.5 ± 7.1 kg/m2) were submitted to body composition, strength and physical function assessments. They answered a Long Covid symptoms prevalence and severity questionnaire. Variables were correlated and participants were compared using the median of the Long Covid symptoms score. Results: muscle mass percentage (r = -0.52) and biceps muscle thickness (r = -0.54) negatively correlated with the symptoms score (P < .05), while body fat (r = 0.56) and BMI (r = 0.59) correlated positively (P < .05). Participants below the median of the symptoms score presented higher muscle mass (30.5 ± 5.5 vs 23.3 ± 3.9%), thickness (26.3 ± 4.2 vs 21.2 ± 4.2mm), relative strength (1.28 ± 0.3 vs 0.96 ± 0.3 AU) and functional performance as per the five times sit-to-stand test (9.7 ± 2.1 vs 12.3 ± 2.4 s), whilst presenting lower body fat percentage (32.0 ± 7.6 vs 45.8 ± 9.4%) and BMI (25.6 ± 4.0 vs 33.1 ± 7.4 kg/m2) compared to those above the median, respectively. Conclusions: participants who have better body composition, greater strength and physical capacity show a lower prevalence and intensity of Long COVID symptoms.
References
Abe, T., DeHoyos, D. V., Pollock, M. L., & Garzarella, L. (2000). Time course for strength and muscle thickness changes following upper and lower body resistance training in men and women. European Journal of Applied Physiology and Occupational Physiology, 81(3). https://doi.org/10.1007/s004210050027
Almeida, I. da S., Durigan, J. L. Q., Carvalho, T. H. D., Rosa, B. V., Ferreira, G. M. L., Garcia, D., Andrade, R. de M., Sousa Neto, I. V. de, Silva, C. R. da, & Nascimento, D. da C. (2022). A medida da força muscular relativa de preensão manual representa a força muscular global em idosas? Research, Society and Development, 11(11), e560111134018. https://doi.org/10.33448/rsd-v11i11.34018
American Lung Association. ([s.d.]). Pulmonary Exercise Tests. Recuperado 22 de março de 2025, de https://www.lung.org/lung-health-diseases/lung-procedures-and-tests/pulmonary-exercise-test
Bigdelou, B., Sepand, M. R., Najafikhoshnoo, S., Negrete, J. A. T., Sharaf, M., Ho, J. Q., Sullivan, I., Chauhan, P., Etter, M., Shekarian, T., Liang, O., Hutter, G., Esfandiarpour, R., & Zanganeh, S. (2022). COVID-19 and Preexisting Comorbidities: Risks, Synergies, and Clinical Outcomes. Frontiers in Immunology, 13. https://doi.org/10.3389/fimmu.2022.890517
Carfì, A., Bernabei, R., & Landi, F. (2020). Persistent symptoms in patients after acute COVID-19. JAMA - Journal of the American Medical Association, 324(6). https://doi.org/10.1001/jama.2020.12603
Centers for Disease Control and Prevention. (2017). Timed Up & Go (TUG). https://www.cdc.gov/steadi/media/pdfs/steadi-assessment-tug-508.pdf
Chen, C., Haupert, S. R., Zimmermann, L., Shi, X., Fritsche, L. G., & Mukherjee, B. (2022). Global Prevalence of Post-Coronavirus Disease 2019 (COVID-19) Condition or Long COVID: A Meta-Analysis and Systematic Review. Journal of Infectious Diseases, 226(9), 1593–1607. https://doi.org/10.1093/infdis/jiac136
Davis, H. E., McCorkell, L., Vogel, J. M., & Topol, E. J. (2023). Long COVID: major findings, mechanisms and recommendations. Nature Reviews Microbiology, 21(3), 133–146. https://doi.org/10.1038/s41579-022-00846-2
DeMars, J., Brown, D. A., Angelidis, I., Jones, F., McGuire, F., O’Brien, K. K., Oller, D., Pemberton, S., Tarrant, R., Verduzco-Gutierrez, M., & Gross, D. P. (2022). What is Safe Long COVID Rehabilitation? Journal of Occupational Rehabilitation. https://doi.org/10.1007/s10926-022-10075-2
Ely, E. W., Brown, L. M., & Fineberg, H. V. (2024). Long Covid Defined. New England Journal of Medicine, 18(391), 1746–1753. https://doi.org/10.1056/NEJMsb2408466
Gil, S., Jacob Filho, W., Shinjo, S. K., Ferriolli, E., Busse, A. L., Avelino-Silva, T. J., Longobardi, I., de Oliveira Júnior, G. N., Swinton, P., Gualano, B., Roschel, H., Bonfá, E., Utiyama, E., Segurado, A., Perondi, B., Morais, A. M., Montal, A., Letaif, L., Fusco, S., … Peres Braido Francisco, M. C. (2021). Muscle strength and muscle mass as predictors of hospital length of stay in patients with moderate to severe COVID-19: a prospective observational study. Journal of Cachexia, Sarcopenia and Muscle, 12(6), 1871–1878. https://doi.org/10.1002/jcsm.12789
Jason, L. A., & Dorri, J. A. (2023). ME/CFS and Post-Exertional Malaise among Patients with Long COVID. Neurology International, 15(1). https://doi.org/10.3390/neurolint15010001
Kirwan, R., McCullough, D., Butler, T., Perez de Heredia, F., Davies, I. G., & Stewart, C. (2020). Sarcopenia during COVID-19 lockdown restrictions: long-term health effects of short-term muscle loss. GeroScience, 42(6). https://doi.org/10.1007/s11357-020-00272-3
Melo, T. A., Duarte, A. C. M., Bezerra, T. S., França, F., Soares, N. S., & Brito, D. (2019). The five times sit-to-stand test: Safety and reliability with older intensive care unit patients at discharge. Revista Brasileira de Terapia Intensiva, 31(1). https://doi.org/10.5935/0103-507X.20190006
Organização Pan-Americana da Saúde. Escritório Regional para as Américas. (2025). Histórico da emergência internacional de COVID-19. https://www.paho.org/pt/historico-da-emergencia-internacional-covid-19
Pereira, A. S. et al. (2018). Metodologia da pesquisa científica. UFSM.
Reis, M. M., & Arantes, P. M. M. (2011). Medida da força de preensão manual – validade e confiabilidade do dinamômetro saehan. Fisioterapia e Pesquisa, 18(2), 176–181.
Salari, N., Khodayari, Y., Hosseinian-Far, A., Zarei, H., Rasoulpoor, S., Akbari, H., & Mohammadi, M. (2022). Global prevalence of chronic fatigue syndrome among long COVID-19 patients: A systematic review and meta-analysis. BioPsychoSocial Medicine, 16(1). https://doi.org/10.1186/s13030-022-00250-5
Shitsuka, R. et al. (2014). Matemática fundamental para tecnologia. (2a ed.) Editora Erica.
Silva, G. M., Pesce, G. B., Martins, D. C., Carreira, L., Fernandes, C. A. M., & Jacques, A. E. (2021). Obesity as an aggravating factor of COVID-19 in hospitalized adults: An integrative review. ACTA Paulista de Enfermagem, 34(eAPE02321). https://doi.org/10.37689/acta-ape/2021AR02321
Tziolos, N. R., Ioannou, P., Baliou, S., & Kofteridis, D. P. (2023). Long COVID-19 Pathophysiology: What Do We Know So Far? Em Microorganisms (Vol. 11, Número 10). Multidisciplinary Digital Publishing Institute (MDPI). https://doi.org/10.3390/microorganisms11102458
Vieira, S. (2021). Introdução à bioestatística. Ed.GEN/Guanabara Koogan.
World Health Organization. (2025, março 23). WHO COVID-19 dashboard. https://data.who.int/dashboards/covid19/deaths?n=o
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Markus Filardi Moura Olinto; Victor César Dias Lins; Maurílio Tiradentes Dutra
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
