Effects of twenty-eight months of detraining imposed by the COVID-19 pandemic on the functional fitness of older women experienced in concurrent and functional training.

PURPOSE: To assess the impacts of 28 months of detraining imposed by the COVID-19 pandemic on the functional fitness of older women practicing functional or concurrent training. MATERIAL AND METHODS: A clinical trial was conducted with 16 weeks of intervention and 28 months of detraining imposed by the COVID-19 pandemic. Ninety-five participants were allocated to functional training (FT - 32), concurrent training (CT - 31), or the control group (CG - 32). All the dependent variables were measured pre-training, post-training, and after the detraining period. The functional fitness was assessed by the put on and take off a t-shirt (PTS - upper limbs), timed up and go (TUG - dynamic balance), five times sit-to-stand (FTSST - lower-limb muscle power), gallon-jug shelf-transfer (GJST - global function), and 10 m walk (W10 m - walking ability) tests. RESULTS: Sixty-three women remained after the detraining period, twenty-four in the FT (66.0 ± 3.8 years), twenty in the CT (65.0 ± 4.3 years), and nineteen in the CG (69.6 ± 5.9 years). Comparing the detraining vs. the pre-intervention, the FT and CT showed a smaller reduction than CG for the PTS (ßFT = -2.296; ßCT = -1.914), timed up and go (ßFT = -0.705; ßCT = -0.600), five times sit-to-stand (ßFT = -1.970; ßCT = -2.970), gallon-jug shelf-transfer (ßFT = -1.512; ßCT = -1.003), without differences in the 10 m walk. Also, the concurrent training showed a smaller reduction than the functional training in the FTSST (ß = 1.000). CONCLUSION: Even after a long detraining period imposed by the COVID-19 pandemic, FT and CT practices were effective strategies for maintaining the functional fitness of older women.

Nutritional risk, not obesity, is associated with mortality in critically ill COVID-19 patients.

BACKGROUND: Despite the identification of obesity as a risk factor for higher rates of hospital and Intensive Care Unit (ICU) admissions and complications due to COVID-19, the association between obesity and mortality in critically ill COVID-19 patients remains controversial, and the nutritional risk is little considered. Hence, our study sought to evaluate the association between obesity, nutritional risk, and mortality in critically ill patients diagnosed with COVID-19. METHODS: Retrospective study were condutcted including adult critically ill COVID-19 patients admitted to an ICU between April 2020 and March 2021. Clinical and laboratory data were collected from electronic medical records. Obesity was classified by body mass index ≥ 30 kg/m2. A mNUTRIC score of ≥ 5 indicated high nutritional risk. Multiple Cox Regression was used to estimate the association between mNUTRIC, obesity, and mortality. RESULTS: From 71 patients aged 59 (± 15) years, 71.8 % were male. The frequencies of obesity (58.7 %) and death (49.3 %) were high, but obesity was not associated with mortality. Based on mNUTRIC, 85.9 % of patients were at high nutritional risk, presenting a higher frequency of mortality than patients at low nutritional risk (50.8 % vs 40.0 %; p = 0.014). Multiple Cox Regression showed that for each unit increase in mNUTRIC score the probability of death almost doubled, regardless of the presence of obesity (HR = 1.74; p < 0.001). CONCLUSIONS: A higher nutritional risk was positively associated with mortality in critically ill COVID-19 patients, regardless of obesity, showing the importance of early identification of nutritional risk for appropriate nutritional interventions in this population.