ABSTRACT
In this paper we discuss the nexus of health and gender inequalities associated with the COVID-19 pandemic and highlight its adverse impacts on women's health, welfare and social standing. The COVID-19 pandemic has exposed the link between socio-economic inequalities and health outcomes, especially in the area of rheumatic and musculoskeletal (RMDs) diseases. Women are more adversely affected by RMDs diseases compared to men. Epidemiological research carried out over several decades has demonstrated the presence of clear gender patterns in the manifestation of musculoskeletal diseases, including osteoarthritis (OA), rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), systemic sclerosis (SS) and osteoporosis (OP). The public health measures that have been adopted to curb the spread of Sars-COV-2 are expected to have a particularly detrimental impact on women in the long term precisely because of the nexus between health outcomes and socio-economic structures. Moreover, the prioritization of urgent care will further compound this effect. COVID-19 has created a condition of ontological insecurity that is becoming increasingly manifested through various chronic diseases and associated comorbidities. RMDs and their impact on mobility and the ability of individuals to be independent, happy and mobile is a key public health challenge in the post-COVID-19 reality and a key part of the ongoing pandemic. There is an urgent need to engage with policymakers to publicize and prioritize this problem and develop viable solutions to address it.
ABSTRACT
BACKGROUND: The identification of coronavirus disease 2019 (COVID-19) risk factors is requested to implement prevention strategies. AIM: To explore the associations between the COVID-19 incidence and malnutrition, sarcopenia, and frailty, identified as potential risk factors in previous cross-sectional studies. METHODS: Malnutrition, sarcopenia, and frailty were assessed at the last available follow-up from the Sarcopenia and Physical Impairments with Advancing Age (SarcoPhAge) cohort (i.e., the fifth year that ended in 2019) according to the Mini-Nutritional Assessment short-form, the European Working Group on Sarcopenia in Older People (EWGSOP2), and the Fried criteria, respectively. Information regarding the COVID-19 was gathered by phone calls interviews in April 2021 to measure its self-declared incidence. Adjusted Cox regressions and Kaplan-Meier curves were performed. RESULTS: The present study included 241 participants [median age 75.6 (73.0-80.6) years, 63.1% women]. Among them, 27 participants (11.2%) developed the non-fatal Covid-19. No significant increased risks of COVID-19 were observed in patients with malnutrition [adjusted HR 1.14 (0.26-5.07)] and sarcopenia [adjusted HR 1.25 (0.35-4.42)]. Nevertheless, the incidence of COVID-19 was significantly higher in frail (44.4%) than in robust participants (8.5%) [Adjusted HR 7.01 (2.69-18.25)], which was confirmed by the Kaplan-Meier curves (p < 0.001). Among the frailty syndrome components, a low physical activity level was the only one significantly associated with an increased risk of COVID-19 [adjusted HR 5.18 (1.37-19.54)]. CONCLUSION: Despite some limitations in the methodology of this study (i.e., limited sample size, COVID-19 incidence self-reported and not assessed systematically using objective measurements) requiring careful consideration, an increased risk to develop COVID-19 was observed in the presence of the frailty syndrome. Further investigations are needed to elaborate on our findings.