Handgrip strength as a prognostic factor for COVID-19 mortality among older adult patients admitted to the intensive care unit (ICU): a comparison Alpha (B.1.1.7) and Delta (B.1.617.2) variants

Abstract

Abstract Handgrip strength (HGS) is a non-invasive and reliable biomarker of overall health, physical function, mobility, and mortality. This study aimed to investigate the possible relationship between HGS and mortality in older adult patients hospitalized with COVID-19 in the intensive care unit (ICU) by Alpha (B.1.1.7) and Delta (B.1.617.2) variants. This retrospective cohort study was conducted on 472 COVID-19 patients (222 female and 250 male) aged 60–85 years admitted to the ICU. Demographic data, underlying comorbidities, COVID-19-related symptoms, as well as laboratory and computed tomography (CT) findings were obtained from the patient’s medical records. Using a JAMAR® hydraulic dynamometer, the average grip strength value (kg) after three measurements on the dominant side was recorded for subsequent analysis. Low grip strength (LGS) was defined as an arbitrary cut-off of two standard deviations below the gender-specific peak mean value of normative HGS in Iranian healthy population, i.e. < 26 kg in males and < 14 kg in females. The findings showed lower mean grip strength and high frequency of LGS in the non-survivors patients versus survivors group and in the Delta (B.1.617.2) variant vs. Alpha (B.1.1.7) variant, respectively (both p < 0.01). The binary logistic regression analysis showed that chronic obstructive pulmonary disease (COPD) (adjusted odds ratio [OR] 5.125, 95% CI 1.425–25.330), LGS (OR 4.805, 95% CI 1.624–10.776), SaO2 (OR − 3.501, 95% CI 2.452–1.268), C-reactive protein (CRP) level (OR 2.625, 95% CI 1.256–7.356), and age (OR 1.118, 95% CI 1.045–1.092) were found to be independent predictors for mortality of patients with Alpha (B.1.1.7) variant (all p < 0.05). However, only four independent predictors including COPD (OR 6.728, 95% CI 1.683–28.635), LGS (OR 5.405, 95% CI 1.461–11.768), SaO2 (OR − 4.120, 95% CI 2.924–1.428), and CRP level (OR 1.893, 95% CI 1.127–8.692) can be predicted the mortality of patients with Delta (B.1.617.2) variant (p < 0.05). Along with the well-known and common risk factors (i.e. COPD, CRP, and SaO2), handgrip strength can be a quick and low-cost prognostic tool in predicting chances of mortality in older adults who are afflicted with COVID-19 variants.

Keywords

• Older adults
• COVID-19
• Intensive care unit (ICU)
• Handgrip strength
• Mortality