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  1. Article ; Online: Association of Physical Activity and Exercise with Physical Performance and Muscle Mass in Older Adults

    Hélio José Coelho-Júnior / Riccardo Calvani / Anna Picca / Matteo Tosato / Francesco Landi / Emanuele Marzetti

    Journal of Clinical Medicine, Vol 12, Iss 24, p

    Results from the Longevity Check-Up (Lookup) 7+ Project

    2023  Volume 7521

    Abstract: Regular engagement in physical activity (PA) or physical exercise (PE) is effective at improving physical performance and body composition in older adults. Less is known about the benefits that may be obtained through combining PA with PE and whether the ...

    Abstract Regular engagement in physical activity (PA) or physical exercise (PE) is effective at improving physical performance and body composition in older adults. Less is known about the benefits that may be obtained through combining PA with PE and whether the effects of activity habits differ between men and women. This study cross-sectionally investigated the association of PA and/or PE with physical performance and anthropometric measures in a large and relatively unselected sample of older adults enrolled in the Longevity Check-up (Lookup) 7+ project. Participants were individuals 65 years and older living in the community who were recruited in unconventional settings across Italy. Adherence to PA or PE was operationalized as involvement in light walking or various types of exercise, respectively, at least twice weekly for a minimum of 30 min per session throughout the last 12 months. Physical performance measures included handgrip strength and five-time sit-to-stand (5STS) tests. Lower-limb muscle power and appendicular skeletal muscle mass (ASM) were estimated through validated equations. We analyzed data of 4119 participants, of whom 2222 (53.4%) were women. The mean age was 72.8 ± 5.8 years in men and 72.1 ± 5.4 years in women. Regular engagement in PA + PE was reported by 139 (7.3%) men and 100 (4.5%) women. Results indicated that regular walking activity and/or PE were significantly associated with better physical performance and greater ASM with sex-specific patterns. Associations were also influenced by the type of activity, physical performance assessment tool, and anthropometric parameters. Men engaged in PA + PE performed better on the 5STS test and had greater handgrip strength, ASM, and relative and specific muscle power than those practicing either PA or PE. In women, the combination of PA and PE was associated with greater handgrip strength. The findings of this study indicate that older adults regularly practicing PA + PE had better physical performance than those who only engaged in either ...
    Keywords handgrip strength ; chair-stand test ; muscle power ; strength training ; aerobic exercise ; body composition ; Medicine ; R
    Subject code 796
    Language English
    Publishing date 2023-12-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: Inadequate Physical Activity Is Associated with Worse Physical Function in a Sample of COVID-19 Survivors with Post-Acute Symptoms

    Vincenzo Galluzzo / Maria Beatrice Zazzara / Francesca Ciciarello / Matteo Tosato / Anna Maria Martone / Cristina Pais / Giulia Savera / Riccardo Calvani / Anna Picca / Emanuele Marzetti / Francesco Landi

    Journal of Clinical Medicine, Vol 12, Iss 2517, p

    2023  Volume 2517

    Abstract: Background —Patients affected by Long COVID often report shorter times spent doing physical activity (PA) after COVID-19. The aim of the present study was to evaluate potential associations between PA levels and parameters of physical function in a ... ...

    Abstract Background —Patients affected by Long COVID often report shorter times spent doing physical activity (PA) after COVID-19. The aim of the present study was to evaluate potential associations between PA levels and parameters of physical function in a cohort of COVID-19 survivors with post-acute symptoms, with a particular focus on individuals aged 65 and older. Materials and methods —PA levels before and after COVID-19 were assessed in a sample of patients that had recovered from COVID-19 and were admitted to a post-acute outpatient service at the Fondazione Policlinico Universitario Agostino Gemelli IRCCS (Rome, Italy). Participation in PA was operationalized as the engagement in leisure-time PA for at least 150 min per week in the last 3 months. Self-rated health and measures of physical performance and muscle strength were assessed. Results —Mean age of 1846 participants was 55.2 ± 14.4 years and 47% were women. Before COVID-19, inactivity was detected in 47% of the whole study population; only 28% maintained pre-COVID-19 PA engagement. Inactivity was more frequent in women. The stopping of physical activity was associated with increased BMI and CRP levels, lower vitamin D levels and a higher prevalence of post-COVID-19 fatigue, dyspnea, arthralgia, and myalgia. Active participants had higher handgrip strength and performed better on both the six-minute walking test (6MWT) and at the one-minute sit-to-stand test (1MSTST). In particular, at the 6MWT, participants 65 and older that were still active after COVID-19 walked 32 m more than sedentary peers. Moreover, the distance covered was 28 m more than those who were active only before COVID-19 ( p = 0.05). Formerly active subjects performed similarly at the 6MWT to inactive participants. PA was associated with better self-rated health. Conclusions —Our findings reveal that inactivity is frequent in the post-acute COVID-19 phase. Stopping physical activity after COVID-19 results in measures of performance that are comparable to those who were never active. ...
    Keywords six-minute walking test ; one-minute sit-to-stand test ; muscle strength ; Long COVID ; geriatrics ; Medicine ; R
    Subject code 796
    Language English
    Publishing date 2023-03-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: Increase in Chronic Medications and Polypharmacy—The Multifaceted Burden of COVID-19 Disease on Public Health Care

    Antonella Gallo / Marcello Covino / Alice Lipari / Simona Pellegrino / Francesca Ibba / Maria Chiara Agnitelli / Matteo Tosato / Francesco Landi / Massimo Montalto / Gemelli against COVID-19 Post-Acute Care Team

    Journal of Personalized Medicine, Vol 13, Iss 1321, p

    2023  Volume 1321

    Abstract: The long-term impact of COVID-19 disease is becoming a major global concern. In this retrospective monocentric analysis, we included consecutive subjects admitted to our COVID-19 Post-Acute Care Service for a SARS-CoV-2 infection that occurred between ... ...

    Abstract The long-term impact of COVID-19 disease is becoming a major global concern. In this retrospective monocentric analysis, we included consecutive subjects admitted to our COVID-19 Post-Acute Care Service for a SARS-CoV-2 infection that occurred between three and twelve months before. A home medication list relative to the period before SARS-CoV-2 infection (baseline) was recorded and compared with that one relative to the time of outpatient visit (follow-up). Drugs were coded according to the Anatomical Therapeutic Chemical Classification (ATC) System. In a total of 2007 subjects, at follow-up, a significant increase with respect to baseline was reported in the total median number of chronic medications (two [0–4] vs. one [0–3]) and in specific ATC-group drugs involving the alimentary, blood, cardiovascular, genitourinary, muscle–skeletal, nervous and respiratory systems. In a multivariate analysis, COVID-19 disease severity and age > 65 years resulted in the best predictors for an increase in the number of medications, while anti-SARS-CoV-2 vaccination played a significant protective role. The long-term care of patients infected by COVID-19 may be more complex than reported so far. Multidisciplinary and integrated care pathways should be encouraged, mainly in older and frailer subjects and for patients experiencing a more severe disease. Vaccination may also represent a fundamental protection against long-term sequelae.
    Keywords Long-COVID ; polypharmacy ; burden ; public health ; Medicine ; R
    Subject code 610
    Language English
    Publishing date 2023-08-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: Effects of l -Arginine Plus Vitamin C Supplementation on l -Arginine Metabolism in Adults with Long COVID

    Riccardo Calvani / Jacopo Gervasoni / Anna Picca / Francesca Ciciarello / Vincenzo Galluzzo / Hélio José Coelho-Júnior / Clara Di Mario / Elisa Gremese / Sara Lomuscio / Anna Maria Paglionico / Lavinia Santucci / Barbara Tolusso / Andrea Urbani / Federico Marini / Emanuele Marzetti / Francesco Landi / Matteo Tosato

    International Journal of Molecular Sciences, Vol 24, Iss 5078, p

    Secondary Analysis of a Randomized Clinical Trial

    2023  Volume 5078

    Abstract: Altered l -arginine metabolism has been described in patients with COVID-19 and has been associated with immune and vascular dysfunction. In the present investigation, we determined the serum concentrations of l -arginine, citrulline, ornithine, ... ...

    Abstract Altered l -arginine metabolism has been described in patients with COVID-19 and has been associated with immune and vascular dysfunction. In the present investigation, we determined the serum concentrations of l -arginine, citrulline, ornithine, monomethyl- l -arginine (MMA), and symmetric and asymmetric dimethylarginine (SDMA, ADMA) in adults with long COVID at baseline and after 28-days of l -arginine plus vitamin C or placebo supplementation enrolled in a randomized clinical trial, compared with a group of adults without previous history of SARS-CoV-2-infection. l -arginine-derived markers of nitric oxide (NO) bioavailability (i.e., l -arginine/ADMA, l -arginine/citrulline+ornithine, and l -arginine/ornithine) were also assayed. Partial least squares discriminant analysis (PLS–DA) models were built to characterize systemic l -arginine metabolism and assess the effects of the supplementation. PLS–DA allowed discrimination of participants with long COVID from healthy controls with 80.2 ± 3.0% accuracy. Lower markers of NO bioavailability were found in participants with long COVID. After 28 days of l -arginine plus vitamin C supplementation, serum l -arginine concentrations and l -arginine/ADMA increased significantly compared with placebo. This supplement may therefore be proposed as a remedy to increase NO bioavailability in people with long COVID.
    Keywords post-acute COVID-19 syndrome ; SARS-CoV-2 ; ADMA ; flow-mediated dilation ; nitric oxide ; nutraceuticals ; Biology (General) ; QH301-705.5 ; Chemistry ; QD1-999
    Language English
    Publishing date 2023-03-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: Lower-Limb Muscle Power Is Negatively Associated with Protein Intake in Older Adults

    Hélio José Coelho-Júnior / Domenico Azzolino / Riccardo Calvani / Ivan de Oliveira Gonçalves / Matteo Tosato / Francesco Landi / Matteo Cesari / Anna Picca / Emanuele Marzetti

    International Journal of Environmental Research and Public Health, Vol 19, Iss 14579, p

    A Cross-Sectional Study

    2022  Volume 14579

    Abstract: The present study examined the association between lower-limb muscle power and protein-related parameters in older adults. This study followed a cross-sectional design. Participants were community-dwelling older adults. Candidates were considered ... ...

    Abstract The present study examined the association between lower-limb muscle power and protein-related parameters in older adults. This study followed a cross-sectional design. Participants were community-dwelling older adults. Candidates were considered eligible if they were 60 years or older, lived independently, and possessed sufficient physical and cognitive abilities to perform all the measurements required by the protocol. The 5 times sit-to-stand (5STS) test was performed as fast as possible according to a standard protocol. Absolute, relative, and allometric muscle power measures were estimated using 5STS-based equations. Diet was assessed by 24-h dietary recall and diet composition was estimated using a nutritional software. One-hundred and ninety-seven older adults participated to the present study. After adjustment for covariates, absolute and allometric muscle power were negatively associated with body weight-adjusted protein intake. Our findings indicate that absolute and allometric muscle power estimated through a simple equation are negatively associated with body weight-adjusted protein intake in community-dwelling older adults.
    Keywords nutrition ; macronutrients ; sarcopenia ; frailty ; physical function ; elderly ; Medicine ; R
    Subject code 796
    Language English
    Publishing date 2022-11-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  6. Article ; Online: Effects of a New Multicomponent Nutritional Supplement on Muscle Mass and Physical Performance in Adult and Old Patients Recovered from COVID-19

    Francesco Landi / Anna Maria Martone / Francesca Ciciarello / Vincenzo Galluzzo / Giulia Savera / Riccardo Calvani / Anna Picca / Emanuele Marzetti / Matteo Tosato / On behalf of Gemelli Against COVID-19 Post-Acute Care Team

    Nutrients, Vol 14, Iss 2316, p

    A Pilot Observational Case–Control Study

    2022  Volume 2316

    Abstract: Objective: The purpose of the present study was to assess the effect of a specific oral nutritional supplement among patients recovered from COVID-19 but suffering symptoms of fatigue. Methods: This is an observational case–control study involving a ... ...

    Abstract Objective: The purpose of the present study was to assess the effect of a specific oral nutritional supplement among patients recovered from COVID-19 but suffering symptoms of fatigue. Methods: This is an observational case–control study involving a sample of 66 COVID-19 survivors divided in two groups, 33 subjects in the intervention group who received the nutritional supplement and 33 subjects in the control group. The nutritional supplement received by subjects in the active group was based on amino acids; vitamin B6 and B1; and malic, succinic and citric acids. After an 8-week follow-up, the main outcomes considered were skeletal muscle index (measured by bioelectrical impedance analysis), physical performance measures (handgrip strength, one-minute chair–stand test, six-minute walking test), and quality of life (using EuroQol visual analogue scale). Results: All the considered areas increased significantly in the subjects receiving the active treatment with oral nutritional supplement in comparison with the baseline values. After adjusting for age, gender, and baseline values, skeletal muscle index, handgrip strength test, the one-minute chair–stand test, and six-minute walking test values were higher among participants in the treatment group compared with subjects in control group. The oral nutritional supplement significantly improved the handgrip strength; similarly, participants in the active group showed a higher improvement in skeletal muscle index, the one-minute chair–stand test, the six-minute walking test, and in quality of life. Conclusion: The nutritional supplement containing nine essential amino acids plus cysteine; vitamin B6 and B1; and malic, succinic and citric acids had a positive effect on nutritional status, functional recovery, and quality of life in COVID-19 survivors still suffering from fatigue. Additional controlled clinical trials are required to corroborate these results.
    Keywords COVID-19 ; personalized medicine ; frailty ; geriatric syndrome ; Nutrition. Foods and food supply ; TX341-641
    Subject code 796
    Language English
    Publishing date 2022-05-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  8. Article ; Online: Impaired Endothelial Function in Convalescent Phase of COVID-19

    Luca Santoro / Lorenzo Falsetti / Vincenzo Zaccone / Antonio Nesci / Matteo Tosato / Bianca Giupponi / Maria Cristina Savastano / Gianluca Moroncini / Antonio Gasbarrini / Francesco Landi / Angelo Santoliquido / on behalf of Gemelli against COVID-19 Post-Acute Care Study Group

    Journal of Clinical Medicine, Vol 11, Iss 1774, p

    A 3 Month Follow Up Observational Prospective Study

    2022  Volume 1774

    Abstract: Background: Endothelial dysfunction has a role in acute COVID-19, contributing to systemic inflammatory syndrome, acute respiratory distress syndrome, and vascular events. Evidence regarding COVID-19 middle- and long-term consequences on endothelium are ... ...

    Abstract Background: Endothelial dysfunction has a role in acute COVID-19, contributing to systemic inflammatory syndrome, acute respiratory distress syndrome, and vascular events. Evidence regarding COVID-19 middle- and long-term consequences on endothelium are still lacking. Our study aimed to evaluate if COVID-19 severity could significantly affect the endothelial function after three months from the acute phase. Methods: We assessed endothelial function in outpatients with previous COVID-19 three months after negative SARS-CoV-2 molecular test by measuring flow-mediated dilation (FMD) in patients categorized according to a four-variable COVID-19 severity scale (“home care”; “hospital, no oxygen”; “hospital, oxygen”; “hospital requiring high-flow nasal canula, non-invasive ventilation, invasive mechanical ventilation, or extracorporeal membrane oxygenation”). FMD difference among COVID-19 severity categories was assessed with analysis of variance; we further clarified the relationship between FMD and previous COVID-19 severity with multivariate logistic models. Results: Among 658 consecutive COVID-19 subjects, we observed a significant linear trend of FMD reduction with the increase of the COVID-19 category ( p < 0.0001). The presence of endothelial dysfunction was more frequent among hospitalized patients (78.3%) with respect to home-care patients (21.7%; p < 0.0001). COVID-19 severity was associated with increased endothelial dysfunction risk (OR: 1.354; 95% CI: 1.06–1.71; p = 0.011) at multivariate binary logistic analysis. FMD showed a significant direct correlation with PaO2 ( p = 0.004), P/F ratio ( p = 0.004), FEV1 ( p = 0.008), and 6MWT ( p = 0.0001). Conclusions: Hospitalized COVID-19 subjects showed an impaired endothelial function three months after the acute phase that correlated with pulmonary function impairment. Further studies are needed to evaluate if these subjects are at higher risk of developing pulmonary disease or future cardiovascular events.
    Keywords endothelial dysfunction ; flow-mediated dilation ; COVID-19 ; post-acute COVID-19 syndrome ; Medicine ; R
    Subject code 610
    Language English
    Publishing date 2022-03-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  9. Article ; Online: Impact of habitual physical activity and type of exercise on physical performance across ages in community-living people.

    Francesco Landi / Riccardo Calvani / Anna Picca / Matteo Tosato / Anna Maria Martone / Emanuela D'Angelo / Elisabetta Serafini / Roberto Bernabei / Emanuele Marzetti

    PLoS ONE, Vol 13, Iss 1, p e

    2018  Volume 0191820

    Abstract: The maintenance of muscle function into late life protects against various negative health outcomes. The present study was undertaken to evaluate the impact of habitual physical activity and exercise types on physical performance across ages in community- ...

    Abstract The maintenance of muscle function into late life protects against various negative health outcomes. The present study was undertaken to evaluate the impact of habitual physical activity and exercise types on physical performance across ages in community-living adults. The Longevity check-up 7+ (Lookup 7+) project is an ongoing cross-sectional survey conducted in unconventional settings (e.g., exhibitions, malls, and health promotion campaigns across Italy) that began on June 1st 2015. The project was designed to raise awareness in the general population on major lifestyle behaviors and risk factors for chronic diseases. Candidate participants are eligible for enrolment if they are at least 18 years of age and provide written informed consent. Physical performance is evaluated through the 5-repetition chair stand test. Analyses were conducted in 6,242 community-living adults enrolled between June 1st 2015 and June 30th 2017, after excluding 81 participants for missing values of the variables of interest. The mean age of the 6,242 participants was 54.4 years (standard deviation 15.2, range 18-98 years), and 3552 (57%) were women. The time to complete the chair stand test was similar from 18 to 40-44 years, and declined progressively across subsequent age groups. Overall, the performance on the chair stand test was better in physically active participants, who completed the test with a mean of 0.5 s less than sedentary enrollees (p < .001). After adjusting for potential confounders, a different distribution of physical performance across exercise intensities was observed, with better performance being recorded in participants engaged in more vigorous activities. Our findings suggest that regular physical activity modifies the age-related pattern of decline in physical performance, with greater benefits observed for more intensive activities. Efforts are needed from health authorities and healthcare providers to promote the large-scale adoption of an active lifestyle throughout the life course.
    Keywords Medicine ; R ; Science ; Q
    Subject code 796
    Language English
    Publishing date 2018-01-01T00:00:00Z
    Publisher Public Library of Science (PLoS)
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  10. Article ; Online: Italian good practice recommendations on management of persons with Long-COVID

    Marina Giuliano / Dorina Tiple / Piergiuseppe Agostoni / Benedetta Armocida / Ludovico Biardi / Anna Rita Bonfigli / Andrea Campana / Maria Ciardi / Fabiano Di Marco / Marco Floridia / Paola Gnerre / Tiziana Grassi / Ignazio Grattagliano / Paola Kruger / Matilde Leonardi / Rocco Liguori / Elisabetta Pagani / Elisa Perger / Flavia Pricci /
    Marinella Ruggeri / Andrea Silenzi / Francesco Spannella / Carlo Tascini / Giulia Teté / Matteo Tosato / Simona Vecchi / Marika Villa / Graziano Onder

    Frontiers in Public Health, Vol

    2023  Volume 11

    Abstract: A significant number of people, following acute SARS-CoV-2 infection, report persistent symptoms or new symptoms that are sustained over time, often affecting different body systems. This condition, commonly referred to as Long-COVID, requires a complex ... ...

    Abstract A significant number of people, following acute SARS-CoV-2 infection, report persistent symptoms or new symptoms that are sustained over time, often affecting different body systems. This condition, commonly referred to as Long-COVID, requires a complex clinical management. In Italy new health facilities specifically dedicated to the diagnosis and care of Long-COVID were implemented. However, the activity of these clinical centers is highly heterogeneous, with wide variation in the type of services provided, specialistic expertise and, ultimately, in the clinical care provided. Recommendations for a uniform management of Long-COVID were therefore needed. Professionals from different disciplines (including general practitioners, specialists in respiratory diseases, infectious diseases, internal medicine, geriatrics, cardiology, neurology, pediatrics, and odontostomatology) were invited to participate, together with a patient representative, in a multidisciplinary Panel appointed to draft Good Practices on clinical management of Long-COVID. The Panel, after extensive literature review, issued recommendations on 3 thematic areas: access to Long-COVID services, clinical evaluation, and organization of the services. The Panel highlighted the importance of providing integrated multidisciplinary care in the management of patients after SARS-CoV-2 infection, and agreed that a multidisciplinary service, one-stop clinic approach could avoid multiple referrals and reduce the number of appointments. In areas where multidisciplinary services are not available, services may be provided through integrated and coordinated primary, community, rehabilitation and mental health services. Management should be adapted according to the patient’s needs and should promptly address possible life-threatening complications. The present recommendations could provide guidance and support in standardizing the care provided to Long-COVID patients.
    Keywords COVID-19 ; Long COVID ; good clinical practices (GCP) ; Italy ; health care systems ; guideline ; Public aspects of medicine ; RA1-1270
    Subject code 360
    Language English
    Publishing date 2023-04-01T00:00:00Z
    Publisher Frontiers Media S.A.
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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