Supplementary Material

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Abstract

Background: Hospitalisation due to COVID-19 infection leads to muscle weakness. This study aimed to evaluate hand grip strength among older adults after COVID-19 infection, and the reliability of two hand-held dynamometers.

Methods: Patients ≥ 65 years reviewed in clinic after their hospitalisation were recruited. Grip strength was assessed using hand-held dynamometer (Jamar model J00105, and Camry model EH101, hand dynamometer). Clinical information was obtained from hospital electronic medical records. Comparison was made of the two dynamometers in different participant and clinical groups. Intraclass correlation coefficient (ICC) was used to determine the inter-instrument reliability between the two dynamometers.

Results: Ninety-three participants (mean[SD] age: 73[6] years, 52.7% males) were recruited an average 55 days after discharge. 79.6% had category 4 COVID-19 (i.e. symptomatic, radiological pneumonia changes, and supplemental oxygen required). Majority (74.2%) of the participants recorded measurements lower than the threshold for low grip strength recommended by the Asian Working Group for Sarcopenia. Increasing age (r = -0.30, p = 0.003), higher Charlson Comorbidity Index score (r = -0.42, p = 0.000), and longer hospital stay (r = -0.22, p = 0.035) were associated with low grip strength. The mean (SD) grip strength was higher with Jamar dynamometer (18.1 ± 7.4 kg) than Camry dynamometer (19.5 ± 6.6 kg). Inter-instrument reliability was excellent (ICC, 0.92).

Conclusion: Low grip strength was prevalent among older people seen after COVID-19 infection. Proactive identification and management of muscle weakness is required in this group of patients.