COVID-19 mortality and its predictors in the elderly: A systematic review.

Background and Aims: Older people have higher rates of comorbidities and may experience more severe inflammatory responses; therefore, are at higher risk of death. Herein, we aimed to systematically review the mortality in coronavirus disease 2019 (COVID-19) patients and its predictors in this age group. Methods: We searched PubMed, Web of Science, and Science Direct using relevant keywords. Retrieved records underwent a two-step screening process consisting of title/abstract and full-text screenings to identify the eligible studies. Results: Summarizing findings of 35 studies demonstrated that older patients have higher mortality rates compared to the younger population. A review of articles revealed that increasing age, body mass index, a male gender, dementia, impairment or dependency in daily activities, presence of consolidations on chest X-ray, hypoxemic respiratory failure, and lower oxygen saturation at admission were risk factors for death. High d-dimer levels, 25-hydroxy vitamin D serum deficiencies, high C-reactive protein (≥5 mg/L) levels plus any other abnormalities of lymphocyte, higher blood urea nitrogen or lactate dehydrogenase, and higher platelet count were predictors of poor prognosis and mortality in the elderly. Studies have also shown that previous treatment with renin-angiotensin-aldosterone system inhibitors, pharmacological treatments of respiratory disorders, antibiotics, corticosteroids, vitamin K antagonist, antihistamines, azithromycin, Itolizumab (an anti-CD6 monoclonal antibody) in combination with other antivirals reduces COVID-19 worsening and mortality. Vaccination against seasonal influenza might also reduce COVID-19 mortality. Conclusion: Overall, a critical consideration is necessary for the care and management of COVID-19 in the aged population considering the drastic contrasts in manifestation and prognosis compared to other age groups. Mortality from COVID-19 is independently associated with the patient's age. Elderly patients with COVID-19 are more vulnerable to poor outcomes. Thus, strict preventive measures, timely diagnosis, and aggressive therapeutic/nontherapeutic care are of great importance to reduce acute respiratory distress syndrome and severe complications in older people.

Resistance Training's Ability to Prevent Cancer-induced Muscle Atrophy Extends Anabolic Stimulus.

PURPOSE: This study aimed to determine the role of mammalian target of rapamycin (mTORC1) activation and catabolic markers in resistance training's (RT) antiatrophy effect during cachexia-induced muscle loss. METHODS: Myofiber atrophy was induced by injecting Walker 256 tumor cells into rats exposed or not exposed to the RT protocol of ladder climbing. The role of RT-induced anabolic stimulation was investigated in tumor-bearing rats with the mTORC1 inhibitor rapamycin, and cross-sectional areas of skeletal muscle were evaluated to identify atrophy or hypertrophy. Components of the mTORC1 and ubiquitin-proteasome pathways were assessed by real-time polymerase chain reaction or immunoblotting. RESULTS: Although RT prevented myofiber atrophy and impaired the strength of tumor-bearing rats, in healthy rats, it promoted activated mTORC1, as demonstrated by p70S6K's increased phosphorylation and myofiber's enlarged cross-sectional area. However, RT promoted no changes in the ratio of p70S6K to phospho-p70S6K protein expression while prevented myofiber atrophy in tumor-bearing rats. Beyond that, treatment with rapamycin did not preclude RT's preventive effect on myofiber atrophy in tumor-bearing rats. Thus, RT's ability to prevent cancer-induced myofiber atrophy seems to be independent of mTORC1's and p70S6K's activation. Indeed, RT's preventive effect on cancer-induced myofiber atrophy was associated with its capacity to attenuate elevated tumor necrosis factor α and interleukin 6 as well as to prevent oxidative damage in muscles and an elevated abundance of atrogin-1. CONCLUSIONS: By inducing attenuated myofiber atrophy independent of mTORC1's signaling activation, RT prevents muscle atrophy during cancer by reducing inflammation, oxidative damage, and atrogin-1 expression.

High Supervised Resistance Training in Elderly Women: The Role of Supervision Ratio.

The objective of this study was to compare the effects of very high supervision (VHS-RT) versus high supervision (HS-RT) ratio resistance training (RT) on irisin, brain-derived neurotrophic factor (BNDF), muscle strength, functional capacity, and body composition in elderly women. Participants performed daily undulating periodized RT over 16 weeks with two different supervision ratios: VHS-RT at 1:2 (supervisor/subject) or HS-RT at 1:5. Serum was used to analyze brain derived neurotropic factor (BDNF) and irisin by enzyme-linked immunosorbent assay (ELISA). Body composition was evaluated by dual-energy X-ray absorptiometry, while functional capacity was evaluated using the Six-minute walk test, and Timed Up and Go (TUG). One- repetition maximum (1RM) was determined for bench press and 45° leg press exercises. For both groups, no differences between baseline and post-training were identified for irisin and lean mass (p > 0.05). Both groups improved bench press 1-RM, 45° leg press 1-RM, and TUG (p < 0.05). The VHS-RT group displayed higher effect sizes for 1-RM tests. Moreover, only VHS-RT group reduced body fat and body fat percentage (p < 0.05). In contrast, the HS-RT increased BDNF (p < 0.01). In this sense, RT enhances muscle strength and functional capacity in elderly women independent of supervision ratio. A greater supervision ratio during RT may induce more improvements in muscle strength, and body composition than lower supervision ratio during RT.

High-Protein Diet Associated with Bocaiuva Supplementation Decreases Body Fat and Improves Glucose Tolerance in Resistance-Trained Rats.

High-protein diets (HPDs) are widely used for health and performance. However, the combination of whey protein and natural foods (i.e., fruits) is still unclear. Thus, we evaluated the role of supplemental HPD with Bocaiuva (Acrocomia sp.) in metabolic and body composition parameters of rats submitted to resistance training (RT). Wistar rats (203.3 ± 30 g) were randomly allocated to five groups: normoproteic control (CON, n = 5), sedentary high-protein (SH, n = 5), RT + H (trained high-protein [TH], n = 5), sedentary+Bocaiuva (SH+B, n = 4), and RT+Bocaiuva (TH+B, n = 4) diet groups. After 12 weeks of RT, the maximal strength increased in both trained groups (P < .05). The TH + B group had lower values of adiposity index (AI) (3.8 ± 0.7% vs. 6.8 ± 1.3%) and visceral fat (0.038 ± 0.004 g/g vs. 0.067 ± 0.012 g/g) compared with the SH group, respectively (P < .05). The other groups did not show differences in values of AI (CON, 5.4 ± 1.6%, TH, 5.4 ± 1.3%, and SH+B, 5.5 ± 1.2%). In addition, the fasting glucose of trained groups (TH, 106.0 ± 4.5, and TH+B, 100.4 ± 13.5 dL/mg) was significantly lower when compared with controls (SH, 120.0 ± 14.4, and SH+B, 119 ± 6.4 dL/mg) (P < .05). Bocaiuva combined with an HPD reduced visceral fat and AI in addition to improving glucose tolerance of rats submitted to RT.

Moderate vs high-load resistance training on muscular adaptations in rats.

AIMS: The main aim of this study was to investigate the moderate versus high-load resistance training on muscle strength, hypertrophy and protein synthesis signaling in rats. METHODS: Twenty rats were randomly allocated into three groups as follow: control group (C, n = 6), high-load training (HL, n = 7) and moderate-load training (ML, n = 7). A ladder climb exercise was used to mimic resistance exercise. ML resistance training consisted of a moderate load, allowing performance at higher volume of load inherent to higher number of repetitions (8-16 climbing). HL resistance training consisted of progressively increase training load, with low volume of load (4-8 climbing). C group remained with physical activity restricted to their cage space. This experiment was conducted over a six-weeks period. Forty-eight hours after the last resistance training session the animals were euthanized for tissue collection. RESULTS: Both HL and ML regimens promoted similar increases in muscle strength, elevated protein synthesis signaling demonstrated by increased skeletal muscle total/phosphorylated P-70S6K ratio and similar increases in plantaris and FHL muscle hypertrophy, all compared to control. All these similarities were demonstrated even though testosterone/cortisol ratio was higher in HL group compared to ML and control. ML regimen caused higher total training volume and soleus muscle hypertrophy, which was not demonstrated in HL group. CONCLUSION: In conclusion, results suggest that both HL and ML induce muscle hypertrophy and increase on strength in a similar way. ML moreover seems to favor slow fiber hypertrophy due the higher training volume.

Resistance Exercise Counteracts Tumor Growth in Two Carcinoma Rodent Models.

PURPOSE: Although resistance exercise (RE) is now recognized as an adjuvant in cancer treatment because of its capacity to prevent muscle wasting, weakness, and cachexia, it is unknown whether RE can mitigate tumor development. Two solid adenocarcinoma models (Walker-256 and Ehrlich) were used to investigate the effects of RE on tumor cell proliferation, growth, and aggressiveness parameters in tumor-bearing animals' life span. METHODS: Walker-256 tumor-bearing rats and Ehrlich tumor-bearing mice were subjected to RE, which consisted of climbing a ladder apparatus with loads tied to their tails. After 4 wk, animals were euthanized, and tumors were excised and assessed for tumor microenvironment evaluation such as cell proliferation and apoptosis determination, collagen deposit, and presence of malignant tumor morphology. RESULTS: Our data demonstrate that RE mitigated tumor growth and favored tumor end points such as lower Scarff-Bloom-Richardson histological grade tumor, denoting slow cell aberrant form and division, decreased tumor cell proliferation (evaluated by nucleus marked with antigen ki-67), and lower viable tumor area in both types of tumors studied. In addition, RE stimulated tumor microvessel density in Walker-256 tumor-bearing rats, but there was no change in their life span. CONCLUSION: RE may mitigate tumor growth and tumor malignancy parameters such as lower histopathological grade, assuming less nuclear pleomorphism and mitotic cells, smaller viable tumor area, and decreased tumor cell proliferation in both adenocarcinomas. In addition, RE induced tumor vascularization.

Effect of 8 Weeks of Hospital-Based Resistance Training Program on TCD4+ Cell Count and Anthropometric Characteristic of Patients With HIV in Tehran, Iran: A Randomized Controlled Trial.

Ghayomzadeh, M, SeyedAlinaghi, S, Shamsi, MM, Rezaei, S, Earnest, CP, Akbarnejad, S, Taj, L, Mohraz, M, Navalta, JW, Ghasemi, P, and Voltarelli, FA. Effect of 8 weeks of hospital-based resistance raining program on TCD4+ cell count and anthropometric characteristic of patients with HIV in Tehran, Iran: A randomized controlled trial. J Strength Cond Res 33(4): 1146-1155, 2019-We examined the effects of an 8-W circuit resistance training (RES) program using elastic bands and body weight on TCD4+ cell counts and anthropometry in patients with HIV. Patients (N = 21) receiving antiretroviral therapy were randomly assigned to resistance training (RES; n = 14) or control (CON; n = 7) groups. RES (3/W) consisted of training with elastic bands and bodyweight training focusing on major muscle groups. CON received standard care. Statistical analyses were performed using general linear models adjusted for age, sex, length of infection, and respective baseline measures. The primary outcome was TCD4+, and secondary outcomes were anthropometry indices. Tertiary assessments explored Pearson correlations surrounding the relationship between changes in anthropometry and TCD4+. We observed significant increases in TCD4+ count accompanying RES training (105.50 cells·mm, 95% confidence interval [CI], 47.42-163.59), whereas CON significantly decreased (-41.01 cells·mm, 95% CI, -126.78 to 44.76). Significant between-group differences were noted (p < 0.02; n = 0.42). We also observed significant reductions in fat mass for RES (1.18 kg, 95% CI = 1.80 to -0.56) vs. increased fat mass for CON (1.21 kg, 95% CI, 0.31 to 2.11). Significant between-group differences were noted (p = 0.001, n = 0.64). Similar effects were noted for lean body mass. No significant changes were observed for body mass. Significant correlations were observed for fat mass (r = -0.699, p = 0.001) and lean mass (r = 0.553, p = 0.017), but not body mass (r = -0.390, p = 0.109) vs. changes in TCD4+. Our results suggest that the RES program used in this study is effective for improving TCD4+ status and body composition in patients with HIV.

The Effects of Resistance Training Volume on Skeletal Muscle Proteome.

Studies are conflicting to whether low volume resistance training (RT) is as effective as high-volume RT protocols with respect to promoting morphological and molecular adaptations. Thus, the aim of the present study was to compare, using a climbing a vertical ladder, the effects of 8 weeks, 3 times per week, resistance training with 4 sets (RT4), resistance training with 8 sets (RT8) and without resistance training control (CON) on gastrocnemius muscle proteome using liquid chromatography mass spectrometry (LC-MS/MS) and cross sectional area (CSA) of rats. Fifty-two proteins were identified by LC-MS/MS, with 39 in common between the three groups, two in common between RT8 and CON, one in common between RT8 and RT4, four exclusive in the CON, one in the RT8, and four in the RT4. The RT8 group had a reduced abundance of 12 proteins, mostly involved in muscle protein synthesis, carbohydrate metabolism, tricarboxylic acid cycle, anti-oxidant defense, and oxygen transport. Otherwise one protein involved with energy transduction as compared with CON group showed high abundance. There was no qualitative protein abundance difference between RT4 and CON groups. These results revealed that high volume RT induced undesirable disturbances on skeletal muscle proteins, while lower volume RT resulted in similar gains in skeletal muscle hypertrophy without impairment of proteome. The CSA was significantly higher in RT8 group when compared to RT4 group, which was significantly higher than CON group. However, no differences were found between trained groups when the gastrocnemius CSA were normalized by the total body weight.

Syngeneic B16F10 Melanoma Causes Cachexia and Impaired Skeletal Muscle Strength and Locomotor Activity in Mice.

Muscle wasting has been emerging as one of the principal components of cancer cachexia, leading to progressive impairment of work capacity. Despite early stages melanomas rarely promotes weight loss, the appearance of metastatic and/or solid tumor melanoma can leads to cachexia development. Here, we investigated the B16F10 tumor-induced cachexia and its contribution to muscle strength and locomotor-like activity impairment. C57BL/6 mice were subcutaneously injected with 5 × 104 B16F10 melanoma cells or PBS as a Sham negative control. Tumor growth was monitored during a period of 28 days. Compared to Sham mice, tumor group depicts a loss of skeletal muscle, as well as significantly reduced muscle grip strength and epididymal fat mass. This data are in agreement with mild to severe catabolic host response promoted by elevated serum tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6) and lactate dehydrogenase (LDH) activity. Tumor implantation has also compromised general locomotor activity and decreased exploratory behavior. Likewise, muscle loss, and elevated inflammatory interleukin were associated to muscle strength loss and locomotor activity impairment. In conclusion, our data demonstrated that subcutaneous B16F10 melanoma tumor-driven catabolic state in response to a pro-inflammatory environment that is associated with impaired skeletal muscle strength and decreased locomotor activity in tumor-bearing mice.

Different exercise protocols improve metabolic syndrome markers, tissue triglycerides content and antioxidant status in rats.

BACKGROUND: An increase in the prevalence of obesity entails great expenditure for governments. Physical exercise is a powerful tool in the combat against obesity and obesity-associated diseases. This study sought to determine the effect of three different exercise protocols on metabolic syndrome and lipid peroxidation markers and the activity of antioxidant enzymes in adult Wistar rats (120 days old). METHODS: Animals were randomly divided into four groups: the control (C) group was kept sedentary throughout the study; the aerobic group (A) swam1 h per day, 5 days per week, at 80% lactate threshold intensity; the strength group (S) performed strength training with four series of 10 jumps, 5 days per week; and the Concurrent group (AS) was trained using the aerobic protocol three days per week and the strength protocol two days per week. RESULTS: Groups A and S exhibited a reduction in body weight compared to group C. All exercised animals showed a reduction in triglyceride concentrations in fatty tissues and the liver. Exercised animals also exhibited a reduction in lipid peroxidation markers (TBARS) and an increase in serum superoxide dismutase activity. Animals in group A had increased levels of liver catalase and superoxide dismutase activities. CONCLUSIONS: We concluded that all physical activity protocols improved the antioxidant systems of the animals and decreased the storage of triglycerides in the investigated tissues.

Exercise counteracts fatty liver disease in rats fed on fructose-rich diet.

BACKGROUND: This study aimed to analyze the effects of exercise at the aerobic/anaerobic transition on the markers of non-alcoholic fatty liver disease (NAFLD), insulin sensitivity and the blood chemistry of rats kept on a fructose-rich diet. METHODS: We separated 48 Wistar rats into two groups according to diet: a control group (balanced diet AIN-93 G) and a fructose-rich diet group (60% fructose). The animals were tested for maximal lactate-steady state (MLSS) in order to identify the aerobic/anaerobic metabolic transition during swimming exercises at 28 and 90 days of age. One third of the animals of each group were submitted to swimming training at an intensity equivalent to the individual MLSS for 1 hours/day, 5 days/week from 28 to 120 days (early protocol). Another third were submitted to the training from 90 to 120 days (late protocol), and the others remained sedentary. The main assays performed included an insulin tolerance test (ITT) and tests of serum alanine aminotransferase [ALT] and aspartate aminotransferase [AST] activities, serum triglyceride concentrations [TG] and liver total lipid concentrations. RESULTS: The fructose-fed rats showed decreased insulin sensitivity, and the late-exercise training protocol counteracted this alteration. There was no difference between the groups in levels of serum ALT, whereas AST and liver lipids increased in the fructose-fed sedentary group when compared with the other groups. Serum triglycerides concentrations were higher in the fructose-fed trained groups when compared with the corresponding control group. CONCLUSIONS: The late-training protocol was effective in restoring insulin sensitivity to acceptable standards. Considering the markers here evaluated, both training protocols were successful in preventing the emergence of non-alcoholic fatty liver status disease.

Spirulina enhanced the skeletal muscle protein in growing rats.

UNLABELLED: BACKGROUND/AIM OF THE STUDY: This study evaluates the effects of the blue green alga spirulina as the sole dietary source of protein on muscle protein in weaning rats. METHODS: Young (30 days) Wistar rats were fed, during 60 days, with 17% protein spirulina (S) and compared to rats fed 17% protein casein (C). We evaluated the muscle total protein and DNA contents and the in vitro protein synthesis and degradation rates as well the myosin protein expression. RESULTS: The groups presented similar body weight (C = 427.3 +/- 8.6; S = 434.6 +/- 7.7 g) and length (C = 25.4 +/- 0.2; S = 25.6 +/- 0.2 cm). Soleus muscle total protein (C = 2.9 +/- 0.1; S = 2.7 +/- 0.1 mg/100 mg) and DNA (C = 0.084 +/- 0.005; S = 0.074 +/- 0.005 mg/100 mg) contents were also similar in both groups. Protein degradation (C = 427.5 +/- 40.6; S = 476.7 +/- 50.5 pmol/mg(-1) h(-1)) did not differ between the groups but protein synthesis (C = 17.5 +/- 1.0; S = 25.2 +/- 1.9 pmol/mg(-1) h(-1)) and myosin content (western blot analyses) were higher (P < 0.05, t test) in spirulina group. CONCLUSIONS: Although the spirulina proved adequate protein quality to maintain body growth, the muscle protein synthesis rates were increased by the ingestion of the experimental diet in young rats.