探討營養在COVID-19後疲勞與COVID-19後急性肌少症患者之角色

The role of Nutrition in post-COVID-19 fatigue and post-COVID-19 acute sarcopenia

全球大流行的嚴重特殊傳染性肺炎（COVID 20 9）是一種由新興冠狀病毒SARS-CoV-2所引發的傳染病。隨者感染者從急性期康復，部分患者症狀仍會持續數週或數月，這些症狀統稱為COVID- 9急性感染後徵候群（Post-COVID conditions）或COVID- 9長期症狀（long COVID）。常見的症狀有疲勞、呼吸困難、行動力下降（肌肉無力）、長期咳嗽與認知功能障礙（腦霧）等，其發生率高且會長期影響日常工作表現與生活品質，因此逐漸被重視。其中疲勞、體重減輕或肌肉功能下降和無力等與COVID- 9後急性肌少症有關。而現今的研究已知營養在發炎相關的疲勞與肌少症上扮演重要角色；故良好的營養管理對於改善或緩解這些症狀具潛在效益，協助患者復原。因此，本篇綜論文章整理與歸納了COVID- 9後疲勞與COVID- 9後急性肌少症的成因以及營養在其中的角色。針對COVID- 9急性感染後徵候群者，抗發炎飲食似乎具潛力調節COVID- 9發炎反應引起的疲勞症狀。而對COVID- 9後急性肌少症者，依據目前的文獻建議攝取充足的熱量（每日每公斤體重27-30大卡）與蛋白質（每日每公斤體重≧ 公克），維持理想體位，以及多選擇富含omega-3脂肪酸的魚類、橄欖油、蔬果以及全榖雜糧等，並搭配中等強度的運動，有助於症狀改善或功能恢復。

Coronavirus disease 2019 (COVID-19) is a highly contagious, infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). While most patients infected with COVID-19 recover within a few weeks, for a few others, symptoms may last for weeks and months after having a COVID-19 infection. This is known as post-COVID condition or long COVID. The most commonly reported symptoms of long COVID include fatigue, dyspnea, muscular weakness, cough and cognitive impairment (brain fog), which can negatively affect the daily activities of patients. Particularly, fatigue and muscle function loss (muscular weakness) may correlate with weight loss and post-COVID-19 acute sarcopenia. Poor nutritional status has been implicated in fatigue and sarcopenia. Presumably, optimal nutrition plays a pivotal role in managing post-COVID conditions, such as fatigue, weight loss, and acute sarcopenia, to support full recovery. This review aims to explore possible mechanisms underlying post-COVID-19 fatigue and acute sarcopenia and summarize current evidence to recommend dietary intervention for individuals with experiencing these symptoms. For individuals with post-COVID-19 fatigue and acute sarcopenia, an anti-inflammatory diet could be encouraged to counteract the related inflammation. The recommended nutrition for post-COVID-19 acute sarcopenia may include adequate protein (≥1 g/kg/day) and energy intake (27- 30 kcal/kg IBW/day) to maintain a desirable weight. A healthy dietary pattern including fruits, vegetables, whole grains, extra virgin olive oil, and omega-3- rich oily fish, together with moderate intensity exercise, may benefit individuals in recovering from post- COVID-19 acute sarcopenia.