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Thoracic sarcopenia as a predictive factor of SARS-COV2 evolution.

J Koehler1, Y Boirie2, L Bensid1

  • 1Service de Radiologie, CHU Clermont-Ferrand Clermont-Ferrand, France.

Clinical Nutrition (Edinburgh, Scotland)
|February 10, 2022
PubMed
Summary

Sarcopenia, a measure of muscle loss, predicts intensive care unit (ICU) admission for patients with SARS-CoV-2 infection. Assessing skeletal muscle index (SMI) and muscle density on admission can identify high-risk patients.

Keywords:
COVIDMalnutritionSARS-COV2SMDSMISarcopenia

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Area of Science:

  • Radiology and Imaging
  • Critical Care Medicine
  • Infectious Diseases

Background:

  • Sarcopenia, characterized by loss of skeletal muscle mass and function, is increasingly recognized as a significant comorbidity.
  • The impact of sarcopenia on outcomes for patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection remains under investigation.

Purpose of the Study:

  • To evaluate the predictive value of computed tomography (CT) imaging for sarcopenia in patients hospitalized with SARS-CoV-2 infection.
  • To determine if sarcopenia assessed via CT at admission correlates with the risk of intensive care unit (ICU) hospitalization.

Main Methods:

  • A retrospective study included 162 patients hospitalized with SARS-CoV-2 infection.
  • Muscle mass (skeletal muscle index, SMI), muscle quality, and body adiposity were quantified using CT scans at T4 and L3 levels upon admission.
  • Demographic data, pulmonary involvement, and ICU admission risk were collected.

Main Results:

  • Lower muscle area at L3 (p=0.007) and reduced SMI (p<0.001) were significantly associated with unfavorable patient outcomes.
  • Muscle area at T4 also showed a significant association with adverse events (p=0.026).
  • Increased abdominal visceral fat area at L3 was linked to a higher risk of ICU hospitalization (p<0.001).

Conclusions:

  • Thoracic and abdominal sarcopenia are independent predictors of ICU admission in SARS-CoV-2 patients.
  • CT-based assessment of sarcopenia upon admission is recommended for identifying patients at higher risk of severe disease progression and ICU transfer.