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

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.