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Sarcopenia and Its Prognostic Role on Hospitalization and In-Hospital Mortality in Coronavirus Disease 2019 Patients
Mehmet Akif Erdöl1, Bircan Kayaaslan2, Mehmet Erdoğan1
1Cardiology Unit, University of Health Sciences, Ankara City Hospital, Turkey.
Insights
Skeletal muscle measurements, including cross-sectional area and attenuation, can predict outcomes in patients hospitalized with coronavirus disease 2019 and cardiovascular risk factors. Lower muscle mass is associated with increased intensive care unit admission, mechanical ventilation, and mortality.
Area of Science:
- Radiology and Imaging
- Cardiovascular Medicine
- Infectious Diseases
Background:
- Coronavirus disease 2019 (COVID-19) is a global pandemic.
- Patients with COVID-19 and cardiovascular risk factors face significant health challenges.
- The prognostic role of skeletal muscle parameters in these patients requires further investigation.
Purpose of the Study:
- To evaluate the prognostic significance of computed tomography (CT)-based skeletal muscle measurements in hospitalized COVID-19 patients with cardiovascular risk factors.
- To assess the relationship between muscle cross-sectional area, index, and attenuation and clinical outcomes.
Main Methods:
- Retrospective analysis of 232 COVID-19 patients with at least one cardiovascular risk factor.
- Automated measurement of erector spinae, pectoralis, and total skeletal muscle (SM) parameters on CT scans.
- Stratification of patients into tertiles based on total SM cross-sectional area (SMcsa) index and correlation with clinical outcomes.
Main Results:
- Higher rates of intensive care unit admission, mechanical ventilation, and mortality were observed in the lowest muscle mass tertile (tertile 3).
- Significantly lower muscle measurements were found in tertile 3 (P < .001).
- Diabetes mellitus, hypertension, and low total SMcsa index were independent predictors of in-hospital mortality.
Conclusions:
- Sarcopenia, assessed by CT-based muscle measurements, can predict disease severity and outcomes in COVID-19 patients.
- Skeletal muscle parameters are valuable prognostic indicators in COVID-19 patients with cardiovascular comorbidities.
- Early identification of sarcopenia may aid in risk stratification and management of COVID-19 patients.
Background:
The coronavirus disease 2019 infection is a global pandemic that has affected the whole world population. We aimed to evaluate the prognostic role of cross-sectional area, muscle index, and muscle attenuation values in computed tomography-based skeletal groups [erector spinae muscle, pectoralis muscle, and total skeletal muscle] of patients hospitalized for coronavirus disease 2019 and with at least 1 cardiovascular risk factor.
Methods:
A total of 232 patients with coronavirus disease 2019 and at least 1 cardiovascular risk factor were enrolled in the study, retrospectively. The cross-sectional area, muscle index, and attenuation of erector spine muscle, pectoralis muscle, and total skeletal muscle were automatically measured on computed tomography images. The study population was assigned into tertiles on the basis of the total SMcsa index. The relationship between the values obtained and the length of hospital stay, admission to intensive care unit, the need for invasive mechani cal ventilation, and mortality was investigated.
Results:
Admission to intensive care unit, need for invasive mechanical ventilation, and mor tality were higher at tertile 3 groups than in the other groups (all P values <.001). Statistically, all muscle measurements were significantly lower in tertile 3 (P <.001). Diabetes mellitus, hypertension, and total SMcsa index were predictors of in-hospital mortality in patients with coronavirus disease 2019 on the basis of Cox regression analysis. In the Kaplan-Meier analysis for the proportion of survivors relative to the total SMcsa index, tertile 3 had the highest mortal ity (survival rates 57%, P < .001).
Conclusions:
Sarcopenia and attendant cardiovascular comorbidities can effectively assess dis ease severity and predict outcome in patients with coronavirus disease 2019.
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