Integrated assessment of computed tomography density in pectoralis and erector spinae muscles as a prognostic...

Area of Science:

• Medical imaging
• Pulmonology
• Infectious diseases

Background:

• Muscle quantification via chest computed tomography (CT) is a prognostic biomarker for coronavirus disease 2019 (COVID-19).
• Previous studies have not comprehensively assessed pectoralis and erector spinae muscles for COVID-19 outcomes.
• This study investigates the impact of these specific muscle parameters on COVID-19 clinical course.

Purpose of the Study:

• To compare the impact of pectoralis and erector spinae muscle area and density on COVID-19 outcomes.
• To determine if muscle density or area is a better predictor of disease severity.
• To stratify the impact of muscle parameters by sex.

Main Methods:

• A multicenter retrospective cohort study of 1410 COVID-19 patients.
• Collected data on pectoralis and erector spinae muscle area and density from chest CT scans.
• Assessed primary outcome of severe disease (oxygen requirement or death) and followed up 167 patients for three months.

Main Results:

• Lower muscle density, not area, correlated with COVID-19 severity.
• Lower erector spinae muscle density was a stronger indicator of severity than pectoralis muscle density.
• Patients with low density in both muscles (Group D) had significantly worse outcomes, particularly men, compared to those with high density in both (Group A).
• Decreased muscle density over three months predicted more severe cases.

Conclusions:

• Muscle density is a more accurate predictor of COVID-19 clinical outcomes than muscle area.
• Integrated assessment of pectoralis and erector spinae muscle densities improves prediction accuracy for COVID-19 clinical course.