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Published on: December 19, 2020
CT scan-derived pectoralis muscle parameters are closely associated with COVID-19 outcomes: A systematic review and
Zhang Wen1, Tao Wang2, Sha Luo1
1Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China.
Insights
Higher pectoralis muscle density (PMD) in COVID-19 patients correlates with lower mortality risk. A higher pectoralis muscle index (PMI) is linked to reduced intubation rates, suggesting CT scan muscle parameters are valuable prognostic tools.
Area of Science:
- Radiology
- Pulmonology
- Critical Care Medicine
Background:
- The prognostic significance of pectoralis muscle characteristics in COVID-19 patients is not well-established.
- Understanding these relationships can aid in patient management and outcome prediction.
Purpose of the Study:
- To systematically evaluate the association between pectoralis muscle parameters and clinical outcomes in COVID-19 patients.
- To determine if chest CT-derived muscle metrics can serve as prognostic indicators.
Main Methods:
- A comprehensive literature search was conducted across major databases (PubMed, Embase, Web of Science, Cochrane Library) from January 2019 to May 2024.
- Meta-analyses (random-effects and fixed-effects models) were performed on data from 9 studies involving 4109 COVID-19 patients.
- Study bias was assessed using the Newcastle-Ottawa scale, and heterogeneity was quantified with the I2 statistic.
Main Results:
- Higher pectoralis muscle density (PMD) was associated with a reduced risk of mortality (OR = 0.95, 95% CI: 0.92-0.99).
- A higher pectoralis muscle index (PMI) correlated with a lower likelihood of requiring intubation (OR = 0.96, 95% CI: 0.92-1.00).
Conclusions:
- Low PMD indicates a slightly increased mortality risk in COVID-19 patients.
- Decreased PMI is a risk factor for intubation, highlighting the prognostic utility of pectoralis muscle parameters on chest CT scans.
Background:
The relationships between pectoralis muscle parameters and outcomes in patients with coronavirus disease 2019 (COVID-19) remain uncertain.
Methods:
We systematically searched PubMed, Embase, Web of Science and the Cochrane Library from 1 January 2019 to 1 May 2024 to identify non-overlapping studies evaluating pectoralis muscle-associated index on chest CT scan with clinical outcome in COVID-19 patients. Random-effects and fixed-effects meta-analyses were performed, and heterogeneity between studies was quantified using the I2 statistic. The risk of study bias was assessed using the Newcastle-Ottawa scale. Funnel plots for detecting small-study effects.
Results:
A total of 9 studies with 4109 COVID-19 patients were included. The meta-analysis findings revealed a correlation between pectoralis muscle parameters and COVID-19 prognosis. Specifically, patients with higher pectoralis muscle density (PMD) exhibited a lower mortality risk, with an odds ratio (OR) of 0.95 (95% CI: 0.92-0.99). The rate of intubation was lower in COVID-19 patients with a high pectoralis muscle index (PMI) (OR = 0.96, 95% CI: 0.92-1.00).
Conclusion:
In summary, a low PMD is associated with a marginally elevated risk of mortality, whereas a decreased PMI represents a risk factor for intubation in COVID-19 patients. These findings suggest that pectoralis muscle parameters on chest CT may be a useful prognostic tool for COVID-19 patients.
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