Impact of sarcopenia in SARS-CoV-2 patients during two different epidemic waves

Abstract

Background Sarcopenia was reported to be associated with poor clinical outcome, higher incidence of community-acquired pneumonia, increased risk of infections and reduced survival in different clinical settings. The aim of our work is to evaluate the prognostic role of sarcopenia in patients with the 2019 novel coronavirus disease (COVID-19). Materials and Methods 272 COVID-19 patients admitted to the University Hospital of Modena (Italy) from February 2020 to January 2021 were retrospectively studied. All included patients underwent a chest computed tomography (CT) scan to assess pneumonia during their hospitalization and showed a positive SARS-CoV-2 molecular test. Sarcopenia was defined by skeletal muscle area (SMA) evaluation at the 12th thoracic vertebra (T12). Clinical, laboratory data and adverse clinical outcome (admission to Intensive Care Unit and death) were collected for all patients. Results prevalence of sarcopenia was high (41,5%) but significantly different in each pandemic wave (57,9% vs 21,6% p<0,0000). At the multivariate analysis, sarcopenia during the first wave (Hazard Ratio 2,29, 95% confidence intervals1,17 to 4,49 p=0,0162) was the only independent prognostic factor for adverse clinical outcome. There were no significant differences in comorbidities and COVID19 severity in terms of pulmonary involvement at lung CT comparing during the first and second wave. Mixed pattern with peripheral and central involvement was found to be dominant in both groups. Conclusion: we highlight the prognostic impact of sarcopenia in COVID-19 patients hospitalized during the first wave. T12 SMA could represent a potential tool to identify sarcopenic patients in particular settings. Further studies are needed to better understand the association between sarcopenia and COVID-19.

The impact of body composition on mortality of COVID-19 hospitalized patients: A prospective study on abdominal fat, obesity paradox and sarcopenia

“…As regards SP, our results confirmed the previous findings of a negative impact of low muscle mass and the outcome of COVID-19 [13,41]. In addition to the obvious role of allowing respiratory contractions, likewise VAT, skeletal muscle is being considered as an endocrine organ with immunomodulatory and antiinflammatory functions [42].…”

Prognostic Value of Diaphragm Diameter, Muscle Volume, and Bone Mineral Density in Critically Ill COVID-19 Patients

“…The authors attributed this to delayed hospital presentations in the first wave of the pandemic due to the health policies implemented. 34 In another prospective study, in which MV was measured with CT, it was shown that acute MV loss was associated with negative clinical outcomes. 35 Based on all these data, we suggest that the MI value should be considered as an indicator of mortality despite the presence of many confounding factors.…”

Physical Therapy for a Multiple Myeloma Patient with COVID-19: A Case Report

“…It has been reported that COVID-19 induces hypercatabolism, resulting in decreased muscle function and sarcopenia. 9,10) Steroid myopathy is also associated with muscle weakness with proximal muscle predominance, resulting in limitation of activities such as standing up. 11) Furthermore, disuse syndrome due to inactivity causes generalized muscle weakness, and ICU-acquired weakness reportedly causes rapid muscle weakness.…”