Relationship between sarcopenia and cachexia with prognostic markers of middle-aged and older inpatients with COVID-19: a case-control study

Abstract

Purpose:SARS-CoV-2 infection can lead to various manifestations beyond an inflammatory response, such as anorexia, hyposmia, and other symptoms that may increase the risk of nutritional disorders. Sarcopenia and cachexia (nutritional disorders) are conditions that appear to influence COVID-19 evolution. Thus, this study aimed to evaluate sarcopenia and cachexia in hospitalized patients with COVID-19, verifying their clinical impacts and relationship with prognostic markers. Methods: This is a case-control study involving inpatients with and without a COVID-19 diagnosis. The occurrence of sarcopenia was evaluated according to European Working Group on Sarcopenia 2 criteria, and cachexia was also evaluated. Inflammatory markers and the 4C Mortality Score were evaluated. Results: The groups were similar regarding age (p = 0.656), sex (p = 0.777), presence of comorbidities (type 2 diabetes p = 0.659; systemic arterial hypertension p = 0.427), and Body Mass Index (p = 0.657). The frequency of sarcopenia and cachexia in patients with COVID-19 was 21.9% and 28.1%, respectively. Sarcopenic patients with COVID-19 had a higher risk of death (4C Mortality Score) (p = 0.038). The occurrence of sarcopenia or cachexia within the COVID-19 group was not associated with inflammatory biomarkers or a higher number of COVID-19 symptoms (p > 0.05). Conclusion: The presence of sarcopenia among COVID-19 patients increased the risk of mortality.