Zhichao Feng1,2, Huafei Zhao1, Wendi Kang1, Qin Liu1, Jianzhen Wu3, Nicola Luigi Bragazzi4, Xiaoqian Ma1,2, Wei Wang1,2, Pengfei Rong1,2. 1. Department of Radiology, Third Xiangya Hospital, Central South University, Changsha, Hunan, China. 2. Molecular Imaging Research Center, Central South University, Changsha, Hunan, China. 3. Third Xiangya Hospital, Central South University, Changsha, Hunan, China. 4. Centre for Disease Modelling, York University, Toronto, Ontario, Canada.
Abstract
BACKGROUND: Skeletal muscle depletion is common in old adults and individuals with chronic comorbidities, who have an increased risk of developing severe coronavirus disease 2019 (COVID-19), which is defined by hypoxia requiring supplemental oxygen. This study aimed to determine the association between skeletal muscle depletion and clinical outcomes in patients with severe COVID-19. METHODS: One hundred and sixteen patients with severe COVID-19 who underwent chest computed tomography scan on admission were included in this multicenter, retrospective study. Paraspinal muscle index (PMI) and radiodensity (PMD) were measured using computed tomography images. The primary composite outcome was the occurrence of critical illness (respiratory failure requiring mechanical ventilation, shock, or intensive care unit admission) or death, and the secondary outcomes were the duration of viral shedding and pulmonary fibrosis in the early rehabilitation phase. Logistic regression and Cox proportional hazards models were employed to evaluate the associations. RESULTS: The primary composite outcome occurred in 48 (41.4%) patients, who were older and had lower PMD (both p < .05). Higher PMD was associated with reduced risk of critical illness or death in a fully adjusted model overall (odds ratio [OR] per standard deviation [SD] increment: 0.87, 95% confidence interval [CI]: 0.80-0.95; p = .002) and in female patients (OR per SD increment: 0.71, 95% CI: 0.56-0.91; p = .006), although the effect was not statistically significant in male patients (p = .202). Higher PMD (hazard ratio [HR] per SD increment: 1.08, 95% CI: 1.02-1.14; p = .008) was associated with shorter duration of viral shedding among female survivors. However, no significant association was found between PMD and pulmonary fibrosis in the early rehabilitation phase, or between PMI and any outcome in both men and women. CONCLUSIONS: Higher PMD, a proxy measure of lower muscle fat deposition, was associated with a reduced risk of disease deterioration and decreased likelihood of prolonged viral shedding among female patients with severe COVID-19.
BACKGROUND: Skeletal muscle depletion is common in old adults and individuals with chronic comorbidities, who have an increased risk of developing severe coronavirus disease 2019 (COVID-19), which is defined by hypoxia requiring supplemental oxygen. This study aimed to determine the association between skeletal muscle depletion and clinical outcomes in patients with severe COVID-19. METHODS: One hundred and sixteen patients with severe COVID-19 who underwent chest computed tomography scan on admission were included in this multicenter, retrospective study. Paraspinal muscle index (PMI) and radiodensity (PMD) were measured using computed tomography images. The primary composite outcome was the occurrence of critical illness (respiratory failure requiring mechanical ventilation, shock, or intensive care unit admission) or death, and the secondary outcomes were the duration of viral shedding and pulmonary fibrosis in the early rehabilitation phase. Logistic regression and Cox proportional hazards models were employed to evaluate the associations. RESULTS: The primary composite outcome occurred in 48 (41.4%) patients, who were older and had lower PMD (both p < .05). Higher PMD was associated with reduced risk of critical illness or death in a fully adjusted model overall (odds ratio [OR] per standard deviation [SD] increment: 0.87, 95% confidence interval [CI]: 0.80-0.95; p = .002) and in female patients (OR per SD increment: 0.71, 95% CI: 0.56-0.91; p = .006), although the effect was not statistically significant in male patients (p = .202). Higher PMD (hazard ratio [HR] per SD increment: 1.08, 95% CI: 1.02-1.14; p = .008) was associated with shorter duration of viral shedding among female survivors. However, no significant association was found between PMD and pulmonary fibrosis in the early rehabilitation phase, or between PMI and any outcome in both men and women. CONCLUSIONS: Higher PMD, a proxy measure of lower muscle fat deposition, was associated with a reduced risk of disease deterioration and decreased likelihood of prolonged viral shedding among female patients with severe COVID-19.
Authors: Hakan Kardas; Maximilian Thormann; Caroline Bär; Jazan Omari; Andreas Wienke; Maciej Pech; Alexey Surov Journal: In Vivo Date: 2022 Jan-Feb Impact factor: 2.155
Authors: Ahmed Al Saedi; Ben Kirk; Sandra Iuliano; Jesse Zanker; Sara Vogrin; Lata Jayaram; Shane Thomas; Christine Golding; Diana Navarro-Perez; Petra Marusic; Sean Leng; Ralph Nanan; Gustavo Duque Journal: BMJ Open Date: 2022-05-06 Impact factor: 3.006