Prevalence of Sarcopenia in Patients With COVID-19: A Systematic Review and Meta-Analysis

Abstract

BackgroundIt has been speculated that patients with sarcopenia are aggravated by the current novel coronavirus disease 2019 (COVID-19) epidemic. However, there is substantial uncertainty regarding the prevalence of sarcopenia in patients with COVID-19.ObjectivesThe purpose of the study was to systematically evaluate the prevalence of sarcopenia in patients with COVID-19, including stratification by gender, study location, study population, study design, and diagnostic criteria.DesignThis is the systematic literature review and meta-analysis.MethodsAn electronic search was performed in MEDLINE/PubMed, Embase, Cochrane Library, and Web of Science and Scopus to identify observational studies reporting a prevalence estimate for sarcopenia in patients with COVID-19. Studies were reviewed in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines and a meta-analysis was performed. Risk of bias (RoB) was assessed using the Newcastle–Ottawa Scale (NOS) for cohort studies and Joanna Briggs Institute (JBI) manual for cross-sectional studies, and Stata 14.0 was used to perform meta-analyses.ResultsA total of 4,639 studies were initially identified. After removing the duplicates and applying the selection criteria, we reviewed 151 full-text studies. A total of 21 studies, including 5,407 patients, were eligible for inclusion in this review finally. The prevalence of sarcopenia in patients with COVID-19 in individual studies varied from 0.8 to 90.2%. The pooled prevalence of sarcopenia in COVID-19 was 48.0% (95% confidence interval, CI: 30.8 to 65.1%, I2 = 99.68%, p = 0.000). We did not find any significant differences in the prevalence estimates between gender specificity (OR = 1.34; 95% CI = 0.80–2.26; p = 0.001). By sex, the prevalence was 42.5% (95% CI: 31.7 to 53.4%) in men and 35.7% (95% CI: 24.2 to 47.2%) in women. The prevalence estimates significantly varied based on population settings and different diagnostic criteria of sarcopenia. ICU patients (69.7, 95% CI: 51.7 to 85.2%) were more likely to suffer from sarcopenia compared to other population settings.ConclusionTo our knowledge, this is the first meta-analysis reporting on the prevalence of sarcopenia in patients with COVID-19. Sarcopenia is frequently observed in patients with COVID-19, with varying prevalence across population settings. This study would be useful for clinicians to prompt the increasing awareness of identifying sarcopenia and developing interventions at patients with COVID-19 with high risk of sarcopenia. Further prospective longitudinal studies to define the association of sarcopenia and its prognostic outcomes in COVID-19 survivors are urgently needed to propose the most appropriate treatment strategies during their admission and discharge.Systematic Review Registration[www.crd.york.ac.uk/prospero/], identifier [CRD42022300431].

Clinical Outcomes and Prevalence of Sarcopenia in Patients with Moderate to Severe COVID-19

“…We found that 47% of patients had sarcopenia, although their BI scores improved to 90 points at discharge. A previous meta-analysis showed that the prevalence of sarcopenia in COVID-19 patients was 48%, which is similar to the prevalence in our study [ 19 ]. A previous study on patients with severe COVID-19 requiring mechanical ventilation reported that 22% of patients were discharged with a cane or rolling walker and 14% were admitted to a rehabilitation facility, although 94% of patients were functionally independent before admission [ 20 ].…”

Changes of sarcopenia case finding by different Asian Working Group for Sarcopenia in community indwelling middle-aged and old people

“…During the COVID-19 pandemic, one study demonstrated the skeletal muscle mass decrease by life space assessment ( 57 ). The pooled prevalence of sarcopenia in COVID-19 was 48.0% in one meta-analysis study ( 58 ). As the subjects at risk of sarcopenia would increase rapidly in post COVID-19 pandemic era, it is plausible to ascertain the utility of case finding by 2019 AWGS.…”

Ultrasonographic findings in long COVID: A cross-sectional study of 312 patients

“…The prevalence of sarcopenia is estimated to be about 48.0% (21 studies, including 5,407 patients) and is more likely to affect ICU patients ( 46 ). Despite the high heterogeneity, this recent meta-analysis of pooled data may explain the findings identified in our study, composed mainly of patients who were treated in the ICU.…”

“…However, to the best of our knowledge, we are the first to report a quantitative measure of this finding 3-11 months after hospital discharge. We emphasize the relevance of continuous follow-up of these patients (33,46). This US protocol can be widely used as a screening test for early detection of skeletal muscle changes in long COVID patients.…”