Sarcopenia and COVID-19

Ekiz, Timur; Kara, Murat; Özcan, Fırat; Ricci, Vincenzo; Özçakar, Levent

doi:10.1097/phm.0000000000001528

Cited by 12 publications

(10 citation statements)

References 12 publications

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“…In COVID-19 patients, advanced age and various pre-existing comorbidities have been associated with higher risk of death ( 1 , 2 , 21 , 27 , 28 ). While the same has been documented for pulmonary parenchymal damage and associated pathologic features assessed on chest CT ( 19 , 22 , 29 ), few articles have investigated whether sarcopenia and lower muscle mass are negative predictors for severe COVID-19 ( 12 – 14 ). Nevertheless, impaired muscle status has long been associated with higher mortality risk in critical care: sarcopenia and lower muscle mass – detected by CT – are primary predictors of worse outcome in mechanically ventilated patients ( 30 – 32 ).…”

Section: Discussionmentioning

confidence: 93%

“…Furthermore, we extended such prognostic evaluation to impaired muscle status, that proved to be the strongest CT-derived independent predictor of both ICU admission and death. Lower muscle mass probably impacts on respiratory muscles function, alongside other mechanisms involving global sarcopenia ( 12 – 14 ), such as the sarcopeniainduced pro-inflammatory profile ( 28 ), interplaying with the cytokine storm triggered by SARS-CoV-2 ( 33 , 34 ), prolonged immobilization during hospitalization, and mechanical ventilation ( 12 – 14 ).…”

Section: Discussionmentioning

confidence: 99%

“…Among body composition parameters, visceral fat has been extensively shown to be an adverse outcome predictor in COVID-19 patients ( 11 ). Conversely, the postulated prognostic impact of lower muscle mass in COVID-19 patients ( 12 ) has only been preliminary evaluated ( 13 , 14 ), although it could be considered a proxy of the general health status and of the action of various typical comorbidities in elderly patients. If present, the exploitation of an association between muscle mass and outcomes in COVID-19 patients would rely on prompt identification of such a status, possibly even on emergency department admission, in order to aid patient stratification.…”

Section: Introductionmentioning

confidence: 99%

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CT-derived Chest Muscle Metrics for Outcome Prediction in Patients with COVID-19

Schiaffino¹,

Albano²,

Cozzi³

et al. 2021

Radiology

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Background Lower muscle mass is a known predictor of unfavorable outcome, but its prognostic impact on COVID-19 patients is unknown. Purpose To investigate the contribution of CT-derived muscle status in predicting clinical outcomes in COVID-19 patients. Materials and Methods Clinical/laboratory data and outcomes (intensive care unit [ICU] admission and death) were retrospectively retrieved for patients with reverse transcriptase polymerase chain reaction-confirmed COVID-19, who underwent chest CT on admission in four hospitals in Northern Italy from February 21 to April 30, 2020. Extent and type of pulmonary involvement, mediastinal lymphadenopathy, and pleural effusion were assessed. Cross-sectional areas and attenuation of paravertebral muscles were measured on axial CT images at T5 and T12 vertebral level. Multivariable linear and binary logistic regression, including calculation odds ratios (OR) with 95% confidence intervals (CIs), were used to build four models to predict ICU admission and death, tested and compared using receiver operating characteristic curve (ROC) analysis. Results A total 552 patients (364 men; median age 65 years, interquartile range 54–75) were included. In a CT-based model, lower-than-median T5 paravertebral muscle area showed the highest ORs for ICU admission (OR 4.8, 95% CI 2.7–8.5; P <.001) and death (OR 2.3, 95% CI 1.0–2.9; P =.027). When clinical variables were included in the model, lower-than-median T5 paravertebral muscle area still showed the highest ORs both for ICU admission (OR 4.3; 95% CI 2.5–7.7; P <.001) and death (OR 2.3, 95% CI 1.3–3.7; P =.001). At ROC analysis, the CT-based model and the model including clinical variables showed the same area under the curve (AUC) for ICU admission prediction (AUC 0.83, P =.380) and were not different in predicting death (AUC 0.86 versus AUC 0.87, respectively, P =.282). Conclusion In hospitalized patients with COVID-19, lower muscle mass on CT was independently associated with ICU admission and hospital mortality.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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CT-derived Chest Muscle Metrics for Outcome Prediction in Patients with COVID-19

Schiaffino¹,

Albano²,

Cozzi³

et al. 2021

Radiology

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“…Drugs can also play a protective or causative role in the development of sarcopenia. Statins, sulfonylureas, glinides have a potential harmful effect on muscle metabolism; while ACE inhibitors, allopurinol, Vitamin D play a protective role on muscle function [ 45 , 46 ]. The muscle is formed of different types of muscle fibers: slow fibers (type I) and fast fibers (types IIa and IIb).…”

Section: Sarcopenia As Biological Substrate Of Physical Frailtymentioning

confidence: 99%

Role of Cachexia and Fragility in the Patient Candidate for Cardiac Surgery

et al. 2021

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Frailty is the major expression of accelerated aging and describes a decreased resistance to stressors, and consequently an increased vulnerability to additional diseases in elderly people. The vascular aging related to frail phenotype reflects the high susceptibility for cardiovascular diseases and negative postoperative outcomes after cardiac surgery. Sarcopenia can be considered a biological substrate of physical frailty. Malnutrition and physical inactivity play a key role in the pathogenesis of sarcopenia. We searched on Medline (PubMed) and Scopus for relevant literature published over the last 10 years and analyzed the strong correlation between frailty, sarcopenia and cardiovascular diseases in elderly patient. In our opinion, a right food intake and moderate intensity resistance exercise are mandatory in order to better prepare patients undergoing cardiac operation.

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“…hypertension) have deleterious multi-system effects not only on the cardiovascular system but also on cognition and the musculoskeletal system-causing muscle atrophy and decline of muscle power/strength, endurance, and physical performance (i.e., sarcopenia) [5].…”

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confidence: 99%

Letter to the editor concerning "Handgrip strength correlates with walking in lumbar spinal stenosis" by Inoue H, et al. (Eur Spine J 2020; 29: 2198–204)

2021

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We would like to congratulate Inoue H, et al. [1] for their article "Handgrip strength correlates with walking in lumbar spinal stenosis" which was recently published in your journal. They have nicely drawn attention to the relationship among grip strength, leg extension power, habitual gait/ walking speed, and intermittent claudication in lumbar spinal stenosis. Herein, we need to note a few remarks/disagreements concerning some of the interpretations in their study. First and foremost, the authors mention that grip strength correlates with "walking" in lumbar spinal stenosis, but it would be better to clarify that it is actually the "walking speed." Second, grip strength has been shown to correlate with many factors including gender, age, height, weight, leg extension power, total area of skeletal muscle at L3 vertebral level, area of the psoas muscle, gait speed, and intermittent claudication. In addition, since comorbid diseases (e.g., anemia and hypertension) are also affected by age and gender; correlation analyses should be performed separately for each gender, in order not to influence all the results. Third, grip strength is associated with gait speed in the normal population as well [2]. Of note, gait speed is also a common denominator for the relationship between sarcopenia and functional dependence; [3] therefore, the weak correlation between grip strength and gait speed in lumbar spinal stenosis would not be that much interesting. Moreover, both grip strength and gait speed are related with aging [2] as well as cognitive functions [4]. Disorders resulting from the renin angiotensin system overactivity (e.g., Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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Sarcopenia and COVID-19

Cited by 12 publications

References 12 publications

CT-derived Chest Muscle Metrics for Outcome Prediction in Patients with COVID-19

CT-derived Chest Muscle Metrics for Outcome Prediction in Patients with COVID-19

Role of Cachexia and Fragility in the Patient Candidate for Cardiac Surgery

Letter to the editor concerning "Handgrip strength correlates with walking in lumbar spinal stenosis" by Inoue H, et al. (Eur Spine J 2020; 29: 2198–204)

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