Kim Ji-Won, Yoon Jun Sik, Kim Eun Jin, Hong Hyo-Lim, Kwon Hyun Hee, Jung Chi Young, Kim Kyung Chan, Sung Yu Sub, Park Sung-Hoon, Kim Seong-Kyu, Choe Jung-Yoon
Division of Rheumatology, Department of Internal Medicine, Daegu Catholic University School of Medicine, Republic of Korea.
Department of Internal Medicine, Busan Paik Hospital, Inje University College of Medicine, Republic of Korea.
J Gerontol A Biol Sci Med Sci. 2021 Jul 13;76(8):e110-e116. doi: 10.1093/gerona/glab085.
The impact of sarcopenia on clinical outcomes of coronavirus disease 2019 (COVID-19) is not clearly determined yet. We aimed to investigate the association between baseline sarcopenia and clinical outcomes in patients with COVID-19.
All hospitalized adult patients with COVID-19 who had baseline chest computed tomography (CT) scans at a Korean university hospital from February 2020 to May 2020 were included. The main outcome was time from hospital admission to discharge. Death was considered as a competing risk for discharge. Baseline skeletal muscle cross-sectional area at the level of the 12th thoracic vertebra was measured from chest CT scans. The lowest quartile of skeletal muscle index (skeletal muscle cross-sectional area divided by height-squared) was defined as sarcopenia.
Of 121 patients (median age, 62 years; 44 men; 29 sarcopenic), 7 patients died and 86 patients were discharged during the 60-day follow-up. Patients with sarcopenia showed a longer time to discharge (median, 55 vs 28 days; p < .001) and a higher incidence of death (17.2% vs 2.2%; p = .004) than those without sarcopenia. Baseline sarcopenia was an independent predictor of delayed hospital discharge (adjusted hazard ratio [aHR], 0.47; 95% confidence interval [95% CI], 0.23-0.96), but was not independently associated with mortality in patients with COVID-19 (aHR, 3.80; 95% CI, 0.48-30.26). The association between baseline sarcopenia and delayed hospital discharge was consistent in subgroups stratified by age, sex, comorbidities, and severity of COVID-19.
Baseline sarcopenia was independently associated with a prolonged hospital stay in patients with COVID-19. Sarcopenia could be a prognostic marker in COVID-19.
肌肉减少症对2019冠状病毒病（COVID-19）临床结局的影响尚未明确确定。我们旨在研究COVID-19患者基线肌肉减少症与临床结局之间的关联。
纳入2020年2月至2020年5月在韩国一家大学医院进行基线胸部计算机断层扫描（CT）的所有住院成年COVID-19患者。主要结局是从入院到出院的时间。死亡被视为出院的竞争风险。通过胸部CT扫描测量第12胸椎水平的基线骨骼肌横截面积。骨骼肌指数（骨骼肌横截面积除以身高平方）的最低四分位数定义为肌肉减少症。
在121例患者（中位年龄62岁；44例男性；29例肌肉减少症患者）中，7例患者在60天随访期间死亡，86例患者出院。与无肌肉减少症的患者相比，肌肉减少症患者的出院时间更长（中位时间分别为55天和28天；p <.001），死亡发生率更高（17.2%对2.2%；p =.004）。基线肌肉减少症是延迟出院的独立预测因素（调整后风险比[aHR]，0.47；95%置信区间[95%CI]，0.23 - 0.96），但与COVID-19患者的死亡率无独立关联（aHR，3.80；95%CI，0.48 - 30.26）。在按年龄、性别、合并症和COVID-19严重程度分层的亚组中，基线肌肉减少症与延迟出院之间的关联是一致的。
基线肌肉减少症与COVID-19患者住院时间延长独立相关。肌肉减少症可能是COVID-19的一个预后标志物。
