Edward B. Singleton Department of Radiology, Texas Children's Hospital, Baylor College of Medicine, 6701 Fannin St., Suite 470, Houston, TX, USA.
Department of Obstetrics and Gynecology, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA.
Radiol Med. 2022 Apr;127(4):440-448. doi: 10.1007/s11547-022-01462-z. Epub 2022 Feb 21.
To assess the association between body composition measures in children with COVID-19 and severity of the disease course and clinical outcome.
A retrospective study of children (< 19 years) with COVID-19 admitted to the hospital who underwent CT of the chest and/or abdomen was conducted. Data compiled from electronic medical records included demographics, body mass index (BMI), length of stay, ICU admission, invasive mechanical ventilation and death. Waist circumference and perimeters for skeletal muscle mass (abdominal, psoas and paraspinal muscles) were measured on an axial CT image at the level of the twelfth thoracic vertebra or first lumbar vertebra using FIJI software.
Fifty-seven subjects were identified (54% male, median age 15.6 years, 61% Hispanic, 23% African-American). 25% (14/57) were admitted to the ICU and 21% (12/57) needed intubation. 9% (5/57) died. Waist circumference ranged between 53.2 and 138.4 cm (mean 86.58 ± 18.74 cm) and skeletal muscle mass ranged between 0.6 and 6.8 cm (mean 3.5 ± 1.19 cm). Lower skeletal muscle mass had a univariate association with ICU admission (odds ratio (OR) 0.4; 95%CI 0.17-0.76; p = 0.01) and mortality (OR 0.22; 95%CI 0.04-0.69; p = 0.01). Multivariate analysis showed similar association after controlling for comorbidities (adjusted OR 0.46; 95%CI 0.19-0.95; p = 0.04 and adjusted OR 0.31; 95%CI 0.06-0.95; p = 0.04, respectively). There was no association between BMI or waist circumference with ICU stay, mechanical ventilation or mortality.
Lower skeletal muscle mass is associated with an adverse clinical course and outcome in children with COVID-19.
评估 COVID-19 患儿的身体成分测量指标与疾病严重程度和临床结局的关系。
对因 COVID-19 住院并接受胸部和/或腹部 CT 检查的儿童进行回顾性研究。从电子病历中收集的数据包括人口统计学、体重指数（BMI）、住院时间、入住 ICU、有创机械通气和死亡。使用 FIJI 软件，在第十二胸椎或第一腰椎的轴位 CT 图像上测量骨骼肌的腰围和周长（腹部、腰大肌和椎旁肌肉）。
共确定了 57 名受试者（54%为男性，中位年龄 15.6 岁，61%为西班牙裔，23%为非裔美国人）。25%（14/57）入住 ICU，21%（12/57）需要插管。9%（5/57）死亡。腰围范围在 53.2 至 138.4cm 之间（平均 86.58±18.74cm），骨骼肌质量范围在 0.6 至 6.8cm 之间（平均 3.5±1.19cm）。骨骼肌质量较低与 ICU 入住（优势比（OR）0.4；95%CI 0.17-0.76；p=0.01）和死亡率（OR 0.22；95%CI 0.04-0.69；p=0.01）有单因素关联。在控制合并症后，多变量分析显示出类似的关联（校正后的 OR 0.46；95%CI 0.19-0.95；p=0.04 和校正后的 OR 0.31；95%CI 0.06-0.95；p=0.04，分别）。BMI 或腰围与 ICU 入住时间、机械通气或死亡率之间没有关联。
COVID-19 患儿的骨骼肌质量较低与不良临床病程和结局相关。
