Department of Radiology and Nuclear Medicine, Otto-von-Guericke University Magdeburg (A.S., H.K., M.P.).
Department of Radiology and Nuclear Medicine, Otto-von-Guericke University Magdeburg (A.S., H.K., M.P.).
Acad Radiol. 2023 Jan;30(1):77-82. doi: 10.1016/j.acra.2022.05.003. Epub 2022 May 16.
To evaluate the impact of low skeletal muscle mass in patients with COVID-19 on relevant outcomes like 30-day mortality, need for intubation and need for intensive care unit admission.
For this study, data from six centers were acquired. The acquired sample comprises 1138 patients. There were 547 women (48.1%) and 591 men (51.9%) with a mean age of 54.5 ± 18.8 years; median age, 55 years; range, 18-84 years). In every case, thoracic CT without intravenous application of contrast medium was performed. The following parameters of the pectoralis muscles were estimated: muscle area as a sum of the bilateral areas of the pectoralis major and minor muscles, muscle density, muscle index (PMI) (pectoralis muscle area divided by the patient's body height square) as a ratio pectoralis major and minor muscles divided by the patient's body height, and muscle gauge as PMI x muscle density.
Overall, 220 patients (19.33%) were admitted to the intensive care unit. In 171 patients (15.03%), mechanical lung ventilation was performed. Finally, 154 patients (13.53%) died within the observation time of 30-day. All investigated parameters of pectoralis muscle were lower in the patients with unfavorable courses of Covid-19. All pectoralis muscle parameters were associated with 30-day mortality in multivariate analyses adjusted for age and sex: pectoralis muscle area, HR = 0.93 CI 95% (0.91-0.95) p < 0.001; pectoralis muscle density, HR = 0.94 CI 95% (0.93-0.96) p < 0.001; pectoralis muscle index, HR = 0.79 CI 95% (0.75-0.85) p < 0.001, pectoralis muscle gauge, HR = 0.995 CI 95% (0.99-0.996) p < 0.001.
in COVID-19, survivors have larger areas and higher index, gauge and density of the pectoralis muscles in comparison to nonsurvivors. However, the analyzed muscle parameters cannot be used for prediction of disease courses.
评估 COVID-19 患者低骨骼肌量对 30 天死亡率、气管插管需求和重症监护病房（ICU）入住需求等相关结局的影响。
本研究共纳入来自 6 家中心的数据，样本量为 1138 例患者，其中 547 例为女性（48.1%），591 例为男性（51.9%），平均年龄为 54.5±18.8 岁，中位年龄为 55 岁，年龄范围为 18-84 岁。所有患者均行未静脉应用对比剂的胸部 CT 检查。分别评估胸大肌和胸小肌双侧面积之和（肌肉面积）、肌肉密度、肌肉指数（PMI）（胸大肌和胸小肌面积除以患者身高的平方）、肌肉指标（胸大肌和胸小肌面积除以患者身高）以及 PMI×肌肉密度（肌肉计）作为胸肌参数。
总体而言，220 例（19.33%）患者入住 ICU，171 例（15.03%）患者行机械通气，154 例（13.53%）患者在 30 天观察期内死亡。所有调查的胸肌参数在 COVID-19 不良病程患者中均较低。在调整年龄和性别后的多变量分析中，所有胸肌参数均与 30 天死亡率相关：肌肉面积，HR=0.93（95%CI：0.91-0.95），p<0.001；肌肉密度，HR=0.94（95%CI：0.93-0.96），p<0.001；肌肉指数，HR=0.79（95%CI：0.75-0.85），p<0.001；肌肉计，HR=0.995（95%CI：0.99-0.996），p<0.001。
在 COVID-19 患者中，与非幸存者相比，幸存者的胸肌面积更大，指数、计和密度更高。然而，分析的肌肉参数不能用于预测疾病过程。
