Istanbul Medeniyet University, Goztepe Prof Dr Suleyman Yalcin City Hospital, Radiology, Istanbul, Turkey.
Istanbul Medeniyet University, Goztepe Prof Dr Suleyman Yalcin City Hospital, Physical Medicine and Rehabilitation, Istanbul, Turkey.
J Musculoskelet Neuronal Interact. 2023 Jun 1;23(2):196-204.
Skeletal muscle area (SMA) at T4 level on chest computed tomography (CT) is a newly available method that can be used as a surrogate sarcopenia marker. The objective of this study is to evaluate association of SMA with adverse COVID-19 outcomes in hospitalized patients.
Hospitalized COVID-19 patients were prospectively recorded in a database containing age, gender, date of admission, date of outcome (discharge, mortality, presence of intensive care unit (ICU) stay, additional coding information (comorbidities, superimposed conditions). Admission CT-scans were retrospectively evaluated for segmentation (bilateral pectoralis major/minor, erector spinae, levator scapulae, rhomboideus minor and major and transversospinalis muscles) and SMA calculation using 3-D slicer software.
167 cases were evaluated (68 male, 72 female, 140 survived, 27 dead). Muscle area was lower in patients with ICU stay (p=0.023, p=0.018, p=0.008) and mortality outcome (p=0.004, p=0.007, p=0.002) for pectoralis, back and SMA. In multivariate Cox-regression analysis, hazard ratio (HR) value for the pectoralis muscle area value below 2800 mm was found to be 3.138(95% CI: 1.171-8.413) for mortality and 2.361(95% CI: 1.012-5.505) for ICU.
Pectoralis muscle area measured at T4 level with 3-D slicer was closely associated with adverse outcomes (mortality, ICU stay) in hospitalized COVID-19 patients. Since early treatment methods for COVID-19 are being evaluated, this method may be a useful adjunct to clinical decision making in regard to prioritization.
胸部 CT 第四胸椎水平骨骼肌面积（SMA）是一种新的可用于替代肌少症标志物的方法。本研究的目的是评估 SMA 与住院 COVID-19 患者不良结局的关系。
前瞻性地将住院 COVID-19 患者记录在包含年龄、性别、入院日期、出院日期、死亡日期、是否入住重症监护病房（ICU）、附加编码信息（合并症、叠加疾病）的数据库中。回顾性评估入院 CT 扫描以进行分割（双侧胸大肌/胸小肌、竖脊肌、肩胛提肌、小菱形肌和大菱形肌以及横突间肌），并使用 3-D slicer 软件计算 SMA。
共评估了 167 例病例（68 例男性，72 例女性，140 例存活，27 例死亡）。在 ICU 入住（p=0.023，p=0.018，p=0.008）和死亡结局（p=0.004，p=0.007，p=0.002）的患者中，胸肌和背部以及 SMA 的肌肉面积较低。多变量 Cox 回归分析显示，胸肌面积值低于 2800mm 的患者死亡风险 HR 值为 3.138（95%CI：1.171-8.413），入住 ICU 的 HR 值为 2.361（95%CI：1.012-5.505）。
使用 3-D slicer 在第四胸椎水平测量的胸肌面积与住院 COVID-19 患者的不良结局（死亡、入住 ICU）密切相关。由于正在评估 COVID-19 的早期治疗方法，该方法可能有助于临床决策，以便优先考虑。
