Bucher Andreas Michael, Behrend Julius, Ehrengut Constantin, Müller Lukas, Emrich Tilman, Schramm Dominik, Akinina Alena, Kloeckner Roman, Sieren Malte, Berkel Lennart, Kuhl Christiane, Sähn Marwin-Jonathan, Fink Matthias A, Móré Dorottya, Melekh Bohdan, Kardas Hakan, Meinel Felix G, Schön Hanna, Kornemann Norman, Renz Diane Miriam, Lubina Nora, Wollny Claudia, Both Marcus, Watkinson Joe, Stöcklein Sophia, Mittermeier Andreas, Abaci Gizem, May Matthias, Siegler Lisa, Penzkofer Tobias, Lindholz Maximilian, Balzer Miriam, Kim Moon-Sung, Römer Christian, Wrede Niklas, Götz Sophie, Breckow Julia, Borggrefe Jan, Meyer Hans Jonas, Surov Alexey
Institute of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany (A.M.B., J.B.).
Department of Radiology, University Hospital of Leipzig, Leipzig, Germany (C.E., H.J.M.).
Acad Radiol. 2025 Apr;32(4):2133-2140. doi: 10.1016/j.acra.2024.11.054. Epub 2024 Dec 15.
The prognostic role of computed tomography (CT)-defined skeletal muscle features in COVID-19 is still under investigation. The aim of the present study was to evaluate the prognostic role of CT-defined skeletal muscle area and density in patients with COVID-19 in a multicenter setting.
This retrospective study is a part of the German multicenter project RACOON (Radiological Cooperative Network of the COVID-19 pandemic). The acquired sample included 1379 patients, 389 (28.2%) women and 990 (71.8%) men. In each case, chest CT was analyzed and pectoralis muscle area and density were calculated. Data were analyzed by means of descriptive statistics. Group differences were calculated using the Mann-Whitney-U test and Fisher's exact test. Univariable and multivariable logistic regression analyses were performed.
The 30-day mortality was 17.9%. Using median values as thresholds, low pectoralis muscle density (LPMD) was a strong and independent predictor of 30-day mortality, HR=2.97, 95%-CI: 1.52-5.80, p=0.001. Also in male patients, LPMD predicted independently 30-day mortality, HR=2.96, 95%-CI: 1.42-6.18, p=0.004. In female patients, the analyzed pectoralis muscle parameters did not predict 30-day mortality. For patients under 60 years of age, LPMD was strongly associated with 30-day mortality, HR=2.72, 95%-CI: 1.17;6.30, p=0.019. For patients over 60 years of age, pectoralis muscle parameters could not predict 30-day mortality.
In male patients with COVID-19, low pectoralis muscle density is strongly associated with 30-day mortality and can be used for risk stratification. In female patients with COVID-19, pectoralis muscle parameters cannot predict 30-day mortality.
计算机断层扫描（CT）定义的骨骼肌特征在新型冠状病毒肺炎（COVID-19）中的预后作用仍在研究中。本研究的目的是在多中心环境中评估CT定义的骨骼肌面积和密度在COVID-19患者中的预后作用。
这项回顾性研究是德国多中心项目RACOON（COVID-19大流行放射学合作网络）的一部分。所采集的样本包括1379例患者，其中女性389例（28.2%），男性990例（71.8%）。对每例患者进行胸部CT分析，并计算胸肌面积和密度。采用描述性统计方法分析数据。使用Mann-Whitney-U检验和Fisher精确检验计算组间差异。进行单变量和多变量逻辑回归分析。
30天死亡率为17.9%。以中位数为阈值，低胸肌密度（LPMD）是30天死亡率的强有力独立预测因素，HR=2.97，95%置信区间：1.52-5.80，p=0.001。在男性患者中，LPMD也能独立预测30天死亡率，HR=2.96，95%置信区间：1.42-6.18，p=0.004。在女性患者中，所分析的胸肌参数不能预测30天死亡率。对于60岁以下的患者，LPMD与30天死亡率密切相关，HR=2.72，95%置信区间：1.17；6.30，p=0.019。对于60岁以上的患者，胸肌参数不能预测30天死亡率。
在男性COVID-19患者中，低胸肌密度与30天死亡率密切相关，可用于风险分层。在女性COVID-19患者中，胸肌参数不能预测30天死亡率。
