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评估既往存在的肌肉萎缩、皮下脂肪体积与新型冠状病毒肺炎预后之间的关系。

Assessment of the Relationship between Pre-Existing Muscle Atrophy, Subcutaneous Fat Volume, and the Prognosis of COVID-19.

作者信息

Zarei Fariba, Sepahdar Afrooz, Saeedi-Moghadam Mahdi, Zeinali-Rafsanjani Banafsheh

机构信息

Medical Imaging Research Center, Shiraz University of Medical Sciences, Shiraz 7134814336, Iran.

Department of Radiology, Shiraz University of Medical Sciences, Shiraz 7134845794, Iran.

出版信息

J Clin Med. 2025 Feb 11;14(4):1154. doi: 10.3390/jcm14041154.

Abstract

Coronavirus disease 2019 (COVID-19), with its rapid transmission and emergence, has become a major global public health concern. COVID-19 patients are at an increased risk of acute skeletal muscle loss and complications such as muscular weakness, depression, and anxiety. Furthermore, sarcopenia has been linked to COVID-19 vulnerability, hospitalization rates, and severity. This study aims to investigate the relationship between pre-existing sarcopenia, subcutaneous fat, and the prognosis of COVID-19. Patients over 18 with positive tests who had chest CT scans without underlying conditions were included in this cohort study. The ratio of muscle volume to the total body surface area was calculated. Patients were divided into four subgroups: outpatients, hospitalized, ICU admitted, and deceased. The initial muscle volume for each group was compared. In total, 127 patients were included in the study, 63 (49%) of whom were male. The mean age of the patients was 51.8 ± 18.16 (from 23 to 87 years). In total, 27 patients (21.3%) were treated as outpatients, 49 patients (38.6%) were hospitalized, and 23 (18.1%) were admitted to the ICU. Twenty-eight patients (22%) died. The total muscle/surface area ratio was significantly associated with disease outcome and prognosis. The ratio was significantly lower in dead individuals ( = 0.017). Sarcopenia was discovered to be significantly associated with the severity of COVID-19 and a poor prognosis. Reducing the risk of severe COVID-19 is possible by identifying and managing sarcopenia-related risk factors.

摘要

2019冠状病毒病(COVID-19)传播迅速且不断出现新情况,已成为全球主要的公共卫生问题。COVID-19患者急性骨骼肌丢失及肌肉无力、抑郁和焦虑等并发症的风险增加。此外,肌肉减少症与COVID-19易感性、住院率及严重程度相关。本研究旨在调查既往存在的肌肉减少症、皮下脂肪与COVID-19预后之间的关系。本队列研究纳入了18岁以上、新冠病毒检测呈阳性、进行了胸部CT扫描且无基础疾病的患者。计算肌肉体积与全身表面积的比值。患者被分为四个亚组:门诊患者、住院患者、入住重症监护病房(ICU)患者和死亡患者。比较每组患者的初始肌肉体积。本研究共纳入127例患者,其中63例(49%)为男性。患者的平均年龄为51.8±18.16岁(23至87岁)。共有27例患者(21.3%)接受门诊治疗,49例患者(38.6%)住院,23例(18.1%)入住ICU。28例患者(22%)死亡。肌肉总量/表面积比值与疾病结局和预后显著相关。死亡个体的该比值显著更低(P = 0.017)。研究发现,肌肉减少症与COVID-19的严重程度及不良预后显著相关。通过识别和管理与肌肉减少症相关的风险因素,有可能降低COVID-19重症风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1be/11856798/9b3336855d18/jcm-14-01154-g001.jpg

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