Association between thoracic density and area with COVID-19 outcomes

Background The relationship between sarcopenia and the consequences of COVID-19 is not yet fully understood. It is noteworthy that information about muscle status can be easily retrieved by segmenting specific regions of skeletal muscles on CT scans. Our aim in this study was to investigate the relationship between sarcopenia and the consequences of COVID-19. Methods In this analytical cross-sectional study, 338 patients with COVID-19 who had a positive PCR test for COVID-19 and underwent chest CT scan in Loghman-e-Hakim Hospital from July to September 2021 were evaluated. Age, sex, background diseases, mechanical ventilation, duration of hospitalization, as well as lab tests, ICU admission and mortality were extracted from patient records. The severity of COVID-19 disease and the area and density of paraspinal muscles at the level of T5 and T12 vertebrae were evaluated through chest CT scans. Results Length of stay had significant relationship with T5 density (1.15 (< 0.001)) and T12 density (1.24 (< 0.001). The mean of T12 area (3.35 (P = 0.005) and T12 density 4.59 (P = 0.012) were significantly lower in ICU admitted. There was a significant relationship between mortality and age, cardiovascular disorders, COPD, underlying disease, length of stay, WBC and lymphocyte levels, as well as the severity of the disease. Conclusions Based on the results of this study, we can infer that the use of CT scan in patients with COVID-19 and the determination of muscle area and density can predict the consequences of COVID-19, such as a longer duration of hospitalization, the need for admission to the ICU, and mortality.