Chest CT-Derived Muscle Analysis in COVID-19 Patients

Background: sarcopenia is a predictor of unfavorable outcomes, but its prognostic impact on patients with COVID-19 is not well known. To evaluate the association between the chest computed tomography (CT) derived muscle analysis of sarcopenia and clinical-radiological outcomes in coronavirus disease 2019 (COVID-19). Methods: in this retrospective study were revised the medical records of patients admitted to the intensive care unit (ICU) and intubated for COVID-19. All patients had undergone chest CT scan prior to intubation, and the cross-sectional areas of the pectoralis muscles (PMA, cm(2)) and density (PMD, HU) were measured at the level of the fourth thoracic vertebral. The relationship between PMA and PMD and CT severity pneumonia, length of ICU, extubation failure/success, and mortality were investigated. Results: a total of 112 patients were included (82 M; mean age 60.5 +/- 11.4 years). Patients with successful extubation had higher PMA compared to patients with failure extubation, 42.1 +/- 7.9 vs. 37.8 +/- 6.4 cm(2) (p = 0.0056) and patients with shorter ICU had higher PMA and PMD compared to those with longer, respectively, 41.6 +/- 8.7 vs. 37.2 +/- 6.7 cm(2) (p = 0.0034) and 30.2 +/- 6.2 vs. 26.1 +/- 4.9 HU (p = 0.0002). No statistical difference in PMA and PMD resulted in CT severity pneumonia and mortality. Conclusion: sarcopenia in COVID-19 patients, evaluated by CT-derived muscle analysis, could be associated with longer ICU stay and failure extubation.