Open AccessReduced muscle mass as predictor of intensive care unit hospitalization in COVID-19 patients
Author(s) -
Chiara Giraudo,
Giovanni Librizzi,
Giulia Fichera,
Raffaella Motta,
Elisabetta Balestro,
Fiorella Calabrese,
Giovanni Carretta,
Anna Maria Cattelan,
Paolo Navalesi,
Michela Pelloso,
Mario Plebani,
Federico Rea,
Roberto Vettor,
Andrea Vianello,
Roberto Stramare
Publication year - 2021
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0253433
Subject(s) - medicine , intensive care unit , hounsfield scale , body mass index , covid-19 , surgery , computed tomography , disease , infectious disease (medical specialty)
Purpose To evaluate if reduced muscle mass, assessed with Computed Tomography (CT), is a predictor of intensive care unit (ICU) hospitalization in COVID-19 patients. Methods In this Institution Review Board approved study, we retrospectively evaluated COVID-19 patients treated in our tertiary center from March to November 2020 who underwent an unenhanced chest CT scan within three weeks from hospitalization.We recorded the mean Hounsfield Unit (Hu) value of the right paravertebral muscle at the level of the 12 th thoracic vertebra, the hospitalization unit (ICU and COVID-19 wards), clinical symptoms, Barthel Index, and laboratory findings.Logistic regression analysis was applied to assess if muscle loss (Hu<30) is a predictor of ICU admission and outcome.Fisher’s exact and Student’s tests were applied to evaluate if differences between patients with and without muscle loss occurred (p<0.05). Results One-hundred-fifty patients matched the inclusion criteria (46 females; mean age±SD 61.3±15 years-old), 36 treated in ICU. Patients in ICU showed significantly lower Hu values (29±24 vs 39.4±12, p = 0.001). Muscle loss was a predictor of ICU admission (p = 0.004).Patients with muscle loss were significantly older (73.4±10 vs 56.4±14 years), had lower Barthel Index scores (54.4±33 vs 85.1±26), red blood-cell count (3.9±1 vs 4.6±1 ×10 12 L −1 ), and Hb levels (11.5±2 vs 13.2±2 g/l ) as well as higher white blood-cell count (9.4±7 vs 7.2±4 ×10 9 L −1 ), C-reactive protein (71.5±71 vs 44±48 U/L ), and lactate dehydrogenase levels (335±163 vs 265.8±116 U/L ) (p<0.05, each). Conclusions Muscle loss seems to be a predictor of ICU hospitalization in COVID-19 patients and radiologists reporting chest CT at admission should note this finding in their reports.