Sonographic assessment of low muscle quantity identifies mortality risk during COVID‐19: a prospective single‐centre study

Publication type:
Journal article
Metadata:
Abstract
<jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>Assessment of muscle quantity by sonographic muscle indices could help identify patients at risk for fatal outcome during coronavirus disease‐2019 (COVID‐19). The aim of this study was to explore sonographic muscle indices as predictors of COVID‐19 outcome and to test the feasibility of sonographic muscle measurement in an isolation context.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Muscle indices, derived from the psoas muscle or thigh muscles, were quantified by sonography in a cohort of patients without COVID‐19 to obtain reference values for low muscle quantity. Gender‐specific median of different muscle indices were defined as threshold value for low muscle quantity. The prognostic relevance of low muscle quantity, was prospectively explored in two cohorts of hospitalized COVID‐19 patients. Optimal muscle index cutoff values predictive for 30 day mortality during COVID‐19 were determined by receiver operating characteristic‐area under the curve and Youden index calculation. Muscle quantity and known prognostic factors of COVID‐19 were analysed by multivariable log‐regression.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Compared with other muscle indices, the psoas muscle area index (PMAI) showed the most favourable characteristics to predict outcome of COVID‐19 disease. Sonographic morphometry of patients without COVID‐19 (<jats:italic>n</jats:italic> = 136) revealed a gender‐specific median for PMAI (male: 291.1 mm<jats:sup>2</jats:sup>/m<jats:sup>2</jats:sup>, female 260.6 mm<jats:sup>2</jats:sup>/m<jats:sup>2</jats:sup>) as threshold value of low muscle quantity. Subsequently, COVID‐19 patients (Cohort I: <jats:italic>n</jats:italic> = 58; Cohort II: <jats:italic>n</jats:italic> = 55) were prospectively assessed by bedside sonography. The studied COVID‐19 patients developed a critical course of disease in 22.4% (Cohort I: <jats:italic>n</jats:italic> = 13/58) and 34.5% (Cohort II: <jats:italic>n</jats:italic> = 20/55). Mortality rate reached 12.1% (Cohort I: <jats:italic>n</jats:italic> = 7/58) and 20.0% (Cohort I: <jats:italic>n</jats:italic> = 11/55) within 30 days of follow up. COVID‐19 patients with a PMAI below the gender‐specific median showed a higher 30 day mortality in both COVID‐19 cohorts (log rank, <jats:italic>P</jats:italic> &lt; 0.05). The optimal PMAI cutoff value (206 mm<jats:sup>2</jats:sup>/m<jats:sup>2</jats:sup>) predicted 30 day mortality of hospitalized COVID‐19 patients with a sensitivity of 72% and specificity of 78.5% (receiver operating characteristic‐area under the curve: 0.793, 95% confidence interval 0.671–0.914, <jats:italic>P</jats:italic> = 0.008). Multivariable log‐regression analysis of PMAI, age, gender, BMI and comorbidities confirmed an independent association of low PMAI with 30 day mortality of COVID‐19 patients (<jats:italic>P</jats:italic> = 0.018).</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Sonographic morphometry provides reliable muscle quantification under hygienic precautions and allows risk stratification of patients with COVID‐19.</jats:p></jats:sec>
Autoren
  • Wolfgang M Kremer
  • Christian Labenz
  • Robert Kuchen
  • Ingo Sagoschen
  • Marc Bodenstein
  • Oliver Schreiner
  • Marcus A Wörns
  • Visvakanth Sivanathan
  • Arndt Weinmann
  • Peter R Galle
  • Martin F Sprinzl
DOI
10.1002/jcsm.12862
eISSN
2190-6009
ISSN
2190-5991
Ausgabe der Veröffentlichung
1
Zeitschrift
Journal of Cachexia, Sarcopenia and Muscle
Sprache
en
Online publication date
2021
Paginierung
169 - 179
Datum der Veröffentlichung
2022
Status
Published
Herausgeber
Wiley
Herausgeber URL
http://dx.doi.org/10.1002/jcsm.12862
Datum der Datenerfassung
2023
Titel
Sonographic assessment of low muscle quantity identifies mortality risk during COVID‐19: a prospective single‐centre study
Ausgabe der Zeitschrift
13

Data source: Crossref

Other metadata sources:
Author's licence
CC-BY-NC
Autoren
  • Wolfgang M Kremer
  • Christian Labenz
  • Robert Kuchen
  • Ingo Sagoschen
  • Marc Bodenstein
  • Oliver Schreiner
  • Marcus-Alexander Wörns
  • Visvakanth Sivanathan
  • Arndt Weinmann
  • Peter R Galle
  • Martin F Sprinzi
Hosting institution
Universitätsbibliothek Mainz
Sammlungen
  • JGU-Publikationen
Resource version
Published version
DOI
10.1002/jcsm.12862
File(s) embargoed
false
Open access
true
ISSN
2190-6009
Ausgabe der Veröffentlichung
1
Zeitschrift
Journal of cachexia, sarcopenia and muscle
Schlüsselwörter
  • 610 Medizin
  • 610 Medical sciences
Sprache
eng
Open access status
Open Access
Paginierung
169 - 179
Datum der Veröffentlichung
2022
Public URL
https://openscience.ub.uni-mainz.de/handle/20.500.12030/8493
Herausgeber
Wiley
Datum der Datenerfassung
2022
Datum, an dem der Datensatz öffentlich gemacht wurde
2022
Zugang
Public
Titel
Sonographic assessment of low muscle quantity identifies mortality risk during COVID-19 : a prospective single-centre study
Ausgabe der Zeitschrift
13

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