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Reduced muscle mass as predictor of intensive care unit hospitalization in COVID-19 patients.
Giraudo, Chiara; Librizzi, Giovanni; Fichera, Giulia; Motta, Raffaella; Balestro, Elisabetta; Calabrese, Fiorella; Carretta, Giovanni; Cattelan, Anna Maria; Navalesi, Paolo; Pelloso, Michela; Plebani, Mario; Rea, Federico; Vettor, Roberto; Vianello, Andrea; Stramare, Roberto.
  • Giraudo C; Department of Medicine-DIMED, University of Padova, Padova, Italy.
  • Librizzi G; Department of Medicine-DIMED, University of Padova, Padova, Italy.
  • Fichera G; Department of Medicine-DIMED, University of Padova, Padova, Italy.
  • Motta R; Department of Medicine-DIMED, University of Padova, Padova, Italy.
  • Balestro E; Respiratory Disease Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy.
  • Calabrese F; Pathological Anatomy Section, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy.
  • Carretta G; Unità Locale Socio Sanitaria-ULSS 3 Serenissima, Veneto Region, Italy.
  • Cattelan AM; Division of Infectious and Tropical Diseases, Padova University Hospital, Padova, Italy.
  • Navalesi P; Anesthesiology and Intensive Care Unit, Department of Medicine-DIMED, University of Padova, Padova, Italy.
  • Pelloso M; Department of Laboratory Medicine, University Hospital of Padova, Padova, Italy.
  • Plebani M; Department of Laboratory Medicine, University Hospital of Padova, Padova, Italy.
  • Rea F; Thoracic Surgery, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy.
  • Vettor R; Internal Medicine, Department of Medicine-DIMED, University of Padova, Padova, Italy.
  • Vianello A; Respiratory Pathophysiology Division, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy.
  • Stramare R; Department of Medicine-DIMED, University of Padova, Padova, Italy.
PLoS One ; 16(6): e0253433, 2021.
Article in English | MEDLINE | ID: covidwho-1278196
ABSTRACT

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 12th 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±1×1012L-1), and Hb levels (11.5±2 vs 13.2±2g/l) as well as higher white blood-cell count (9.4±7 vs 7.2±4×109L-1), C-reactive protein (71.5±71 vs 44±48U/L), and lactate dehydrogenase levels (335±163 vs 265.8±116U/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.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: SARS-CoV-2 / COVID-19 / Hospitalization / Intensive Care Units / Muscles Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2021 Document Type: Article Affiliation country: Journal.pone.0253433

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Full text: Available Collection: International databases Database: MEDLINE Main subject: SARS-CoV-2 / COVID-19 / Hospitalization / Intensive Care Units / Muscles Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2021 Document Type: Article Affiliation country: Journal.pone.0253433