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Influence of reduced muscle mass and quality on ventilator weaning and complications during intensive care unit stay in COVID-19 patients.
Damanti, Sarah; Cristel, Giulia; Ramirez, Giuseppe Alvise; Bozzolo, Enrica Paola; Da Prat, Valentina; Gobbi, Agnese; Centurioni, Clarissa; Di Gaeta, Ettore; Del Prete, Andrea; Calabrò, Maria Grazia; Calvi, Maria Rosa; Borghi, Giovanni; Zangrillo, Alberto; De Cobelli, Francesco; Landoni, Giovanni; Tresoldi, Moreno.
  • Damanti S; Unit of General Medicine and Advanced Care, IRCCS San Raffaele Scientific Institute, Italy. Electronic address: damanti.sarah@hsr.it.
  • Cristel G; Department of Radiology, Centre for Experimental Imaging, IRCCS San Raffaele Scientific Institute, Milan, Italy.
  • Ramirez GA; Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy.
  • Bozzolo EP; Unit of General Medicine and Advanced Care, IRCCS San Raffaele Scientific Institute, Italy.
  • Da Prat V; Unit of General Medicine and Advanced Care, IRCCS San Raffaele Scientific Institute, Italy.
  • Gobbi A; Vita-Salute San Raffaele University, Milano, Italy.
  • Centurioni C; Vita-Salute San Raffaele University, Milano, Italy.
  • Di Gaeta E; Department of Radiology, Centre for Experimental Imaging, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milano, Italy.
  • Del Prete A; Department of Radiology, Centre for Experimental Imaging, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milano, Italy.
  • Calabrò MG; Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy.
  • Calvi MR; Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy.
  • Borghi G; Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy.
  • Zangrillo A; Vita-Salute San Raffaele University, Milano, Italy; Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy.
  • De Cobelli F; Department of Radiology, Centre for Experimental Imaging, IRCCS San Raffaele Scientific Institute, Milan, Italy.
  • Landoni G; Vita-Salute San Raffaele University, Milano, Italy; Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy.
  • Tresoldi M; Unit of General Medicine and Advanced Care, IRCCS San Raffaele Scientific Institute, Italy.
Clin Nutr ; 41(12): 2965-2972, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-1356177
ABSTRACT
BACKGROUND &

AIMS:

Sarcopenia, a loss of muscle mass, quality and function, which is particularly evident in respiratory muscles, has been associated with many clinical adverse outcomes. In this study, we aimed at evaluating the role of reduced muscle mass and quality in predicting ventilation weaning, complications, length of intensive care unit (ICU) and of hospital stay and mortality in patients admitted to ICU for SARS-CoV-2-related pneumonia.

METHODS:

This was an observational study based on a review of medical records of all adult patients admitted to the ICU of a tertiary hospital in Milan and intubated for SARS-CoV-2-related pneumonia during the first wave of the COVID-19 pandemic. Muscle mass and quality measurement were retrieved from routine thoracic CT scans, when sections passing through the first, second or third lumbar vertebra were available.

RESULTS:

A total of 81 patients were enrolled. Muscle mass was associated with successful extubation (OR 1.02, 95% C.I. 1.00-1.03, p = 0.017), shorter ICU stay (OR 0.97, 95% C.I. 0.95-0.99, p = 0.03) and decreased hospital mortality (HR 0.98, 95% C.I. 0.96-0.99, p = 0.02). Muscle density was associated with successful extubation (OR 1.07, 95% C.I. 1.01-1.14; p = 0.02) and had an inverse association with the number of complications in ICU (Β -0.07, 95% C.I. -0.13 - -0.002, p = 0.03), length of hospitalization (Β -1.36, 95% C.I. -2.21 - -0.51, p = 0.002) and in-hospital mortality (HR 0.88, 95% C.I. 0.78-0.99, p = 0.046).

CONCLUSIONS:

Leveraging routine CT imaging to measure muscle mass and quality might constitute a simple, inexpensive and powerful tool to predict survival and disease course in patients with COVID-19. Preserving muscle mass during hospitalisation might have an adjuvant role in facilitating remission from COVID-19.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Ventilator Weaning / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study Limits: Adult / Humans Language: English Journal: Clin Nutr Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Ventilator Weaning / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study Limits: Adult / Humans Language: English Journal: Clin Nutr Year: 2022 Document Type: Article