ABSTRACT
BACKGROUND: Sarcopenia is associated with negative outcomes in intensive care unit (ICU) patients and during chronic diseases. We aimed to evaluate if low skeletal muscle index (SMI) measured by computed tomography (CT) at the thoracic level is associated with poor outcomes in hospitalized patients with respiratory COVID-19. METHODS: Patients admitted to the hospital between March 1st and June 9, 2020 with a confirmed diagnosis of respiratory COVID-19 in the Emergency Department were included in this retrospective cohort study. SMI was assessed from a transverse CT image at the T12 level. We analysed the association between thoracic SMI and mortality, ICU admissions, infections, length of stay and gravity scores. RESULTS: We included 244 patients, whose median age was 62 (20-95) years, mean body mass index was 28,6 kg/m2, and 34% were obese patients. 102 patients (41,8%) had low thoracic SMI. On multivariable analysis, low thoracic SMI was associated with more infections (OR = 1,88 [1,06-2,98]) and increased length of stay (OR = 1,87 [1,14-3,49]) but not with mortality (OR = 1.37 [0.54-3.52]), whereas it was inversely associated with ICU admission (OR = 5,56 [1,96-16,67]. CONCLUSION: Low SMI measured by CT at the thoracic level T12 is associated with negative outcomes in patients with respiratory COVID-19.
Subject(s)
COVID-19 , Sarcopenia , Humans , Middle Aged , Retrospective Studies , COVID-19/pathology , Muscle, Skeletal/diagnostic imaging , Muscle, Skeletal/pathology , Sarcopenia/diagnosis , Body Mass IndexABSTRACT
A Gram-negative organism isolated from a btich, in Madagascar, was examined by bacteriologic, immunologic and metabolic methods, in parallel with cultures representative of the Brucella species. The organism fits well into the genus Brucella on the basis of its growth, biochemical and antigenic characteristics and was found to have the metabolic pattern on L-asparagine (-), L-arginine (+) and DL-ornithine (+) that identifies and defines the species Brucella suis. It is of rough colonial morphology and electron microscopy showed a cell wall structure similar to that of other rough Brucella. By all the other recommended criteria for btotype identification it was found to be similar to Brucella suis biotype 5 best known as Brucella canis. In contrast to the strains of this biotype, it grows on basic fuchsin at 20 mug/ml and on safranine O at 200 mug/ml. These differences obtained with just one strain would not justify by now the proposal for a new biotype. We favor the designation Brucella suis biotype 5 proposed by Meyer, and the validity of Brucella canis (Carmichael and Bruner) as a separate species is discussed. It is the first strain of Brucella isolated in Madagascar.
