Prolonged loss of intercostal muscle mass and its predictors in COVID-19 patients: A retrospective study from tertiary hospital.
Medicine (Baltimore)
; 103(22): e38284, 2024 May 31.
Article
en En
| MEDLINE
| ID: mdl-39259107
ABSTRACT
Sarcopenia is a contributing factor in the development of long-COVID syndrome. We aimed to investigate how intercostal muscle mass changes over 3 months compared to other chest wall muscles following COVID-19 infection, along with identifying factors contributing to intercostal muscle loss during follow-up. We retrospectively studied 110 COVID-19 patients, analyzing muscle masses in the intercostal, pectoralis, and thoracic 12th vertebra level (T12) on initial and follow-up CT scans. Muscle mass was quantitatively assessed using density histogram analysis. We calculated the muscle difference ratio (MDR) as the following formula (initial muscle mass - follow-up muscle mass)/initial muscle mass. Patients were categorized into 2 groups <3 months follow-up (nâ
=â
53) andâ
≥â
3 months follow-up (nâ
=â
57). We employed stepwise logistic regression, using intercostal MDRâ
≥â
25% in follow-up as an independent variable and ageâ
<â
65 years, ventilator use, steroid use, follow-upâ
>â
3 months, hospital stayâ
>â
13 days, body mass indexâ
<â
18.5 kg/m², and female gender as dependent variables. The loss of intercostal muscle was the most severe among the 3 chest wall muscles in the CT follow-up. Intercostal MDR was significantly higher in theâ
≥â
3 months follow-up group compared to theâ
<â
3 months group (32.5â
±â
23.6% vs 19.0â
±â
21.1%, Pâ
=â
.002). There were no significant differences in pectoralis MDR or T12 MDR between the 2 groups. Stepwise logistic regression identified steroid use (3.494 (1.419-8.604), Pâ
=â
.007) and a follow-up periodâ
>â
3 months [3.006 (1.339-6.748), Pâ
=â
.008] as predictors of intercostal MDRâ
≥â
25%. The intercostal muscle wasting was profound compared to that in the pectoralis and T12 skeletal muscles in a follow-up CT scan, and the intercostal muscle wasting was further aggravated after 3 months of COVID-19 infection. The use of steroids and a follow-up period exceeding 3 months were significant predictors forâ
≥â
25% of intercostal muscle wasting in follow-up.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Músculos Intercostales
/
Tomografía Computarizada por Rayos X
/
Sarcopenia
/
Centros de Atención Terciaria
/
COVID-19
Límite:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Medicine (Baltimore)
Año:
2024
Tipo del documento:
Article
País de afiliación:
Corea del Sur
Pais de publicación:
Estados Unidos