Impacto da baixa massa muscular e mioesteatose sobre a mortalidade de pacientes com COVID-19 em hospital do Nordeste brasileiro: coorte retrospectiva

Abstract

Introduction: Changes in muscle mass in patients with COVID-19 may be associated with sarcopenia and unfavourable clinical outcomes. In this context, computed tomography (CT) is an effective gold standard diagnostic technique for evaluating muscle mass, one of the pillars for diagnosing sarcopenia. Objective: To evaluate the impact of low muscle mass and myosteatosis on the mortality of patients with COVID-19 hospitalized in a private hospital in northeastern Brazil during two pandemic periods. Casuistry and Methods: This observational, descriptive, and retrospective cohort study was conducted at Hospital Aliança (Salvador-Bahia) with adult and elderly patients admitted to the unit diagnosed with COVID-19 from May 2020 to March 2021. Patients admitted during the two peak months of the pandemic (June 2020 and March 2021) were selected for muscle mass and myosteatosis assessment using images of the 12th thoracic vertebra (T12) via CT available in the system. Nutritional variables, symptoms related to COVID-19, clinical outcomes, comorbidities, and laboratory tests were collected from the patient's electronic medical records. Results: 1,266 patients were identified, and the quantity and quality of the muscle mass of 277 individuals were evaluated. Low muscle mass and myosteatosis were associated with a higher risk of death in patients hospitalized for COVID-19. Main conclusions: Low muscle mass and myosteatosis are significantly associated with higher mortality in patients with COVID-19, with patients with myosteatosis having a higher relative risk of death (4.19 times).