Assessment of body composition in adults hospitalized with acute COVID-19: a scoping review

Predictors of Coronavirus disease 2019 in older patients: Exploring body composition and muscle strength

BACKGROUND & AIMS

Evidence underscores the impact of the inflammatory response caused by Coronavirus Disease 2019 (COVID-19) on nutritional status. However, there remains a notable gap in research investigating preexisting alterations in body composition and muscle function as potential risk factors for COVID-19 development. Thus, this study aimed to examine the relationship between abnormalities in body composition and muscle function and the incidence of COVID-19 among older patients.

METHODS

This was a secondary analysis of a cohort study involving older patients. Body composition assessment was estimated using bioelectrical impedance analysis (BIA), and included measurements of fat mass (%), total body water (TBW, %), and appendicular lean soft tissues (ALST/ALSTI: ALST normalized to height2). Muscle function was evaluated through the handgrip strength (HGS) test. Data on COVID-19 status were collected through telephone interviews with patients or their immediate relatives, after 12-24 months after hospital discharge.

RESULTS

This analysis included 120 subjects (59.1 % males, median age: 69 years old). Higher values of fat mass (%) independently predicted COVID-19 infection (HR adjusted 1.11, 95 % CI 1.04 to 1.18, P = 0.003). We also observed a trend indicating that higher TBW% was associated with a potential lower hazard for COVID-19 infection (HR adjusted 0.94, 95 % CI 0.89 to 1.01, P = 0.08). ALST, ALSTI, and HGS were not associated with a higher hazard for COVID-19 infection (all P-values >.05).

CONCLUSION

This study demonstrates the relevance of addressing excess body fat in older patients to potentially mitigate the risk of COVID-19 infection.

Changes in Body Composition During Intensive Care Unit Stay and Outcomes in Patients with Severe COVID-19 Pneumonia: A Retrospective Cohort Study

This single-center retrospective observational study investigated the association between changes in body composition during hospitalization and outcomes in patients with severe coronavirus disease (COVID-19) pneumonia. Body composition was assessed using chest computed tomography (CT) within 3 days of intensive care unit admission and follow-up CT within 14 days. The study population comprised 89 adult patients, among whom 57 survived. The median APACHE II score on admission was 16. Initial CT scans showed that the iliopsoas muscle volume, sum of the pectoralis major and minor muscle areas, and erector spinae muscle (ESM) area were significantly larger in survivors than in non-survivors (p = 0.019, 0.011, and 0.001, respectively). Subcutaneous fat tissue (SAT) volume was higher in survivors (p = 0.003), and the rate of change in the SAT volume was lower in survivors (p = 0.043). Multivariate logistic regression analysis revealed that a high APACHE II score (OR: 0.834, 95% CI: 0.741-0.938, p = 0.002) and small ESM area (OR: 1.001, 95% CI: 1.000-1.002, p = 0.031) were independent predictors of mortality. In conclusion, the loss of supporting respiratory muscles, particularly ESM, may play a critical role beyond general acute sarcopenia, and the preserved SAT in non-survivors may reflect abnormal glucose metabolism due to severe inflammation.