The following is a summary of “Intermittent body composition analysis as monitoring tool for muscle wasting in critically ill COVID-19 patients,” published in the July 2023 issue of Critical Care by Kolck et al.

SARS-CoV-2 infection can cause acute respiratory distress syndrome (ARDS), complicated by severe muscle wasting. Limited data on muscle loss in critically ill COVID-19 patients, with available computed tomography (CT) scans for follow-up. Researchers initiated a retrospective study to explore muscle wasting parameters in these patients, pioneering the clinical use of body composition analysis (BCA) as an intermittent monitoring tool.

They performed BCA on 54 patients, involving at least 3 measurements each during hospitalization, resulting in 239 assessments. Alterations in Psoas Muscle Area (PMA) and Total Abdominal Muscle Area (TAMA) were evaluated using Linear Mixed Model analysis. PMA was calculated as the daily muscle loss rate across monitoring and consecutive scans. Cox Regression was utilized for survival associations. Receiver Operating Characteristic (ROC) analysis and Youden Index were applied to establish a deterioration threshold.

The results showed Intermittent BCA unveiled higher long-term PMA loss rates of 2.62% (vs. 1.16%, P< 0.001) and max muscle decay of 5.48% (vs. 3.66%, P=0.039) daily in non-survivors. The initial decay rate didn’t differ significantly between survival groups but was significantly associated with survival in Cox regression (P=0.011). PMA loss averaged over stay had top discriminatory power in ROC analysis (AUC = 0.777). A threshold of 1.84% daily long-term PMA decline was defined; surpassing it proved a significant BCA-derived mortality predictor.

They concluded that CT-based BCA was valuable for monitoring muscle wasting in COVID-19 patients.

Source: annalsofintensivecare.springeropen.com/articles/10.1186/s13613-023-01162-5