Effects of sarcopenia on in-hospital results and mid-term follow-up in patients with coronary artery disease and COVID-19

Year 2024, , 70 - 76, 04.01.2024

Merve Erkan , İsmet Zengin

https://doi.org/10.18621/eurj.1316381

Abstract

Objectives: Sarcopenia is associated with atherosclerosis, vascular dysfunction, and poor in-hospital prognosis in the general COVID-19 population. Coronary artery disease (CAD) is also associated with poor prognosis in patients with COVID-19, however, the influencing factors in this association have not yet been fully documented. This study aimed to evaluate the effect of sarcopenia on both in-hospital acute-term and mid-term follow-up clinical results in patients with CAD and COVID-19.

Methods: The study population was selected from the general COVID-19 population. It consisted of 50 patients with CAD (group I) and 80 age- and gender-matched patients without CAD (group II). In-hospital acute term endpoints were determined as intensive care unit (ICU) admission, intubation, mortality, and its combination. Mid-term follow-up was also made for three-month. Sarcopenia was assessed by indexed skeletal muscle mass at T12 vertebrae level (T12-SMI) on initial chest computed tomography. Multivariable logistic regression analysis was used to detect independently related factors to endpoints.

Results: Group I had more severe COVID-19 disease and a higher rate of hospitalization, ICU admission, intubation as well as mortality compared to group II in acute-term. T12-SMI was lower and sarcopenia was more frequent in group I than in group II. During the three-month mid-term follow-up period, no additional adverse results occurred in both groups. In multivariate regression analysis; sarcopenia was independently related to in-hospital combined endpoint.

Conclusions: Sarcopenia is associated with in-hospital combined endpoint in patients with CAD during acute-term of COVID-19. However, it has no effect on three-month mid-term follow-up.

Keywords

COVID-19, coronary artery disease, sarcopenia

References

• 1. Zhu N, Zhang D, Wang W, et al A Novel Coronavirus from Patients with Pneumonia in China, 2019. N Engl J Med. 2020;382(8):727-733. doi: 10.1056/NEJMoa2001017.
• 2. Scoccia A, Gallone G, Cereda A, et al. Impact of clinical and subclinical coronary artery disease as assessed by coronary artery calcium in COVID-19. Atherosclerosis. 2021;328:136-143. doi: 10.1016/j.atherosclerosis.2021.03.041.
• 3. Angeli F, Marazzato J, Verdecchia P, et al. Joint effect of heart failure and coronary artery disease on the risk of death during hospitalization for COVID-19. Eur J Intern Med. 2021;89:81-86. doi: 10.1016/j.ejim.2021.04.007.
• 4. Zuin M, Rigatelli G, Bilato C, Rigatelli A, Roncon L, Ribichini F. Preexisting coronary artery disease among coronavirus disease 2019 patients: a systematic review and meta-analysis. J Cardiovasc Med (Hagerstown). 2022;23(8):535-545. doi: 10.2459/JCM.0000000000001343.
• 5. Cruz-Jentoft AJ, Bahat G, Bauer J, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16-31. doi: 10.1093/ageing/afy169.
• 6. Beaudart C, McCloskey E, Bruyère O, et al. Sarcopenia in daily practice: assessment and management. BMC Geriatr. 2016;16(1):170. doi: 10.1186/s12877-016-0349-4.
• 7. Bahat G, Ilhan B. Sarcopenia and the cardiometabolic syndrome: a narrative review. Eur Geriatr Med. 2016;6:220-223. doi: 10.1016/j.eurger.2015.12.012.
• 8. Bone AE, Hepgul N, Kon S, Maddocks M. Sarcopenia and frailty in chronic respiratory disease. Chron Respir Dis. 2017;14(1):85-99. doi: 10.1177/1479972316679664.
• 9. Beaudart C, Biver E, Reginster JY, Rizzoli R, Rolland Y, Bautmans I, et al. Validation of the SarQoL(R), a specific health-relate9. Beaudart C, Biver E, Reginster JY, et al. Validation of the SarQoL®, a specific health-related quality of life questionnaire for Sarcopenia. J Cachexia Sarcopenia Muscle. 2017;8(2):238-244. doi: 10.1002/jcsm.12149.d quality of life questionnaire for Sarcopenia. J Cachexia Sarcopenia Muscle 2017;8:238-44.
• 10. De Buyser SL, Petrovic M, Taes YE, et al. Validation of the FNIH sarcopenia criteria and SOF frailty index as predictors of long-term mortality in ambulatory older men. Age Ageing. 2016;45(5):602-608. doi: 10.1093/ageing/afw071.
• 11. Montano-Loza AJ, Meza-Junco J, Prado CM, et al. Muscle wasting is associated with mortality in patients with cirrhosis. Clin Gastroenterol Hepatol. 2012;10(2):166-673. doi: 10.1016/j.cgh.2011.08.028.
• 12. Gu DH, Kim MY, Seo YS, et al. Clinical usefulness of psoas muscle thickness for the diagnosis of sarcopenia in patients with liver cirrhosis. Clin Mol Hepatol. 2018;24(3):319-330. doi: 10.3350/cmh.2017.0077.
• 13. Cawthon PM, Lui LY, Taylor BC, et al. Clinical Definitions of Sarcopenia and Risk of Hospitalization in Community-Dwelling Older Men: The Osteoporotic Fractures in Men Study. J Gerontol A Biol Sci Med Sci. 2017;72(10):1383-1389. doi: 10.1093/gerona/glw327.
• 14. Kim JW, Yoon JS, Kim EJ, Hong HL, Kwon HH, Jung CY, et al. Prognostic implic14. Kim JW, Yoon JS, Kim EJ, et al. Prognostic Implication of Baseline Sarcopenia for Length of Hospital Stay and Survival in Patients With Coronavirus Disease 2019. J Gerontol A Biol Sci Med Sci. 2021;76(8):e110-e116. doi: 10.1093/gerona/glab085.ation of baseline sarcopenia for length of hospital stay and survival in patients with coronavirus disease 2019. J Gerontol A Biol Sci Med Sci 2021;76:e110-6.
• 15. Moctezuma-Velázquez P, Miranda-Zazueta G, et al. Low Thoracic Skeletal Muscle Area Is Not Associated With Negative Outcomes in Patients With COVID-19. Am J Phys Med Rehabil. 2021;100(5):413-418. doi: 10.1097/PHM.0000000000001716.
• 16. Feng Z, Zhao H, Kang W, et al. Association of Paraspinal Muscle Measurements on Chest Computed Tomography With Clinical Outcomes in Patients With Severe Coronavirus Disease 2019. J Gerontol A Biol Sci Med Sci. 2021;76(3):e78-e84. doi: 10.1093/gerona/glaa317.
• 17. China National Health Commission. Diagnosis and Treatment of Pneumonitis Caused by New Coronavirus Avaiable at: http://en.nhc.gov.cn/2020-03/29/c_78469.htm.Accessed May 30,2020.
• 18. Younus S, Maqsood H, Sattar A, Younas A, Shakeel HA. A novel chest CT severity score in COVID-19 and its correlation with severity and prognosis of the lung disease: a retrospective cohort study. Ann Med Surg (Lond) 2022;82:104692.
• 19. Amarasekera AT, Chang D, Schwarz P, Tan TC. Does vascular endothelial dysfunction play a role in physical frailty and sarcopenia? A systematic review. Age Ageing. 2021;50(3):725-732. doi: 10.1093/ageing/afaa237.
• 20. Dvoretskiy S, Lieblein-Boff JC, Jonnalagadda S, Atherton PJ, Phillips BE, Pereira SL. Exploring the Association between Vascular Dysfunction and Skeletal Muscle Mass, Strength and Function in Healthy Adults: A Systematic Review. Nutrients. 2020;12(3):715. doi: 10.3390/nu12030715.