CT-Defined Pectoralis Muscle Density Predicts 30-Day Mortality in Hospitalized Patients with COVID-19: A Nationwide Multicenter Study

Bucher AM, Behrend J, Ehrengut C, Müller L, Emrich T, Schramm D, Akinina A, Kloeckner R, Sieren M, Berkel L, Kuhl C, Sähn MJ, Fink MA, Móré D, Melekh B, Kardas H, Meinel FG, Schön H, Kornemann N, Renz DM, Lubina N, Wollny C, Both M, Watkinson J, Stöcklein S, Mittermeier A, Abaci G, May M, Siegler L, Penzkofer T, Lindholz M, Balzer M, Kim MS, Römer C, Wrede N, Götz S, Breckow J, Borggrefe J, Meyer HJ, Surov A (2024)

Publication Type: Journal article

Publication year: 2024

Journal

DOI: 10.1016/j.acra.2024.11.054

Abstract

Rationale and Objectives: The prognostic role of computed tomography (CT)-defined skeletal muscle features in COVID-19 is still under investigation. The aim of the present study was to evaluate the prognostic role of CT-defined skeletal muscle area and density in patients with COVID-19 in a multicenter setting. Materials and Methods: This retrospective study is a part of the German multicenter project RACOON (Radiological Cooperative Network of the COVID-19 pandemic). The acquired sample included 1379 patients, 389 (28.2%) women and 990 (71.8%) men. In each case, chest CT was analyzed and pectoralis muscle area and density were calculated. Data were analyzed by means of descriptive statistics. Group differences were calculated using the Mann–Whitney-U test and Fisher's exact test. Univariable and multivariable logistic regression analyses were performed. Results: The 30-day mortality was 17.9%. Using median values as thresholds, low pectoralis muscle density (LPMD) was a strong and independent predictor of 30-day mortality, HR = 2.97, 95%-CI: 1.52–5.80, p = 0.001. Also in male patients, LPMD predicted independently 30-day mortality, HR = 2.96, 95%-CI: 1.42–6.18, p = 0.004. In female patients, the analyzed pectoralis muscle parameters did not predict 30-day mortality. For patients under 60 years of age, LPMD was strongly associated with 30-day mortality, HR = 2.72, 95%-CI: 1.17;6.30, p = 0.019. For patients over 60 years of age, pectoralis muscle parameters could not predict 30-day mortality. Conclusion: In male patients with COVID-19, low pectoralis muscle density is strongly associated with 30-day mortality and can be used for risk stratification. In female patients with COVID-19, pectoralis muscle parameters cannot predict 30-day mortality.

Authors with CRIS profile

Involved external institutions

Universitätsklinikum Heidelberg Germany (DE) Universitätsklinikum Magdeburg A.ö.R. Germany (DE) Universitätsmedizin Rostock Germany (DE) Medizinische Hochschule Hannover (MHH) / Hannover Medical School Germany (DE) Universitätsklinikum Augsburg Germany (DE) Universitätsklinikum Schleswig-Holstein (UKSH) Germany (DE) Klinikum der Universität München Germany (DE) Charité - Universitätsmedizin Berlin Germany (DE) Universitätsklinikum Essen Germany (DE) Universitätsklinikum Münster Germany (DE) Universitätsklinikum Hamburg-Eppendorf (UKE) Germany (DE) Universitätsklinikum Leipzig Germany (DE) Ruhr-Universität Bochum (RUB) Germany (DE) Universitätsklinikum Aachen (UKA) Germany (DE) Universitätsmedizin der Johannes Gutenberg-Universität Mainz Germany (DE) Universitätsklinikum Halle (Saale) Germany (DE) Universitätsklinikum Frankfurt am Main (KGU) Germany (DE)

How to cite

APA:

Bucher, A.M., Behrend, J., Ehrengut, C., Müller, L., Emrich, T., Schramm, D.,... Surov, A. (2024). CT-Defined Pectoralis Muscle Density Predicts 30-Day Mortality in Hospitalized Patients with COVID-19: A Nationwide Multicenter Study. Academic Radiology. https://doi.org/10.1016/j.acra.2024.11.054

MLA:

Bucher, Andreas Michael, et al. "CT-Defined Pectoralis Muscle Density Predicts 30-Day Mortality in Hospitalized Patients with COVID-19: A Nationwide Multicenter Study." Academic Radiology (2024).

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