Abstract

Introduction: Sarcopenia is common in patients with COVID-19 who are admitted to the ICU. Cross-sectional muscle area measurement calculated from thoracic tomography imaging is a method to evaluate presence of sarcopenia. We aimed to investigate the prognostic value of the muscle and fat tissue volume measurements which are calculated from the chest CT images taken at ICU admission in COVID-19 pneumonia patients, in terms of duration of MV, ICU stay and the rate of mortality.

Methods: After ethical committee approval, adult patients who were admitted to the ICU between August 2020 and February 2021, with positive COVID PCR and respiratory distress were included into the study. Patients with inadequate thorax tomography imaging were excluded. The laboratory parameters, admission APACHEII, SOFA, NUTRIC scores, durations of MV, ICU and hospital stay, rates of mortality at 28 and 90 days were recorded from the hospital data system. Chi-Square Tests, Mann-Whitney U tests, Spearman correlations, multivariate binary logistic regression tests were used for statistical analyses.

Results: A total of 139 patients were included into the analysis. The median duration of mechanical ventilation was 7 days, ICU stay was 17 days, and the 90-day mortality rate was 43%. There were no statistically significant correlations between the measurement of the muscle/fat tissue volume and the NUTRIC score, the durations of the MV, ICU or hospital stay. We found significant correlations between NUTRIC score and the duration of MV (p <0.01, r = 0.364), ICU stay (p = 0.011, r =0.216), the prealbumin value on the 14th day (p<0.01, r=0.496).The NUTRIC score (B=0.558, p.026) and SOFA score (B=0.760, p.001) at admission day were independent predictors of mortality.

Discussion and Conclusion: The measurements of muscle and fat tissue volume from chest CT images don’t have prognostic value for predicting duration of MV, ICU stay and mortality whereas NUTRIC score is a predictor for mortality in critically ill COVID-19 patients.

Keywords: COVID-19, sarcopenia, muscle/fat volume

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Copyright © 2025 The author(s). This is an open access article distributed under the Creative Commons Attribution License (CC BY), which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is properly cited.

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1.
Akıncı SB, Akpınar E, Altın C, Bulut Yüksel ND, Abdurrahimli N. Prognostic value of measurements of cross-sectional muscle area and subcutaneous, mediastinal fat tissue in COVID-19 patients’ thoracic tomography images. Turk J Intensive Care. 2025;23(2):94-103. https://doi.org/10.63729/TJIC.2025.639