Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Apr 8:9:846901.
doi: 10.3389/fnut.2022.846901. eCollection 2022.

Myosteatosis Significantly Predicts Persistent Dyspnea and Mobility Problems in COVID-19 Survivors

Rebecca De Lorenzo  1   2 , Anna Palmisano  2   3 , Antonio Esposito  2   3 , Chiara Gnasso  2   3 , Valeria Nicoletti  2   3 , Riccardo Leone  2   3 , Davide Vignale  2   3 , Elisabetta Falbo  1   2 , Marica Ferrante  1   2 , Marta Cilla  1 , Cristiano Magnaghi  1 , Sabina Martinenghi  1 , Giordano Vitali  1 , Alessio Molfino  4 , Patrizia Rovere-Querini  1   2 , Maurizio Muscaritoli  4 , Caterina Conte  5   6
Affiliations

Myosteatosis Significantly Predicts Persistent Dyspnea and Mobility Problems in COVID-19 Survivors

Rebecca De Lorenzo et al. Front Nutr. .

Abstract

Background: Persistent symptoms including dyspnea and functional impairment are common in COVID-19 survivors. Poor muscle quality (myosteatosis) associates with poor short-term outcomes in COVID-19 patients. The aim of this observational study was to assess the relationship between myosteatosis diagnosed during acute COVID-19 and patient-reported outcomes at 6 months after discharge.

Methods: Myosteatosis was diagnosed based on CT-derived skeletal muscle radiation attenuation (SM-RA) measured during hospitalization in 97 COVID-19 survivors who had available anthropometric and clinical data upon admission and at the 6-month follow-up after discharge. Dyspnea in daily activities was assessed using the modified Medical Research Council (mMRC) scale for dyspnea. Health-related quality of life was measured using the European quality of life questionnaire three-level version (EQ-5D-3L).

Results: Characteristics of patients with (lowest sex- and age-specific tertile of SM-RA) or without myosteatosis during acute COVID-19 were similar. At 6 months, patients with myosteatosis had greater rates of obesity (48.4 vs. 27.7%, p = 0.046), abdominal obesity (80.0 vs. 47.6%, p = 0.003), dyspnea (32.3 vs. 12.5%, p = 0.021) and mobility problems (32.3 vs. 12.5%, p = 0.004). Myosteatosis diagnosed during acute COVID-19 was the only significant predictor of persistent dyspnea (OR 3.19 [95% C.I. 1.04; 9.87], p = 0.043) and mobility problems (OR 3.70 [95% C.I. 1.25; 10.95], p = 0.018) at 6 months at logistic regression adjusted for sex, age, and BMI.

Conclusion: Myosteatosis diagnosed during acute COVID-19 significantly predicts persistent dyspnea and mobility problems at 6 months after hospital discharge independent of age, sex, and body mass.

Clinical trial registration: [www.ClinicalTrials.gov], identifier [NCT04318366].

Keywords: SARS-CoV-2; dyspnea; long-COVID; myosteatosis; obesity; sarcopenia; skeletal muscle.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Chest CT images at the T12 level in two patients with COVID-19 pneumonia. In (A) (30-year-old man), the skeletal muscle area segmented at the T12 level is characterized by normal mass and high mean SM-RA (56.5 HU); in (B) (72-year-old woman), impaired muscle status is evident, with fat infiltration and low mean SM-RA (11.1 HU).
FIGURE 2
FIGURE 2
Proportion of patients with any problems in the EQ-5D dimensions (mobility, self-care, usual activities, pain/discomfort, anxiety/depression) and proportion of patients with dyspnea in the group without (high skeletal muscle radiation attenuation, SM-RA) or with (low SM-RA) myosteatosis. *p = 0.021; **p = 0.004.
See this image and copyright information in PMC

References

    1. Cuerda C, Sanchez Lopez I, Gil Martinez C, Merino Viveros M, Velasco C, Cevallos Penafiel V, et al. Impact of COVID-19 in nutritional and functional status of survivors admitted in intensive care units during the first outbreak. Preliminary results of the NUTRICOVID study. Clin Nutr. (2021). 10.1016/j.clnu.2021.11.017 [Epub ahead of print]. - DOI - PMC - PubMed
    1. Du HW, Fang SF, Wu SR, Chen XL, Chen JN, Zhang YX, et al. Six-month follow-up of functional status in discharged patients with coronavirus disease 2019. BMC Infect Dis. (2021) 21:1271. 10.1186/s12879-021-06970-3 - DOI - PMC - PubMed
    1. Huang C, Huang L, Wang Y, Li X, Ren L, Gu X, et al. 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. Lancet. (2021) 397:220–32. 10.1016/S0140-6736(20)32656-8 - DOI - PMC - PubMed
    1. Charfeddine S, Ibn Hadj Amor H, Jdidi J, Torjmen S, Kraiem S, Hammami R, et al. Long COVID 19 syndrome: is it related to microcirculation and endothelial dysfunction? Insights from TUN-EndCOV study. Front Cardiovasc Med. (2021) 8:745758. 10.3389/fcvm.2021.745758 - DOI - PMC - PubMed
    1. Adeloye D, Elneima O, Daines L, Poinasamy K, Quint JK, Walker S, et al. The long-term sequelae of COVID-19: an international consensus on research priorities for patients with pre-existing and new-onset airways disease. Lancet Respir Med. (2021) 9:1467–78. 10.1016/S2213-2600(21)00286-1 - DOI - PMC - PubMed

Associated data