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. 2022 Apr 20:9:837719.
doi: 10.3389/fnut.2022.837719. eCollection 2022.

Function Over Mass: A Meta-Analysis on the Importance of Skeletal Muscle Quality in COVID-19 Patients

Flaydson Clayton Silva Pinto  1 , Márcia Fábia Andrade  1   2 , Guilherme Henrique Gatti da Silva  1   3 , Jaline Zandonato Faiad  1 , Ana Paula Noronha Barrére  1 , Renata de Castro Gonçalves  1 , Gabriela Salim de Castro  1   2 , Marília Seelaender  1
Affiliations

Function Over Mass: A Meta-Analysis on the Importance of Skeletal Muscle Quality in COVID-19 Patients

Flaydson Clayton Silva Pinto et al. Front Nutr. .

Abstract

COVID-19 caused by SARS-CoV-2 infection is a highly contagious disease affecting both the higher and lower portions of the respiratory tract. This disease reached over 265 million people and has been responsible for over 5.25 million deaths worldwide. Skeletal muscle quality and total mass seem to be predictive of COVID-19 outcome. This systematic review aimed at providing a critical analysis of the studies published so far reporting on skeletal muscle mass in patients with COVID-19, with the intent of examining the eventual association between muscle status and disease severity. A meta-analysis was performed to evaluate whether skeletal muscle quantity, quality and function were related to disease severity. Systematic reviews and meta-analyses were conducted according to the guidelines of the Cochrane Handbook for Systematic Reviews of Interventions and reported according to the guidelines of the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guide. From a total of 1,056 references found, 480 were selected after removing duplicates. Finally, only 7 met the specified inclusion criteria. The results of this meta-analysis showed that skeletal muscle quality, rather than quantity, was associated with COVID-19 severity, as confirmed by lower skeletal muscle density and lower handgrip strength in patients with severe disease. Muscle function assessment can thus be a valuable tool with prognostic value in COVID-19.

Keywords: COVID-19; SARS-CoV-2; coronavirus; disease outcome; muscle density; sarcopenia; skeletal muscle; skeletal muscle index.

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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
The PRISMA flowchart of systematic process.
Figure 2
Figure 2
The Newcastle-Ottawa Scale (NOS).
Figure 3
Figure 3
The forest plot of SMI and survival rate. SD, standard deviation; CI, confidence intervals.
Figure 4
Figure 4
The forest plot of muscle density status and survival rate. SD, standard deviation; CI, confidence intervals; HU, Hounsfield units.
Figure 5
Figure 5
The forest plot of hand grip status and survival rate. *Unpublished data. SD, standard deviation; CI, confidence intervals.
See this image and copyright information in PMC

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