Andreas Michael Bucher, Julius Behrend, Constantin Ehrengut, Lukas Müller, Tilman Emrich, Dominik Schramm, Alena Akinina, Roman Kloeckner, Malte Sieren, Lennart Berkel, Christiane Kuhl, Marwin-Jonathan Sähn, Matthias A Fink, Dorottya Móré, Bohdan Melekh, Hakan Kardas, Felix G Meinel, Hanna Schön, Norman Kornemann, Diane Miriam Renz, Nora Lubina, Claudia Wollny, Marcus Both, Joe Watkinson, Sophia Stöcklein, Andreas Mittermeier, Gizem Abaci, Matthias May, Lisa Siegler, Tobias Penzkofer, Maximilian Lindholz, Miriam Balzer, Moon-Sung Kim, Christian Römer, Niklas Wrede, Sophie Götz, Julia Breckow, Jan Borggrefe, Hans Jonas Meyer, Alexey Surov
{"title":"CT-Defined Pectoralis Muscle Density Predicts 30-Day Mortality in Hospitalized Patients with COVID-19: A Nationwide Multicenter Study.","authors":"Andreas Michael Bucher, Julius Behrend, Constantin Ehrengut, Lukas Müller, Tilman Emrich, Dominik Schramm, Alena Akinina, Roman Kloeckner, Malte Sieren, Lennart Berkel, Christiane Kuhl, Marwin-Jonathan Sähn, Matthias A Fink, Dorottya Móré, Bohdan Melekh, Hakan Kardas, Felix G Meinel, Hanna Schön, Norman Kornemann, Diane Miriam Renz, Nora Lubina, Claudia Wollny, Marcus Both, Joe Watkinson, Sophia Stöcklein, Andreas Mittermeier, Gizem Abaci, Matthias May, Lisa Siegler, Tobias Penzkofer, Maximilian Lindholz, Miriam Balzer, Moon-Sung Kim, Christian Römer, Niklas Wrede, Sophie Götz, Julia Breckow, Jan Borggrefe, Hans Jonas Meyer, Alexey Surov","doi":"10.1016/j.acra.2024.11.054","DOIUrl":null,"url":null,"abstract":"<p><strong>Rationale and objectives: </strong>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.</p><p><strong>Materials and methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":50928,"journal":{"name":"Academic Radiology","volume":" ","pages":""},"PeriodicalIF":3.8000,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Academic Radiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.acra.2024.11.054","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
CT-Defined Pectoralis Muscle Density Predicts 30-Day Mortality in Hospitalized Patients with COVID-19: A Nationwide Multicenter Study.
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.
期刊介绍：
Academic Radiology publishes original reports of clinical and laboratory investigations in diagnostic imaging, the diagnostic use of radioactive isotopes, computed tomography, positron emission tomography, magnetic resonance imaging, ultrasound, digital subtraction angiography, image-guided interventions and related techniques. It also includes brief technical reports describing original observations, techniques, and instrumental developments; state-of-the-art reports on clinical issues, new technology and other topics of current medical importance; meta-analyses; scientific studies and opinions on radiologic education; and letters to the Editor.
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