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The effect of pre-existing sarcopenia on outcomes of critically ill patients treated for COVID-19

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31 gen 2025
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Fig. 1.

Flow chart
Flow chart

Effect of sarcopenia on High flow oxygen

Variables Patients with sarcopenian =54 Patients without sarcopenia n = 50 Total n = 104 p
Age, years 69.1 (+/−1) 63.9 (+/−13.4) 66.6(+/−12.4) 0.032
Male, n (%) 42 (77.8) 26 (52) 68 (65.4) 0.006

Comorbidities
Respiratory, n (%) 17 (31.5) 21 (42) 38 (36.5) 0.266
Cardiac, n (%) 19 (35.2) 25 (50) 44 (42.3) 0.127
Renal, n (%) 3 (5.6) 4 (8) 7 (6.7) 0.619
Diabetes, n (%) 18 (33.3) 19 (38) 37 (35.6) 0.619
BMI, kg/m2 27 (+/− 4.9) 32.71 (+/−6.7) 29.8 (+/−6.5) <0.001

CT-Scan variables
Lung damage, n (%):
  Mild (<25%) 17 (31.5) 15 (30) 32 (30.8) 0.795
  Moderate (25–50%) 29 (53.7) 24 (48) 53 (51)
  Severe (50–75%) 7 (13) 9 (18) 16 (15.4)
  Very severe (>75%) 1 (1.9) 2 (4) 3 (2.9)
Pulmonary embolism, n (%) 4 (7.4) 1 (2) 5 (4.8) 0.198

Scores
SAPS II 36.2 (+/−12.8) 28.8 (+/−9.2) 32.6 (+/−11.7) 0.001
SOFA 3.4 (+/−2.1) 2.6 (+/−1.7) 2.9 (+/−1.9) 0.084

Biological parameters on ICU admission
Lymphocytes, G/L 0.9 (+/−0.9) 1.1 (+/− 1.4) 1.0 (+/−1.2) 0.298
Albumin, g/L 29.2 (+/−4.9) 29.5 (+/−3.3) 29.3(+/−4.4) 0.859

Outcomes
Mortality, n (%) 6 (11.1) 4 (8) 10 (9.6) 0,421
Pneumonia, n (%) 1 (1.9) 1 (2) 2 (1.9) 0.733
HFO duration, days 6.8 (+/−4.4) 5 (+/− 2.9) 5.9 (+/−3.8) 0.005
ICU LOS, days 8.2 (+/− 5) 6.3 (+/− 3.1) 7.3 (+/− 4.3) 0.019
Hospital LOS, days 21.8 (+/− 17.6) 17.1 (+/− 14.2) 19.3 (+/−16.1) 0.143

Patients characteristics and outcomes_

Variables Patients with sarcopenia n=75 Patients without sarcopenia n = 75 Total n = 150 p
Age, years 69.6 (+/−10) 64.6 (+/−12.1) 67.1 (+/−11.4) 0.006
Male, n (%) 59 (78) 41 (41) 100 (66.7) 0.002

Comorbidities
Respiratory, n (%) 25 (33) 26 (34.7) 51 (34) 0.863
Cardiac, n (%) 29 (38.7) 39 (52) 68 (45.3) 0.101
Renal, n (%) 6 (8) 10 (13) 16 (10.7) 0.290
Diabetes, n (%) 23 (30.7) 29 (38.7) 52 (34.7) 0.303
Obesity**, n (%) 19 (26) 50 (66.7) 69 (46.6) <0.001
BMI, kg/m2 27.3 (+/−4.7) 33.1 (+/−6.6) 30.3 (+/−6.4) <0.001

CT scan variables
Lung damage, n (%):
  Mild (<25%) 21 (28) 21 (28) 42 (28) 0.050
  Moderate (25–50%) 42 (56) 30 (40) 72 (48)
  Severe (>50%) 12 (16) 24 (32) 36 (24)
Pulmonary embolism, n (%) 5 (6.8) 1 (1.3) 6 (4) 0.102
SMA, cm2 70.5 (+/− 16.6) 93.1 (+/−23.7) 83.3 (+/−23.8) <0.001
SMI, cm2/m2 23.4 (+/− 4.5) 32.7 (+/−6.9) 28.8 (+/−7.5) <0.001

Scores
SAPS II 36.1 (+/−14.7) 33.7 (+/−12.1) 34.9 (+/−13.5) 0.267
SOFA 5.4 (+/−8.1) 3.6 (+/−2.9) 4.34 (+/−5.8) 0.089

Biological parameters on ICU admission
Lymphocytes, G/L 0.84 (+/−0.83) 1.11 (+/− 1.22) 0.97 (+/−1.04) 0.112
Albumin, g/L 27.5 (+/−4.8) 29 (+/−5.3) 28.1 (+/−5.1) 0.266
CRP, mg/L 144.7 (+/− 116.2) 119.5 (+/− 89.3) 131.9 (+/−103.8) 0.155
D-Dimers, μg/L 1889.1 (+/−1632.6) 1291.42 (+/1311.5) 1598.5 (+/1508.5) 0.038
Fibrinogen, mmol/L 6.4 (+/−1.5) 6.9 (+/−1.6) 6.5 (+/−1.6) 0.624

Outcomes
Mortality, n (%) 12 (16) 10 (13.3) 22 (14.7) 0.644
Pneumonia, n (%) 15 (20) 22 (29.3) 37 (24.7) 0.185
MV, n (%) 21 (28) 23 (37.3) 44 (29.3) 0.110
HFO duration, days 5.8 (+/−4.6) 4.0 (+/− 3) 4.9 (+/− 4) 0.005
MV duration, days 6.9 (+/− 9) 9.6 (+/− 12.1) 8.5 (+/−10.9) 0.233
ICU LOS, days 12.1 (+/− 9.7) 13.1 (+/− 12.2) 12.6 (+/− 11) 0.575
Hospital LOS, days 26.9 (+/− 22.8) 24.6 (+/− 20.6) 25.8 (+/− 21.7) 0.509

Effect of sarcopenia in obese patients

Variables Obese patients with sarcopenia n =19 Obese patients without sarcopenia n = 50 Total n = 69 p
Age, years 69.8 (+/−10.5) 63.17 (+/−12.8) 65 (+/−12.5) 0.048
Male, n (%) 14 (73.7) 28 (56) 32 (60.9) 0.179

Comorbidities
Respiratory, n (%) 9 (47.4) 22 (44.0) 31 (44.9) 0.802
Cardiac, n (%) 8 (42.1) 27 (54) 35 (50.7) 0.377
Renal, n (%) 3 (15.8) 10 (20) 13 (18.8) 0.689
Diabetes, n (%) 8 (42.1) 24 (48) 32 (46.4) 0.661
BMI, kg/m2 33.2 (+/− 4.5) 36.3 (+/−5.7) 35.5 (+/−5.6) 0.036

CT scan variables
SMA, cm2 66.4 (+/− 12.1) 99.5 (+/−25) 90.9 (+/−27.3) <0.001
SMI, cm2/m2 23.0 (+/− 7.6) 34.9 (+/−7.4) 31.79 (+/−8.6) <0.001

Scores
SAPS II 35.8 (+/−17.6) 34.1 (+/−11.9) 34.6 (+/−13.6) 0.652
SOFA 7.2 (+/−11.6) 3.8 (+/−2.8) 4.5 (+/−5.8) 0.069

Biological parameters at admission
Lymphocytes, G/L 1.00 (+/−1.4) 1.01 (+/− 0.6) 1.01 (+/−0.9) 0.971
Albumin, g/L 28.8 (+/−6) 28.7 (+/−6) 28.8 (+/−6) 0.94

Outcomes
Mortality, n (%) 4 (21.1) 5 (10) 9 (13) 0.223
Pneumonia, n (%) 6 (31.6) 16 (32) 22 (31.9) 0.973
MV, n (%) 7 (36.8) 18 (36.0) 25 (36.2) 0.984
HFO duration, days 4.6 (+/−3.3) 3.6 (+/− 2.7) 3.9 (+/−2.9) 0.207
MV duration, days 8.0 (+/− 8.1) 11.8 (+/− 13.5) 10.8 (+/−12.4) 0.367
ICU LOS, days 12.5 (+/− 8.7) 14.7 (+/− 14.2) 14.1 (+/− 12.9) 0.518
Hospital LOS, days 263.8 (+/− 22.4) 25.5 (+/− 21.3) 25.1 (+/− 21.5) 0.768

Effect of mechanical ventilation at admission

Variables Mechanical ventilation on admission n =13 No mechanical ventilation on admission n = 137 Total n = 150 p
Age, years 67.1 (+/−11.4) 67.13 (+/−11.4) 67.13(+/−11.3) 0.998
Male, n (%) 6 (46.2) 94 (68.6) 100 (66.7) 0.101

Comorbidities
Respiratory, n (%) 3 (23.1) 48 (35) 51 (34) 0.294
Cardiac, n (%) 6 (46.2) 62 (45.3) 68 (45.3) 0.950
Renal, n (%) 1 (7.7) 15 (10.9) 16 (10.7) 0.584
Diabetes, n (%) 5 (30.8) 48 (35) 52 (34.7) 0.509
Sarcopenia, n (%) 4 (30.8) 71 (51.8) 75 (50) 0.123
BMI, kg/m2 33.1(+/− 8) 30.0 (+/−6.2) 30.3 (+/−6.4) 0.101

CT-Scan variables
Lung damage, n(%):
  Mild (<25%) 3 (23.1) 39 (28.5) 42 (28) 0.062
  Moderate (25–50%) 3 (23.1) 69 (50.4) 72 (48)
  Severe (50–75%) 6 (46.2) 24 (17.5) 30 (20)
  Very severe (>75%) 1 (7.7) 5 (3.6) 6 (4)
Pulmonary embolism, n (%) 0 (0) 6 (4.4) 6 (4) 0.573

Scores
SAPS II 46.8 (+/−18.7) 33.8 (+/−12.1) 34.9 (+/−13.5) 0.001
SOFA 6.0 (+/−4.2) 4.2 (+/−6) 4.3 (+/−5.8) 0.276

Biological parameters at admission
Lymphocytes, G/L 0.96 (+/−0.8) 0.97 (+/− 1.1) 0.97 (+/−1.1) 0.968
Albumin, g/L 28.8 (+/−8.1) 28.0 (+/−4.5) 28.1 (+/−5.1) 0.670

Outcomes
Mortality, n (%) 3 (23.1) 19 (13.9) 22 (14.7) 0.292
Pneumonia, n (%) 11 (84.6) 26 (19) 37 (24.7) <0.001
MV duration, days 19.0 (+/− 9.6) 6.8 (+/− 10.2) 8.5 (+/−10.9) <0.001
ICU LOS, days 23.7 (+/− 13.28) 11.5 (+/− 10.2) 12.6 (+/− 11.0) 0.001
Hospital LOS, days 34.0 (+/− 20.4) 25.0 (+/− 21.7) 25.8 (+/− 21.7) 0.154