Sarcopenia, sarcopenic obesity and the clinical outcome of the older inpatients with COVID-19 infection: a prospective observational study

• Published in: BMC geriatrics Vol. 24; no. 1; pp. 578 - 9
• Main Authors: Zong, Min, Zhao, Anda, Han, Weijia, Chen, Yanqiu, Weng, Tingwen, Li, Shijie, Tang, Lixin, Wu, Jiang
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 04-07-2024; BioMed Central; BMC
• Subjects: Aged; Aged patients; Aged, 80 and over; Body mass index; Cardiovascular disease; Chronic illnesses; Chronic infection; Chronic obstructive pulmonary disease; Complications and side effects; Coronaviruses; COVID-19; COVID-19 - complications; COVID-19 - epidemiology; COVID-19 - mortality; COVID-19 - therapy; COVID-19 infection; Female; Females; Frailty; Geriatric Assessment - methods; Geriatrics; Hospital Mortality - trends; Hospitalization - trends; Hospitals; Humans; Infections; Intubation; Kidney diseases; Lymphocytes; Male; Malnutrition; Medical prognosis; Medical treatment; Mortality; Musculoskeletal system; Nutrition; Obesity; Obesity - complications; Obesity - epidemiology; Obesity - therapy; Observational studies; Older people; Patient outcomes; Patients; Prognosis; Prospective Studies; Sarcopenia; Sarcopenia - epidemiology; Sarcopenia - therapy; Sarcopenic obesity; SARS-CoV-2; Software; Variables; Weight control; China; United States > US; Sarcopenic obesity; Sarcopenia; COVID-19 infection; Intubation; Mortality
• ISSN: 1471-2318; 1471-2318
• DOI: 10.1186/s12877-024-05177-w

We aimed to investigate the impact of sarcopenia and sarcopenic obesity (SO) on the clinical outcome in older patients with COVID-19 infection and chronic disease.
We prospectively collected data from patients admitted to Huadong Hospital for COVID-19 infection between November 1, 2022, and January 31, 2023. These patients were included from a previously established comprehensive geriatric assessment (CGA) cohort. We collected information on their pre-admission condition regarding sarcopenia, SO, and malnutrition, as well as their medical treatment. The primary endpoint was the incidence of intubation, while secondary endpoints included in-hospital mortality rates. We then utilized Kaplan-Meier (K-M) survival curves and the log-rank tests to compare the clinical outcomes related to intubation or death, assessing the impact of sarcopenia and SO on patient clinical outcomes.
A total of 113 patients (age 89.6 ± 7.0 years) were included in the study. Among them, 51 patients had sarcopenia and 39 had SO prior to hospitalization. Intubation was required for 6 patients without sarcopenia (9.7%) and for 18 sarcopenia patients (35.3%), with 16 of these being SO patients (41%). Mortality occurred in 2 patients without sarcopenia (3.3%) and in 13 sarcopenia patients (25.5%), of which 11 were SO patients (28%). Upon further analysis, patients with SO exhibited significantly elevated risks for both intubation (Hazard Ratio [HR] 7.43, 95% Confidence Interval [CI] 1.26-43.90, P < 0.001) and mortality (HR 6.54, 95% CI 1.09-39.38, P < 0.001) after adjusting for confounding factors.
The prevalence of sarcopenia or SO was high among senior inpatients, and both conditions were found to have a significant negative impact on the clinical outcomes of COVID-19 infection. Therefore, it is essential to regularly assess and intervene in these conditions at the earliest stage possible.