Muscle Mass and COVID-19: Exploring the Prognostic Value of Sarcopenia through Psoas Volume Analysis using Artificial Intelligence Technology

<bold>Background:</bold> Sarcopenia is characterized by the loss of skeletal muscle mass and associated disability. While obesity is recognized as a prognostic factor for the coronavirus disease 2019 (COVID-19), the association between sarcopenia and COVID-19 outcomes remains obscure. <bold>Aims:</bold> This study aims to explore the relationship between sarcopenia, as determined by the psoas major muscle volume (PMV), and the prognosis of COVID-19. <bold>Methods:</bold> We conducted a retrospective analysis of patients diagnosed with COVID-19. PMV, measured using the SYNAPSE VINCENT (FUJIFILM Corp, Tokyo, Japan), was adjusted for patient height to derive the PMV index (PMVI). <bold>Results:</bold> The study included 296 patients (117 females), with a median age of 67.5 years (IQR: 53.0-79.0) and a median height of 162.0 cm (152.6-169.6). The median PMV was 239.62 cm³ (173.14-328.82), with a PMVI of 56.89 (46.50-71.85). The survival group comprised 257 patients (104 females), and the deceased group included 39 patients (13 females). Univariate analysis indicated significant differences in age (65.0 vs. 74.0 years), PMV (244.50 vs. 194.94 cm³), and PMVI (59.23 vs. 47.32) (p<0.05). Notable comorbidities were hematologic cancer (6 vs. 5 cases) and hyperlipidemia (78 vs. 5 cases) (p<0.05). Multivariate analysis revealed a significant association of COVID-19 prognosis with PMVI (OR: 0.956, 95% CI 0.928-0.984, p<0.05), hyperlipidemia (OR: 0.212, 95% CI 0.069-0.658, p<0.05), and gender (OR: 0.349, 95% CI 0.148-0.822, p<0.05).<bold>Conclusions:</bold> Our findings indicate that patients in the deceased group had significantly lower PMVI, suggesting that muscle mass loss and sarcopenia could be potential risk factors for COVID-19 mortality.