Measurement of chest muscle mass in COVID-19 patients on mechanical ventilation using tomography

Background: Sarcopenia, characterized by a reduction in skeletal muscle mass and function, is a prevalent complication in the Intensive Care Unit (ICU) and is related to increased mortality. This study aims to determine whether muscle and fat mass measurements at the T12 and L1 vertebrae using chest tomography can predict mortality among critically ill COVID-19 patients requiring invasive mechanical ventilation (MV). Methods: Fifty-one critically ill COVID-19 patients on MV underwent chest tomography within 72 h of ICU admission. Muscle mass was measured using the Core Slicer program. Results: After adjustment for potential confounding factors related to background and clinical parameters, a 1-unit increase in muscle mass, subcutaneous, and intra-abdominal fat mass at the L1 level was associated with approximately 1–2% lower odds of negative outcomes and in-hospital mortality. No significant association was found between muscle mass at the T12 level and patient outcomes. Furthermore, no significant results were observed when considering a 1-standard deviation increase as the exposure variable. Conclusion: Measuring muscle mass using chest tomography at the T12 level does not effectively predict outcomes for ICU patients. However, muscle and fat mass at the L1 level may be associated with a lower risk of negative outcomes. Additional studies should explore other potential markers or methods to improve prognostic accuracy in this critically ill population.