Myosteatosis Significantly Predicts Persistent Dyspnea and Mobility Problems in COVID-19 Survivors

Rebecca De Lorenzo; Anna Palmisano; Antonio Esposito; Chiara Gnasso; Valeria Nicoletti; Riccardo Leone; Davide Vignale; Elisabetta Falbo; Marica Ferrante; Marta Cilla; Cristiano Magnaghi; Sabina Martinenghi; Giordano Vitali; Alessio Molfino; Patrizia Rovere-Querini; Maurizio Muscaritoli; Caterina Conte

doi:10.3389/fnut.2022.846901

Myosteatosis Significantly Predicts Persistent Dyspnea and Mobility Problems in COVID-19 Survivors

Front Nutr. 2022 Apr 8:9:846901. doi: 10.3389/fnut.2022.846901. eCollection 2022.

Authors

Rebecca De Lorenzo^{1

2}, Anna Palmisano^{2

3}, Antonio Esposito^{2

3}, Chiara Gnasso^{2

3}, Valeria Nicoletti^{2

3}, Riccardo Leone^{2

3}, Davide Vignale^{2

3}, Elisabetta Falbo^{1

2}, Marica Ferrante^{1

2}, Marta Cilla¹, Cristiano Magnaghi¹, Sabina Martinenghi¹, Giordano Vitali¹, Alessio Molfino⁴, Patrizia Rovere-Querini^{1

2}, Maurizio Muscaritoli⁴, Caterina Conte^{5

6}

Affiliations

¹ Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy.
² School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.
³ Clinical and Experimental Radiology Unit, Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Milan, Italy.
⁴ Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy.
⁵ Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy.
⁶ Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, Milan, Italy.

Abstract

Background: Persistent symptoms including dyspnea and functional impairment are common in COVID-19 survivors. Poor muscle quality (myosteatosis) associates with poor short-term outcomes in COVID-19 patients. The aim of this observational study was to assess the relationship between myosteatosis diagnosed during acute COVID-19 and patient-reported outcomes at 6 months after discharge.

Methods: Myosteatosis was diagnosed based on CT-derived skeletal muscle radiation attenuation (SM-RA) measured during hospitalization in 97 COVID-19 survivors who had available anthropometric and clinical data upon admission and at the 6-month follow-up after discharge. Dyspnea in daily activities was assessed using the modified Medical Research Council (mMRC) scale for dyspnea. Health-related quality of life was measured using the European quality of life questionnaire three-level version (EQ-5D-3L).

Results: Characteristics of patients with (lowest sex- and age-specific tertile of SM-RA) or without myosteatosis during acute COVID-19 were similar. At 6 months, patients with myosteatosis had greater rates of obesity (48.4 vs. 27.7%, p = 0.046), abdominal obesity (80.0 vs. 47.6%, p = 0.003), dyspnea (32.3 vs. 12.5%, p = 0.021) and mobility problems (32.3 vs. 12.5%, p = 0.004). Myosteatosis diagnosed during acute COVID-19 was the only significant predictor of persistent dyspnea (OR 3.19 [95% C.I. 1.04; 9.87], p = 0.043) and mobility problems (OR 3.70 [95% C.I. 1.25; 10.95], p = 0.018) at 6 months at logistic regression adjusted for sex, age, and BMI.

Conclusion: Myosteatosis diagnosed during acute COVID-19 significantly predicts persistent dyspnea and mobility problems at 6 months after hospital discharge independent of age, sex, and body mass.

Clinical trial registration: [www.ClinicalTrials.gov], identifier [NCT04318366].

Keywords: SARS-CoV-2; dyspnea; long-COVID; myosteatosis; obesity; sarcopenia; skeletal muscle.

Associated data

ClinicalTrials.gov/NCT04318366