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

## TL;DR

This study shows that pre-existing sarcopenia in critically ill COVID-19 patients is linked to longer high-flow oxygen use but not to other poor outcomes like ICU mortality.

## Contribution

The study identifies a specific association between sarcopenia and prolonged high-flow oxygenation in critically ill COVID-19 patients.

## Key findings

- Pre-existing sarcopenia was found in 50% of the studied critically ill COVID-19 patients.
- Sarcopenia was associated with longer high-flow oxygenation duration but not with increased ICU mortality or hospital stay.
- No significant differences in outcomes were found between sarcopenic and non-sarcopenic obese patients.

## Abstract

Sarcopenia, defined by a loss of skeletal muscle mass and function, has been identified as a prevalent condition associated with poor clinical outcome among critically ill patients. This study aims to evaluate the impact of pre-existing sarcopenia on outcomes in critically ill patients with acute respiratory failure (ARF) due to COVID-19.

A retrospective study was carried out on COVID-19 patients admitted to intensive care. Pre-existing sarcopenia was assessed using early CT scans. Clinical outcomes, including duration of high-flow oxygenation (HFO), mechanical ventilation (MV), length of hospital stay (LOS) and ICU mortality, were evaluated according to sarcopenia status.

Among the studied population, we found a high prevalence (75 patients, 50%) of pre-existing sarcopenia, predominantly in older male patients. Pre-existing sarcopenia significantly impacted HFO duration (6.8 (+/−4.4) vs. 5 (+/−2.9) days; p=0.005) but did not significantly affect MV requirement (21 (28%) vs. 23 (37.3%); p=185), MV duration (7 vs. 10 days; p=0.233), ICU mortality (12 (16%) vs. 10 (13.3 %); p=0.644) or hospital LOS (27 vs. 25 days; p=0.509). No differences in outcomes were observed between sarcopenic and non-sarcopenic obese patients.

Pre-existing sarcopenia in critically ill COVID-19 patients is associated with longer HFO duration but not with other adverse outcomes. Further research is needed to elucidate the mechanisms and broader impact of sarcopenia on septic critically ill patient outcomes.