Muscle area loss in critically ill COVID-19 patients during the first two weeks of ICU admission

Abstract

Introduction Critically ill patients commonly experience significant muscle area loss, up to around 18% within ten days. The dynamics of muscle area changes during ICU stays and after discharge in COVID-19 patients are not well understood, and conventional risk factors may vary in this population.

Methods In this retrospective Dutch cohort study at Amsterdam University Medical Centre, individuals diagnosed with COVID-19 from March 2020 to April 2022 were enrolled from the Amsterdam UMC COVID-19 Biobank. Muscle area at level Th12 was measured using thoracic CT scans conducted due to evolving COVID-19 understanding. A multiple regression analysis in SPSS with key variables (sex, age, BMI category, APACHE IV score) explored associations with muscle area loss during the first 10–18 days of ICU admission.

Results The study included 34 patients; 26.5% were female. Body weight distribution: 2.9% underweight, 32.4% normal weight, 47.1% overweight, and 17.6% obese. Average age at ICU admission was 61.9 years (SD 11.7). Mean muscle area at admission was 93.3 cm² (SD 18.9), with an average loss of 10.3 cm² (SD 6.68) during the first 10–18 days of ICU admission, representing 11.0% reduction. All four variables added not statistically significantly to the prediction (p = 0.360). None of the four variables significantly predicted muscle area loss, p < 0.05.

Conclusion Critically ill COVID-19 patients suffer muscle wasting and have a mean muscle area loss of 10.3 cm2 during the first two weeks of ICU admission, representing 11.0% reduction. This study found no statistically significant predictions of muscle area loss during the first two weeks of ICU admission based on sex, age, BMI category or APACHE IV score.