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

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

JOURNAL=Frontiers in Nutrition

VOLUME=9

YEAR=2022

URL=https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2022.846901

DOI=10.3389/fnut.2022.846901

ISSN=2296-861X

ABSTRACT=<sec><title>Background</title><p>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.</p></sec><sec><title>Methods</title><p>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).</p></sec><sec><title>Results</title><p>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%, <italic>p</italic> = 0.046), abdominal obesity (80.0 vs. 47.6%, <italic>p</italic> = 0.003), dyspnea (32.3 vs. 12.5%, <italic>p</italic> = 0.021) and mobility problems (32.3 vs. 12.5%, <italic>p</italic> = 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], <italic>p</italic> = 0.043) and mobility problems (OR 3.70 [95% C.I. 1.25; 10.95], <italic>p</italic> = 0.018) at 6 months at logistic regression adjusted for sex, age, and BMI.</p></sec><sec><title>Conclusion</title><p>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.</p></sec><sec><title>Clinical Trial Registration</title><p>[<ext-link ext-link-type="uri" xlink:href="https://www.ClinicalTrials.gov" xmlns:xlink="http://www.w3.org/1999/xlink">www.ClinicalTrials.gov</ext-link>], identifier [NCT04318366].</p></sec>