AUTHOR=Xu Ying , Xu Jia-wen , You Peng , Wang Bing-Long , Liu Chao , Chien Ching-Wen , Tung Tao-Hsin 

TITLE=Prevalence of Sarcopenia in Patients With COVID-19: A Systematic Review and Meta-Analysis

JOURNAL=Frontiers in Nutrition

VOLUME=9

YEAR=2022

URL=https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2022.925606

DOI=10.3389/fnut.2022.925606

ISSN=2296-861X

ABSTRACT=<sec><title>Background</title><p>It has been speculated that patients with sarcopenia are aggravated by the current novel coronavirus disease 2019 (COVID-19) epidemic. However, there is substantial uncertainty regarding the prevalence of sarcopenia in patients with COVID-19.</p></sec><sec><title>Objectives</title><p>The purpose of the study was to systematically evaluate the prevalence of sarcopenia in patients with COVID-19, including stratification by gender, study location, study population, study design, and diagnostic criteria.</p></sec><sec><title>Design</title><p>This is the systematic literature review and meta-analysis.</p></sec><sec><title>Methods</title><p>An electronic search was performed in MEDLINE/PubMed, Embase, Cochrane Library, and Web of Science and Scopus to identify observational studies reporting a prevalence estimate for sarcopenia in patients with COVID-19. Studies were reviewed in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines and a meta-analysis was performed. Risk of bias (RoB) was assessed using the Newcastle–Ottawa Scale (NOS) for cohort studies and Joanna Briggs Institute (JBI) manual for cross-sectional studies, and Stata 14.0 was used to perform meta-analyses.</p></sec><sec><title>Results</title><p>A total of 4,639 studies were initially identified. After removing the duplicates and applying the selection criteria, we reviewed 151 full-text studies. A total of 21 studies, including 5,407 patients, were eligible for inclusion in this review finally. The prevalence of sarcopenia in patients with COVID-19 in individual studies varied from 0.8 to 90.2%. The pooled prevalence of sarcopenia in COVID-19 was 48.0% (95% confidence interval, CI: 30.8 to 65.1%, <italic>I</italic><sup>2</sup> = 99.68%, <italic>p</italic> = 0.000). We did not find any significant differences in the prevalence estimates between gender specificity (OR = 1.34; 95% CI = 0.80–2.26; <italic>p</italic> = 0.001). By sex, the prevalence was 42.5% (95% CI: 31.7 to 53.4%) in men and 35.7% (95% CI: 24.2 to 47.2%) in women. The prevalence estimates significantly varied based on population settings and different diagnostic criteria of sarcopenia. ICU patients (69.7, 95% CI: 51.7 to 85.2%) were more likely to suffer from sarcopenia compared to other population settings.</p></sec><sec><title>Conclusion</title><p>To our knowledge, this is the first meta-analysis reporting on the prevalence of sarcopenia in patients with COVID-19. Sarcopenia is frequently observed in patients with COVID-19, with varying prevalence across population settings. This study would be useful for clinicians to prompt the increasing awareness of identifying sarcopenia and developing interventions at patients with COVID-19 with high risk of sarcopenia. Further prospective longitudinal studies to define the association of sarcopenia and its prognostic outcomes in COVID-19 survivors are urgently needed to propose the most appropriate treatment strategies during their admission and discharge.</p></sec><sec><title>Systematic Review Registration</title><p>[<ext-link ext-link-type="uri" xlink:href="http://www.crd.york.ac.uk/prospero/" xmlns:xlink="http://www.w3.org/1999/xlink">www.crd.york.ac.uk/prospero/</ext-link>], identifier [CRD42022300431].</p></sec>