Evaluation of muscle atrophy in patients with severe covid19 and its relationship with inflammatory factors

Abstract

The available clinical evidence has indicated noticeable changes in the characteristics of the body's muscular system, especially the occurrence of muscle atrophy and changes in the fat tissue around the muscle in patients with covid-19. Also, evidence has shown a possible relationship between the occurrence of muscle atrophy and the activation of inflammatory processes related to the disease of Covid-19. Our aim in this study was to evaluate changes in muscle thickness and fat during the first seven days after being infected with Covid-19 and to evaluate the relationship between these changes and laboratory biomarkers, especially inflammatory markers. Methodology: This study was an analytical cross-sectional study that was conducted on 65 patients with covid-19 hospitalized in the intensive care unit. The follow-up of the patients was that on the first, third and seventh day of hospitalization in ICU, ultrasound of the quadriceps muscle was performed by measuring the muscle thickness by an experienced sonologist. In addition, inflammatory laboratory parameters were also investigated at the time of admission of patients. Results: During the first seven days after being infected with covid-19, a significant decrease in muscle thickness and also in muscle fat tissue was evident among patients requiring hospitalization. The decrease in muscle thickness in these patients had an inverse relationship with the leukocyte count and also with the blood urea and creatinine level. In other words, the occurrence of leukopenia as well as uremia had a strong significant relationship with the occurrence of muscle atrophy in these patients. There was no significant relationship between muscle atrophy in the mentioned patients and the severity of the disease based on the severity of pulmonary involvement. The decrease in the fat-muscle mass of these patients had a significant relationship with the leukocyte count, neutrophil to lymphocyte ratio, as well as the blood urea and creatinin level, and in other words, similar to the changes in muscle thickness, the decrease in fat mass was related to leukopenia and uremia. Less muscle thickness and muscle-fat thickness were seen in patients with keukocytosis and uremia at on the first day of hospitalization