Prognostic Value of Diaphragm Diameter, Muscle Volume, and Bone Mineral Density in Critically Ill COVID-19 Patients


Emekli E., Bostancı Can E. Z.

Journal of Intensive Care Medicine, cilt.38, sa.9, ss.847-855, 2023 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 38 Sayı: 9
  • Basım Tarihi: 2023
  • Doi Numarası: 10.1177/08850666231169494
  • Dergi Adı: Journal of Intensive Care Medicine
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, MEDLINE
  • Sayfa Sayıları: ss.847-855
  • Anahtar Kelimeler: bone mineral density, computed tomography, COVID-19, diaphragm diameter, intensive care unit, muscle volume
  • Eskişehir Osmangazi Üniversitesi Adresli: Hayır

Özet

Objective: We aimed to analyze the prognostic value of muscle volume (MV), bone mineral density (BMD), and diaphragm diameter (DD) in COVID-19. Method: The study included 498 patients admitted to the intensive care unit (ICU) with a positive polymerase chain reaction test for COVID-19 from March 11, 2020, through August 31, 2022. The patients’ laboratory and demographic data of the patients at the time of ICU admission were recorded. MV, DD, and BMD measurements were performed using computed tomography examinations. Muscle index (MI) was calculated as MV/height2. Quartiles were determined for all 4 measurements. Patients in the lowest quartile were recorded as having low MV, MI, DD, and BMD values. The parameters were evaluated for the whole group and compared according to gender and mortality. The multiple regression analysis was performed for the prediction of mortality. Results: In the mortality group, the male and female patients had significantly statistically lower values in MV (P <.001 and P =.002, respectively), MI (P <.001 and P =.005, respectively), DD (P <.001 and P <.001, respectively), and BMD (P =.002 and P <.001, respectively). In the multiple regression analysis, low MI (OR: 2.03, 95% CI: 1.14-3.61, P =.016) and DD (OR: 10.47, 95% CI: 5.59-19.59, P <.001) values remained significant for the prediction of mortality. Conclusion: BMD is a risk factor for mortality in patients with severe COVID-19, but cannot be used as an independent predictor. However, MI and DD can be used as independent predictors of mortality even in severe cases.