TABLE 2.
Body composition abnormalities in patients with COVID-19
| Study | Body compartment analyzed | Technique | Prevalence of body composition abnormalities | Cutoff values used to define abnormalities |
|---|---|---|---|---|
| Beltrao [47] | Muscle mass | CT | Low SMA: 111 of 200 (55.5%) | SMA: <92 cm2 |
| Cornejo-Pareja [48] | Muscle mass | BIA | SPhA quartiles (lowest to highest) | Categorized SPhA into quartiles |
| Q1: 34 of 127 (26.8%) | Q1: lower 25th percentile (<−2) | |||
| Q2: 31 of 127 (24.4%) | Q2: 25th–50th percentile (−1.9 to −0.8) | |||
| Q3: 34 of 127 (26.8%) | Q3: 50th to 75th percentile (−0.7 to 0.2) | |||
| Q4: 28 of 127 (22%) | Q4: >75th percentile (≥0.3) | |||
| Damanti [4] | Muscle mass and radiodensity | CT | Low SMI: 53 of 81 (65.4%) | SMI: specific to each sex and vertebra level according to Derstine et al. [66] |
| Low SMD: 69 of 81 (85.2%) | Low SMD: specific to each vertebra level according to Derstine et al. [66] | |||
| De Lorenzo [72] | Adipose tissue | CT (estimated %BF) | Obese: 12 of 22 (54.5%) | Defined using age- and sex-specific %BF cutoffs [128] |
| Del Giorno [49] | FFM FM Body cell mass |
BIA | At nutritional risk | Defined malnourished when BIA parameters were lower than the 15th percentile |
| Low PhA: 79 of 90 (87.8%) | Low PhA: 4.3° | |||
| Low FFM: 76 of 90 (84.4%) | Low FFM: 27.9 kg/m | |||
| Low FM: 76 of 90 (84.4%) | Low FM: 6.2 kg/m | |||
| Erdöl [50] | Muscle mass | CT | Low SMI: 77 of 232 (33.2%) | Low SMI: data-driven tertiles (specific cutoff values not reported) |
| Favre [20] | Adipose tissue | CT | High VAT: 64 of 165 (38.8%) | High VAT: ≥128.5 cm2 |
| Feng [51] | Muscle mass and radiodensity | CT | Low paraspinal muscle index: Males: 32 of 63 (50.8%) Females: 26 of 53 (49.1%) |
Low paraspinal muscle index: defined using gender-specific medians (values not reported) |
| Low paraspinal SMD: Males: 32 of 63 (50.8%) Females: 27 of 53 (50.9%) |
Low paraspinal SMD: defined using gender-specific medians (values not reported) | |||
| Giraudo [52] | Muscle radiodensity | CT | Low SMD: 43 of 150 (28.7%) | Low SMD: <30 HU |
| Goehlr [70] | Adipose tissue | CT | High VAT: 263 of 378 (69.6%) | High VAT: ≥100 cm2 |
| Kang [53] | Muscle mass and adipose tissue | CT | Low SMI: 103 of 127 (81.1%) | Low SMI at L2 <50 cm2/m2 for males; <39 cm2/m2 for females |
| High VAT:SAT ratio: 40 of 127 (31.5%) | High VAT:SAT ratio: as a proxy of high visceral adiposity >1.33 for males; >0.71 for females |
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| Low SMD: 15 of 127 (11.8%) | Low SMD: as a proxy of myosteatosis <32.7 HU for males; <28.9 for females |
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| Kim [54] | Muscle mass | CT | Low SMI: 29 of 121 (24%) | SMI: ≤24 cm2/m2 for males; ≤20 cm2/m2 for females |
| Koehler [55] | Muscle mass and radiodensity | CT | Low SMI at L3: 83 of 162 (51.2%) | Low SMI at L3: <52.3 cm2/m2 for males; <38.6 cm2/m2 for females (both BMI < 30 kg/m2) 54.3 cm2/m2 for males 46.6 cm2/m2 for females (both BMI > 30 kg/m2) |
| Low SMD at L3: 105 of 162 (64.8%) | Low SMD: <32.5 HU for females; <35.5 HU for males |
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| Kremer [42] | Muscle mass | US | Low psoas muscle area index: Males: 33 of 69 (47.8%) Females: 20 of 44 (45.5%) |
Low psoas muscle area index: Defined using gender-specific median muscle indices from reference cohort I (≤ median) |
| Males: 246.9 mm2/m2 | ||||
| Females: 224.1 mm2/m2 | ||||
| McGovern [56] | Muscle mass and radiodensity | CT | Low SMI: 39 of 63 (62%) | Low SMI: <43 cm2/m2 for males; <41 cm2/m2 for females (both BMI < 25 kg/m2) <53 cm2/m2 for males; SMI <41 cm2/m2 for females (both BMI >25 kg/m2) |
| Low SMD: 51 of 63 (81%) | Low SMD: <41 HU for BMI < 25 kg/m2; <33 HU for BMI ≥ 25 kg/m2) |
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| Adipose tissue | High VAT: 42 of 63 (67%) | VAT: males >160 cm2; females >80 cm2 | ||
| High SAT: 47 of out 63 (75%) | SAT: males >50.0 cm2/m2; females >42.0 cm2/m2) | |||
| Menozzi [41] | Muscle mass | CT | Low SMA: 41.5% (overall) First wave: 88 of 155 (57.9%) Second wave: 25 of 117 (21.6%) |
Low SMA: <92.3 cm2 for males; <56.1 cm2 in females |
| Moctezuma-Velázquez [57] | Muscle mass | CT | Low SMI: 115 of 519 (22.2%) | Low SMI: <42.6 cm2/m2 for males; <30.6 cm2/m2 for females |
| Molwitz [58] | Muscle mass | CT | Low SMI: Prado et al. [68]: Male: 18 of 20 (90%) Female: 6 of 12 (50%) Martin et al. [67]: Male: 17 of 20 (85%) Female: 7 of 12 (58.3%) Werf et al. [69]: Male: 11 of 20 (55%) Female: 3 of 12 (25%) |
Low SMI: specific to each sex and vertebra level according to Prado et al. [68], Martin et al. [67], Werf et al. [69] cutoffs |
| Ogata [6] | Adipose tissue | CT | VAT/TAT: | Defined using data-driven tertiles |
| Lowest: 17 of 53 (32.1%) | Lowest VAT/TAT: ≤48.9% | |||
| Middle: 18 of 53 (34.0%) | Middle VAT/TAT: 49.0% to 66.1% | |||
| Highest: 18 of 53 (34.0%) | Highest VAT/TAT: ≥66.2% | |||
| Osuna-Padilla [59] | Muscle mass | CT | Low SPhA: Nonsurvivors: 24 of 25 (96%) Survivors: 29 of 42 (69%) |
Low SPhA: < −1.65 |
| Osuna-Padilla [40] | Muscle mass | CT | Low SMI: 41 of 86 (48%) | Low SMI: ≤52.3 cm2/m2 for males; ≤38.6 cm2/m2 for females (both BMI < 30 kg/m2) ≤54.3 cm2/m2 for males; ≤46.6 cm2/m2 for females (both BMI > 30 kg/m2) |
| Padilha [60] | Muscle radiodensity | CT | Low SMD: 71 of 200 (35.5%) | Low SMD: <35.5 HU for males; <27.7 HU for females |
| Pediconi [71] | Adipose tissue | CT | VAT-defined obesity: 40 of 62 (64.5%) | VAT-defined obesity: >130 cm2 |
| VAT-defined overweight: 10 of 62 (16.1%) | VAT-defined overweight: 100–129 cm2 | |||
| Stevanovic [73] | FM | BIA | Very high %BF:50.9% | Very high %BF: Males: >25% for ages 20–39; >27.5% for ages 40–59; >30% for ages ≥60 Females: >39.5% for ages 20–39; >40% for ages 40–59; >41.5% for ages ≥60 |
| Ufuk [61] | Muscle mass | CT | Low pectoralis muscle index: Males: 25 of 76 (32.9%) Females: 19 of 54 (35.2%) |
Low pectoralis muscle index: smallest tertile of height-square adjusted pectoralis area values for each sex |
| Watanabe [92] | Adipose tissue | CT | N/R | High VAT: defined using data-driven quartiles |
| Wilkinson [38] | Muscle mass | BIA | Low ALST: ALST index: 8321 of 490,301 (1.7%) ALST/BMI: 8293 of 490,301 (1.7%) Either index: 9342 of 490,301 (1.9%) |
Low ALST (defined using 2 distinct indices): ALST index (ALST/height2): <7.26 kg/m2 for males and <5.45 kg/m2 for females [129] ALST/BMI: <0.789 in males and <0.512 in females [130] High % BF: >25% in men and >35% in women [131]. Sarcopenic obesity: defined as the presence of obesity and low muscle mass (using both ALST index and ALST/BMI definitions) |
| Yang [62] | Muscle radiodensity | CT | Low SMD: 71 of 143 (49.7%) | Low SMD: 32.7 HU in males and 28.9 HU in females |
| Adipose tissue | High VAT/SAT: 72 of 143 (50.3%) | High VAT/SAT: median values of 1.33 for males and 0.71 in females | ||
| Yi [63] | Muscle mass | CT | Low SMI: 78 of 234 (33.3%) | Low SMI: data-driven tertiles (specific cutoff values not reported) |
| Low SDM: 77 of 234 (32.9%) | Low SMD: data-driven tertiles (specific cutoff values not reported) | |||
| Ying-Hao [64] | Muscle mass | CT | Low pectoralis muscle index: 39 of 116 (33.6%) | Low pectoralis muscle index: 16.4 cm2/m2 for males and 13.8 cm2/m2 for females |
ALST, appendicular lean soft tissue; HU, Hounsfield unit; L2, second lumbar vertebra; L3, third lumbar vertebra; N/R, not reported; PhA, phase angle; SAT, subcutaneous adipose tissue; SMA, skeletal muscle area; SMD, skeletal muscle radiodensity; SMI, skeletal muscle index; SPhA, standardized phase angle; TAT, total adipose tissue; VAT, visceral adipose tissue. Note: The study by Watanabe et al. [92] categorized patients into data-driven quartiles of VAT; however, the authors did not specify the final number of patients in each group, so data could not be abstracted here.