TABLE 3.
Number and direction of associations between body composition abnormalities and clinical outcomes in acute COVID-19 (N = 62 studies).
| Main outcomes | Assessment | Direction of associations |
Summary of findings | ||
|---|---|---|---|---|---|
| Positive | Inverse | Unrelated/mixed | |||
| Mortality | Skeletal muscle (by CT) | — | 11 | 14 | Muscle mass was inversely associated with mortality in 13 of 29 (44.8%) instances |
| Skeletal muscle (by US) | — | 2 | 1 | ||
| Compartments related to muscle mass (by BIA) | — | — | 1 | ||
| Muscle radiodensity (by CT) | — | 6 | 8 | Muscle radiodensity was inversely associated with mortality in 6 of 14 (42.9 %) instances | |
| Muscle echo intensity (by US) | 2 | — | — | Muscle eco intensity was positively associated with mortality in 2 of 2 (100%) instances | |
| Phase angle (by BIA) | — | 3 | 1 | Phase angle was inversely associated with mortality in 3 of 4 (75.0%) instances | |
| FM (by BIA) | 2 | — | — | Adipose tissue and FM were positively associated with mortality in 10 of 26 (38.5%) instances | |
| Adipose tissue (that is, VAT, SAT, TAT, IMAT by CT) | 8 | 3 | 13 | ||
| ICU admission | Skeletal muscle (by CT) | — | 5 | 7 | Muscle mass was inversely associated with ICU admission in 6 of 17 (35.3%) instances |
| Skeletal muscle (by US) | — | 1 | — | ||
| Compartments related to muscle mass (by BIA) | 1 | — | 3 | ||
| Muscle radiodensity (by CT) | — | 3 | 3 | Muscle radiodensity was inversely associated with ICU admission in 3 of 6 (50.0%) instances | |
| Muscle echo intensity (by US) | 1 | — | — | Muscle echo intensity positively associated with mortality in 1 of 1 (100%) instance | |
| Phase angle (by BIA) | — | 2 | 2 | Phase angle was inversely associated with ICU admission in 2 of 4 (50.0%) instances | |
| FM (by BIA) | 1 | 1 | 2 | Adipose tissue and FM were positively associated with ICU admission in 11 of 20 (55.0%) instances | |
| Adipose tissue (that is, VAT, SAT, TAT, IMAT by CT) | 10 | 1 | 5 | ||
| MV/degree of severity | Skeletal muscle (by CT) | — | 7 | 18 | Muscle mass was inversely associated with MV/severity in 7 of 29 (24.1%) instances |
| Skeletal muscle (by US) | — | — | 2 | ||
| Compartments related to muscle mass (by BIA) | — | — | 2 | ||
| Muscle radiodensity (by CT) | — | 7 | 7 | Muscle radiodensity was inversely associated with MV/severity in 7 of 14 (50.0%) instances | |
| Muscle echo intensity (by US) | — | — | 1 | Muscle eco intensity was unrelated/mixed associated with MV/severity in 1 of 1 (100%) instance | |
| Phase angle (by BIA) | — | 1 | 3 | Phase angle was inversely associated with MV/severity in 1 of 4 (25.0%) instances | |
| FM (by BIA) | 2 | 1 | — | Adipose tissue and FM were positively associated with MV/severity in 14 of 30 (46.7%) instances | |
| Adipose tissue (that is, VAT, SAT, TAT, IMAT by CT) | 12 | — | 15 | ||
| Hospitalization/LOS | Skeletal muscle (by CT) | — | 8 | 11 | Muscle mass was inversely associated with hospitalization/LOS in 8 of 24 (33.3%) instances |
| Skeletal muscle (by US) | — | — | 1 | ||
| Compartments related to muscle mass (by BIA) | — | — | 4 | ||
| Muscle radiodensity (by CT) | — | 6 | 5 | Muscle radiodensity was inversely associated with hospitalization/LOS in 6 of 11 (54.5%) instances | |
| Muscle echo intensity (by US) | — | — | 1 | Muscle echo intensity was unrelated/mixed associated with hospitalization/LOS in 1 of 1 (100%) instance | |
| Phase angle (by BIA) | — | 2 | 3 | Phase angle was inversely associated with hospitalization/LOS in 2 of 5 (40.0%) instances | |
| FM (by BIA) | 1 | — | 3 | Adipose tissue and FM were positively associated with hospitalization/LOS in 9 of 18 (50.0%) instances | |
| Adipose tissue (that is, VAT, SAT, TAT, IMAT by CT) | 8 | — | 6 | ||
ICU, intensive care unit; IMAT, intra- and intermuscular adipose tissue; LOS, length of hospital stay; MV, mechanical ventilation; SAT, subcutaneous adipose tissue; TAT, total adipose tissue; US, ultrasound; VAT, visceral adipose tissue. The ratio of waist circumference to paravertebral muscle circumference was positively associated with ICU admission in one study [91], which was not included in the summary above due to this measurement significantly differing from other included body composition measures.