Abstract
Aim: The aim of this study was to quantitatively analyze volume of the erector spinae muscle in COVID-19 pneumonia using an artificial intelligence-based automated segmentation program, and to investigate the relationship between pulmonary infiltration ratio and volume of the erector spinae muscle.
Methods: In this retrospective study, thoracic CT images of patients who tested positive for SARS-CoV-2 on RT-PCR and had COVID-19 pneumonia were analyzed. Based on the percentage of pulmonary involvement, the study cohort was divided into two groups (Group I: less than 25% involvement and Group II: more than %25 involvement). Volume of the erector spinae muscle and severity of lung involvement were quantitatively analyzed using an artificial intelligence-based automated segmentation program. The data of group I and group II were compared.
Results: The study population consisted of 74 subjects; 35 in Group I and 39 in Group II. Significant negative correlations were observed between the total pulmonary infiltration ratio and the volume of the erector spinae muscle. Furthermore, the analysis demonstrated that lung density, total lung infiltration volume, serum C-reactive protein (CRP) level, serum ESR level, and total erector spinae muscle volume can serve as valuable indicators for assessing the severity of lung involvement in patients with COVID-19 pneumonia.
Conclusion: Measurement of erector spinae muscle volume may be useful for assessment of pulmonary infiltration in patients with COVID-19 pneumonia
Keywords: Erector spinae muscle volume, COVID-19 pneumonia, pulmonary infiltration, automated segmentation, artificial intelligence
Copyright and license
Copyright © 2023 The Author(s). This is an open-access article published by Bolu İzzet Baysal Training and Research Hospital under the terms of the Creative Commons Attribution License (CC BY) which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is properly cited.
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References
- Wu YC, Chen CS, Chan YJ. The outbreak of COVID-19: An overview. J Chin Med Assoc. 2020; 83(3): 217-20. https://doi.org/10.1097/JCMA.0000000000000270
- Ørskov S, Nielsen BF, Føns S, Sneppen K, Simonsen L. The COVID-19 pandemic: key considerations for the epidemic and its control. APMIS. 2021; 129(7): 408-20. https://doi.org/10.1111/apm.13141
- World Health Organization (WHO). Novel Coronavirus (COVID-19) situation. Available at: https://covid19.who.int (Accessed on June 7, 2023).
- Woloshin S, Patel N, Kesselheim AS. False Negative Tests for SARS-CoV-2 Infection - Challenges and Implications. N Engl J Med. 2020; 383(6): e38. https://doi.org/10.1056/NEJMp2015897
- Fang Y, Zhang H, Xie J, et al. Sensitivity of Chest CT for COVID-19: Comparison to RT-PCR. Radiology. 2020; 296(2): E115-7. https://doi.org/10.1148/radiol.2020200432
- Chung M, Bernheim A, Mei X, et al. CT Imaging Features of 2019 Novel Coronavirus (2019-nCoV). Radiology. 2020; 295(1): 202-7. https://doi.org/10.1148/radiol.2020200230
- Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020; 395(10229): 1054-62. https://doi.org/10.1016/S0140-6736(20)30566-3
- Park MJ, Cho JM, Jeon KN, et al. Mass and fat infiltration of intercostal muscles measured by CT histogram analysis and their correlations with COPD severity. Acad Radiol. 2014; 21(6): 711-7. https://doi.org/10.1016/j.acra.2014.02.003
- Bak SH, Kwon SO, Han SS, Kim WJ. Computed tomography-derived area and density of pectoralis muscle associated disease severity and longitudinal changes in chronic obstructive pulmonary disease: a case control study. Respir Res. 2019; 20(1): 226. https://doi.org/10.1186/s12931-019-1191-y
- Kalafateli M, Karatzas A, Tsiaoussis G, et al. Muscle fat infiltration assessed by total psoas density on computed tomography predicts mortality in cirrhosis. Ann Gastroenterol. 2018; 31(4): 491-98. https://doi.org/10.20524/aog.2018.0256
- Sjøblom B, Grønberg BH, Wentzel-Larsen T, et al. Skeletal muscle radiodensity is prognostic for survival in patients with advanced non-small cell lung cancer. Clin Nutr. 2016; 35(6): 1386-93. https://doi.org/10.1016/j.clnu.2016.03.010
- Namm JP, Thakrar KH, Wang CH, et al. A semi-automated assessment of sarcopenia using psoas area and density predicts outcomes after pancreaticoduodenectomy for pancreatic malignancy. J Gastrointest Oncol. 2017; 8(6): 936-44. https://doi.org/10.21037/jgo.2017.08.09
- Hayashi N, Ando Y, Gyawali B, et al. Low skeletal muscle density is associated with poor survival in patients who receive chemotherapy for metastatic gastric cancer. Oncol Rep. 2016; 35(3): 1727-31. https://doi.org/10.3892/or.2015.4475
- Lo WD, Evans DC, Yoo T. Computed Tomography-Measured Psoas Density Predicts Outcomes After Enterocutaneous Fistula Repair. JPEN J Parenter Enteral Nutr. 2018; 42(1): 176-85. https://doi.org/10.1002/jpen.1028
- Tzeng YH, Wei J, Tsao TP, et al. Computed Tomography-Determined Muscle Quality Rather Than Muscle Quantity Is a Better Determinant of Prolonged Hospital Length of Stay in Patients Undergoing Transcatheter Aortic Valve Implantation. Acad Radiol. 2020; 27(3): 381-88. https://doi.org/10.1016/j.acra.2019.05.007
- Nelke C, Dziewas R, Minnerup J, Meuth SG, Ruck T. Skeletal muscle as potential central link between sarcopenia and immune senescence. EBioMedicine. 2019; 49: 381-88. https://doi.org/10.1016/j.ebiom.2019.10.034
- Moctezuma-Velázquez P, Miranda-Zazueta G, Ortiz-Brizuela E, et al. Low thoracic skeletal muscle area is not associated with negative outcomes in patients with COVID-19. Am J Phys Med Rehabil. 2021; 100(5): 413-8. https://doi.org/10.1097/PHM.0000000000001716
- Erkan M, Atasoy D, Sayan HE, Topal D, Güneş M. Sarcopenia is associated with mortality in patients with COVID-19 independent of other demographic risk factors. The European Research Journal. 2023; 9(2): 73-80. https://doi.org/10.18621/eurj.1056560
- Gil S, Jacob Filho W, Shinjo SK, et al. Muscle strength and muscle mass as predictors of hospital length of stay in patients with moderate to severe COVID-19: a prospective observational study. J Cachexia Sarcopenia Muscle. 2021; 12(6): 1871-8. https://doi.org/10.1002/jcsm.12789
- Moon SW, Choi JS, Lee SH, et al. Thoracic skeletal muscle quantification: low muscle mass is related with worse prognosis in idiopathic pulmonary fibrosis patients. Respir Res. 2019; 20(1): 35. https://doi.org/10.1186/s12931-019-1001-6
- Hocaoglu E, Ors S, Yildiz O, Inci E. Correlation of Pectoralis Muscle Volume and Density with Severity of COVID-19 Pneumonia in Adults. Acad Radiol. 2021; 28(2): 166-72. https://doi.org/10.1016/j.acra.2020.11.017
- Beltrão FEDL, Beltrão DCDA, Carvalhal G, et al. Low muscle mass and high visceral fat mass predict mortality in patients hospitalized with moderate-to-severe COVID-19: a prospective study. Endocr Connect. 2022; 11(10): e220290. https://doi.org/10.1530/EC-22-0290
- Giraudo C, Librizzi G, Fichera G, et al. Reduced muscle mass as predictor of intensive care unit hospitalization in COVID-19 patients. PLoS One. 2021; 16(6): e0253433. https://doi.org/10.1371/journal.pone.0253433
- Bonorino KC, Cani KC. Early mobilization in the time of COVID-19. Rev Bras Ter Intensiva. 2020; 32(4): 484-6. https://doi.org/10.5935/0103-507X.20200086
- Mardani R, Ahmadi Vasmehjani A, Zali F, et al. Laboratory Parameters in Detection of COVID-19 Patients with Positive RT-PCR; a Diagnostic Accuracy Study. Arch Acad Emerg Med. 2020; 8(1): e43.
- Lippi G, Plebani M. Laboratory abnormalities in patients with COVID-2019 infection. Clin Chem Lab Med. 2020; 58(7): 1131-4. https://doi.org/10.1515/cclm-2020-0198
- Wang L. C-reactive protein levels in the early stage of COVID-19. Med Mal Infect. 2020; 50(4): 332-4. https://doi.org/10.1016/j.medmal.2020.03.007
- Chen L, Liu HG, Liu W, et al. Analysis of clinical features of 29 patients with 2019 novel coronavirus pneumonia. Zhonghua Jie He He Hu Xi Za Zhi. 2020; 43(3): 203-8. https://doi.org/10.3760/cma.j.issn.1001-0939.2020.03.013
- Kurt C, Altunçeki Ç Yildirim A. Contribution of Erythrocyte Sedimentation Rate to Predict Disease Severity and Outcome in COVID-19 Patients. Can J Infect Dis Med Microbiol. 2022; 2022: 6510952. https://doi.org/10.1155/2022/6510952
- Demirkol ME, Bilgin S, Kahveci G, et al. C-reactive protein-to-lymphocyte ratio is a reliable marker in patients with COVID-19 infection: the CLEAR COVID study. Cir Cir. 2022; 90(5): 596-601. https://doi.org/10.24875/CIRU.22000124