Effects of SARS-CoV-2 on changes in muscle mass and muscle strength in the intensive care unit setting: a single-center, unblinded, prospective study

Abstract

The prevalence of sarcopenia increases in the intensive care unit (ICU) and critically ill patients. In this study, we aimed to evaluate the muscle mass and muscle strength changes in patients diagnosed with coronavirus disease 19 (COVID-19) pneumonia in the ICU setting using anthropometric and ultrasonographic measurements. A total of 30 patients with COVID-19 pneumonia hospitalized in the ICU between June 2021 and December 2021 were included in this single-center, unblinded, prospective study. Thigh circumference and muscle mass of the rectus femoris were measured and anthropometric and ultrasonographic examination were performed. The muscle strength was evaluated using the Medical Research Council (MRC) grading system in non-intubated patients. All measurements were recorded on Days 1, 7, 14, and 21. All patients were followed for 21 days. At the end of 21 days, the muscle mass of the right and left rectus femoris decreased by 47% and 52.8%, respectively based on ultrasonographic examination. In addition, the muscle mass of the right and left rectus femoris decreased by 25.3% and 25.4%, respectively based on anthropometric measurements. The muscle strength of the thigh of the lower limb was evaluated using the MRC scores and each parameter decreased by one unit: the muscle strength was 5/5 at the time of ICU admission, while it regressed to 3/5 at week 2 and 2/5 at week 3. Intensive care unit-acquired weakness (ICU-AW) may develop in critically ill patients with COVID-19 due to the disease itself or treatment methods. A special attention should be paid to accurately assess and treat ICU-AW in this patient population.