Unveiling the detrimental vicious cycle linking skeletal muscle and COVID-19: A systematic review and meta-analysis

IF 3.6 2区医学 Q1 MEDICINE, GENERAL & INTERNAL Journal of Evidence‐Based Medicine Pub Date : 2024-07-08 DOI:10.1111/jebm.12629

Qin Wang, Peipei Shi, Lu Cao, Haoran Li, Xiankai Chen, Peiyu Wang, Jianjiang Zhang

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Abstract

Objective

Skeletal muscle catabolism supports multiple organs and systems during severe trauma and infection, but its role in COVID-19 remains unclear. This study investigates the interactions between skeletal muscle and COVID-19.

Methods

The PubMed, EMbase, and The Cochrane Library databases were systematically searched from January 2020 to August 2023 for cohort studies focusing on the impact of skeletal muscle on COVID-19 prevalence and outcomes, and longitudinal studies examining skeletal muscle changes caused by COVID-19. Skeletal muscle quantity (SMQN) and quality (SMQL) were assessed separately. The random-effect model was predominantly utilized for statistical analysis.

Results

Seventy studies with moderate to high quality were included. Low SMQN/SMQL was associated with an increased risk of COVID-19 infection (OR = 1.62, p < 0.001). Both the low SMQN and SMQL predicted COVID-19-related mortality (OR = 1.53, p = 0.016; OR = 2.18, p = 0.001, respectively). Mortality risk decreased with increasing SMQN (OR = 0.979, p = 0.009) and SMQL (OR = 0.972, p = 0.034). Low SMQN and SMQL were also linked to the need for intensive care unit/mechanical ventilation, increased COVID-19 severity, and longer hospital stays. Significant skeletal muscle wasting, characterized by reduced volume and strength, was observed during COVID-19 infection and the pandemic.

Conclusions

This study reveals a detrimental vicious circle between skeletal muscle and COVID-19. Effective management of skeletal muscle could be beneficial for treating COVID-19 infections and addressing the broader pandemic. These findings have important implications for the management of future virus pandemics.

Systematic review registration

PROSPERO CRD42023395476.

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揭示骨骼肌与 COVID-19 之间的有害恶性循环：系统回顾和荟萃分析。

目的：骨骼肌分解代谢在严重创伤和感染期间支持多个器官和系统，但其在 COVID-19 中的作用仍不清楚。本研究调查了骨骼肌与 COVID-19 之间的相互作用：从 2020 年 1 月到 2023 年 8 月，我们在 PubMed、EMbase 和 Cochrane 图书馆数据库中系统检索了有关骨骼肌对 COVID-19 发病率和结果影响的队列研究，以及研究 COVID-19 引起骨骼肌变化的纵向研究。骨骼肌数量（SMQN）和质量（SMQL）分别进行评估。统计分析主要采用随机效应模型：结果：共纳入了 70 项中等至高质量的研究。低SMQN/SMQL与COVID-19感染风险增加有关（OR = 1.62，p 结论：该研究揭示了一种有害的恶性循环：本研究揭示了骨骼肌与 COVID-19 之间的有害恶性循环。对骨骼肌进行有效管理有利于治疗 COVID-19 感染和应对更广泛的流行病。这些发现对未来病毒大流行的管理具有重要意义：系统综述注册：prospero crd42023395476。

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来源期刊

Journal of Evidence‐Based Medicine MEDICINE, GENERAL & INTERNAL-

CiteScore

11.20

自引率

1.40%

发文量

期刊介绍： The Journal of Evidence-Based Medicine (EMB) is an esteemed international healthcare and medical decision-making journal, dedicated to publishing groundbreaking research outcomes in evidence-based decision-making, research, practice, and education. Serving as the official English-language journal of the Cochrane China Centre and West China Hospital of Sichuan University, we eagerly welcome editorials, commentaries, and systematic reviews encompassing various topics such as clinical trials, policy, drug and patient safety, education, and knowledge translation.