We examined the impact of loss of skeletal muscle mass in post-acute sequelae of SARS-CoV-2 (PASC) infection, hospital readmission rate, self-perception of health, and health care costs in a cohort of COVID-19 survivors.
Prospective observational study.
Setting and Participants
Tertiary Clinical Hospital. Eighty COVID-19 survivors aged 59±14 years were prospectively assessed.
Handgrip strength and vastus lateralis muscle cross-sectional area (CSAVL) were evaluated at hospital admission, discharge, and 6 months after discharge. PASC were evaluated 6 months after discharge (main outcome). Also, health care costs, hospital readmission rate, and self-perception of health were evaluated 2 and 6 months after hospital discharge. To examine whether the magnitude of muscle mass loss impacts the outcomes, we ranked patients according to relative CSAVL reduction during hospital stay into either “high muscle loss” (-18±11%) or “low muscle loss” (-4±2%) group, based on median values.
High muscle loss group showed greater prevalence of fatigue (76% vs. 46%, P=0.0337) and myalgia (66% vs. 36%, P=0.0388), and lower muscle mass (-8% vs. 3%, P < 0.0001) than low muscle loss group 6 months after discharge. No between-group difference was observed for hospital readmission and self-perceived health (P>0.05). High muscle loss group demonstrated greater total COVID-19-related health care costs 2 ($77283.87 vs. $3057.14, P=0.0223, respectively) and 6 months ($90001.35 vs. $12913.27, P=0.0210, respectively) after discharge vs. low muscle loss group. Muscle mass loss was shown to be a predictor of total COVID-19-related health care costs at 2 (adjusted β=$10070.81, P<0.0001) and 6 months after discharge (adjusted β=$9885.63, P<0.0001).
Conclusions and Implications
COVID-19 survivors experiencing high muscle mass loss during hospital stay fail to fully recover muscle health. In addition, greater muscle loss was associated with a higher frequency of post-acute sequelae of SARS-CoV-2 and greater total COVID-19-related health care costs 2 and 6 months after discharge. Altogether, these data suggest that the loss of muscle mass resulting from COVID-19 hospitalization may incur in an economical burden to health care systems.