A study carried out at Hospital Aliança, through the Rede D’Or Institute (IDOR) and support from the Maria Emília Foundation, identified that low muscle mass and myosteatosis (intramuscular fat), assessed by computed tomography (CT), are significantly associated to higher mortality rates in patients with Covid-19. The alert is the result of nutritionist Rafael Pinto’s doctoral thesis, for which 277 patients hospitalized in the hospital in Salvador, including adults and the elderly, were evaluated between June 2020 and March 2021.
The specialist explains that excess body fat can occur not only in the upper layer of the muscles, but can also be found between the muscle fibers, a characteristic called myosteatosis. “A more detailed assessment of muscle mass in patients with COVID-19, using CT, allows us to associate low muscle mass and myosteatosis with negative outcomes and carry out interventions during hospitalization and post-discharge, which can even save lives. ”, describes Dr. Rafael Pinto, who completed his doctoral thesis this month, entitled Impact of low muscle mass and myosteatosis on the mortality of patients with COVID-19 in a hospital in northeastern Brazil, associated with the Postgraduate Program in Science of Health (UFBA). For the study analyses, computed tomography was performed at the thoracic level (T12).
The hepatologist at Hospital Aliança, Dr. Raymundo Paraná, highlights that the study of these metabolic syndromes associated with Covid-19 have been increasingly valued in Medicine for analyzing a series of chronic diseases. “It is a marker of poor prognosis in patients with chronic liver disease and is also a marker of metabolic syndrome, especially myosteatosis.”
Dr. Paraná highlights that metabolic syndrome affects 3.5% of the population and was quickly identified as one of the main risk factors for mortality in Covid-19. “Metabolic syndrome is made up of obesity, high blood pressure, dyslipidemia, changes in blood glucose, but patients with myosteatosis mean that there is a dysfunction in the cell’s energy generating plant, which is the mitochondria. As a result, steatosis appears in the liver and muscle as a sign that the organism is metabolically altered”, explains the doctor, reinforcing that the study on mortality in Covid-19 in patients with myosteatosis opens up perspectives for evaluations in other acute diseases. and chronic, also with risk of mortality.
Validation of Computed Tomography (CT) for Sarcopenia
There are several methods to assess sarcopenia and loss of muscle strength. Some of them in the physical examination of the patient and others through imaging. In the case of studying the clinical cases of patients participating in this study, as they were diagnosed with Covid-19, they had already undergone a Chest Tomography. “With this, we validate the assessment of sarcopenia and myosteatosis through Chest Tomography as another tool that is available to doctors to assess sarcopenia in their patients in various diseases”, highlights Paraná.
Knowledge and research development
Hospital Aliança Rede D’Or follows the same logic as large American and European hospital chains, where medical assistance is associated with the generation of knowledge and the development of research. The D’Or Institute for Teaching and Research, which generates and democratizes knowledge, has been enabling an atmosphere of highly qualified professionals at the institutions belonging to the Network. “Hospital Aliança, until then, had much more research activity focused on case-by-case studies. But, based on this study, the first doctoral thesis developed through IDOR at the hospital, places Aliança on the select list of private hospitals in Brazil that produce knowledge”, celebrates Paraná, also a professor at the Faculty of Medicine at the Federal University of Bahia ( UFBA).
