Acute Muscle Mass Loss Predicts Long-Term Fatigue, Myalgia, and Health Care Costs in COVID-19 Survivors

Objective: We examined the impact of loss of skeletal muscle mass in post-acute sequelae of SARS-CoV-2 infection, hospital readmission rate, self-perception of health, and health care costs in a cohort of COVID-19 survivors.Design: Prospective observational study.Setting and Participants: Tertiary Clinical Hospital. Eighty COVID-19 survivors age 59 +/- 14 years were prospectively assessed.Methods: Handgrip strength and vastus lateralis muscle cross-sectional area were evaluated at hospital admission, discharge, and 6 months after discharge. Post-acute sequelae of SARS-CoV-2 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 vastus lateralis muscle cross-sectional area reduction during hospital stay into either high muscle loss (-18 +/- 11%) or low muscle loss (-4 +/- 2%) group, based on median values. Results: High muscle loss group showed greater prevalence of fatigue (76% vs 46%, P =.0337) and myalgia (66% vs 36%, P = .0388), and lower muscle mass (-8% vs 3%, P < .0001) than low muscle loss group 6 months after discharge. No between-group difference was observed for hospital readmission and self -perceived health (P > .05). High muscle loss group demonstrated greater total COVID-19-related health care costs 2 ($77,283.87 vs. $3057.14, P = .0223, respectively) and 6 months ($90,001.35 vs $12, 913.27, P = .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 f3 = $10, 070.81, P < .0001) and 6 months after discharge (adjusted f3 = $9885.63, P < .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.(c) 2022 AMDA -The Society for Post-Acute and Long-Term Care Medicine.

Automated summary

This study aimed to investigate the impact of decreased skeletal muscle mass in COVID-19 survivors. The research found that the high muscle loss group had a higher prevalence of fatigue and myalgia, lower muscle mass, and higher COVID-19-related healthcare costs.