The impact of osteosarcopenia and its parameters on mortality of COVID-19 in-hospitalized older patients: the findings of BEH (Bushehr elderly health) program

Gita Shafiee; Maryam Marzban; Faeze Abbaspour; Amirhossein Darabi; Narges Zargar Balajam; Akram Farhadi; Mohammad Mehdi Khaleghi; Hossein Taherzadeh; Noushin Fahimfar; Azar Falahatzadeh; Negin Ghasemi; Afshin Ostovar; Iraj Nabipour; Bagher Larijani; Ramin Heshmat

doi:10.1007/s40200-024-01443-1

The impact of osteosarcopenia and its parameters on mortality of COVID-19 in-hospitalized older patients: the findings of BEH (Bushehr elderly health) program

J Diabetes Metab Disord. 2024 Jun 12;23(2):1919-1928. doi: 10.1007/s40200-024-01443-1. eCollection 2024 Dec.

Authors

Gita Shafiee¹, Maryam Marzban², Faeze Abbaspour¹, Amirhossein Darabi³, Narges Zargar Balajam¹, Akram Farhadi³, Mohammad Mehdi Khaleghi^{3

4}, Hossein Taherzadeh⁵, Noushin Fahimfar⁶, Azar Falahatzadeh⁷, Negin Ghasemi⁷, Afshin Ostovar⁶, Iraj Nabipour³, Bagher Larijani⁸, Ramin Heshmat¹

Affiliations

¹ Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
² Statistical Genetics Lab, QIMR Berghofer Medical Research Institute, Brisbane, QLD Australia.
³ The Persian Gulf Tropical Medicine Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran.
⁴ Sport Science Department, Human Faculty, Persian Gulf University, Bushehr, Iran.
⁵ Educational Deputy Bahmani Campus, Bushehr University of Medical Sciences, Bushehr, Iran.
⁶ Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
⁷ Student Research Committee, Bushehr University of Medical Sciences, Bushehr, Iran.
⁸ Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

Abstract

Background: It has been documented that old age and chronic diseases are associated with poor prognosis and mortality among COVID-19 patients. Osteosarcopenia is a geriatric syndrome with a considerable prevalence which increases morbidity and mortality. This study investigated the relationship between COVID-19 mortality and osteosarcopenia and its parameters in-hospitalized patients in Bushehr, Iran.

Methods: In this retrospective cohort study, participants of the Bushehr Elderly Health (BEH) program who were hospitalized due to COVID-19 between 1st March 2020 and 23rd September 2021 were assessed. Osteosarcopenia was considered as the presence of both osteopenia/osteoporosis and sarcopenia. We used the Cox proportional hazards model to identify the association between oteosarcopenia and the risk of COVID-mortality in 2442 person-days.

Results: Among 4173 participants,297 patients were in-hospitalized due to COVID-19. We found that 80(26.94%) patients expired due to COVID-19 during the follow-up period. Osteosarcopenia and its parameters were more prevalent in patients who expired. The incidence rate of mortality among osteosarcopenic patients was 5.04(3.43- 7.40) per 100 person-days. In the Cox proportional hazards models, osteosarcopenia and its parameters increase the risk of COVID-mortality [Osteosarcopenia: HR_adjusment:1.73(1.00-3.01), sarcopenia: HR_adjusment:1.72(1.00-2.99), Osteoporosis: HR_adjusment:2.67(1.53-4.67), Low muscle mass: HR_adjusment:1.90(1.05-3.46), low muscle strength: HR_adjusment:1.80(1.03-3.16), and low gait speed: HRadj:2.39(1.31-4.38). The ORs of ICU admission and use of invasive mechanical ventilation among osteosarcopenic patients and its parameters were higher than those without it.

Conclusions: This study identified the impact of osteosarcopenia and its parameters on the mortality of in-hospitalized patients with COVID-19. Assessment of musculoskeletal disorders could help in early warning of older patients with severe COVID-19.

Supplementary information: The online version contains supplementary material available at 10.1007/s40200-024-01443-1.

Keywords: COVID-19; Elderly; Iran; Mortality; Osteosarcopenia.

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