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

Abstract

AbstractObjectiveSkeletal 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.MethodsThe 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.ResultsSeventy 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.ConclusionsThis 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 registrationPROSPERO CRD42023395476.