Journal Article

CT scan-derived pectoralis muscle parameters are closely associated with COVID-19 outcomes: A systematic review and meta-analysis

Wen, Zhang, Liu, Yiwen, Luo, Sha, Wang, Tao

2025

Overview

The relationships between pectoralis muscle parameters and outcomes in patients with coronavirus disease 2019 (COVID-19) remain uncertain. We systematically searched PubMed, Embase, Web of Science and the Cochrane Library from 1 January 2019 to 1 May 2024 to identify non-overlapping studies evaluating pectoralis muscle-associated index on chest CT scan with clinical outcome in COVID-19 patients. Random-effects and fixed-effects meta-analyses were performed, and heterogeneity between studies was quantified using the I2 statistic. The risk of study bias was assessed using the Newcastle-Ottawa scale. Funnel plots for detecting small-study effects. A total of 9 studies with 4109 COVID-19 patients were included. The meta-analysis findings revealed a correlation between pectoralis muscle parameters and COVID-19 prognosis. Specifically, patients with higher pectoralis muscle density (PMD) exhibited a lower mortality risk, with an odds ratio (OR) of 0.95 (95% CI: 0.92-0.99). The rate of intubation was lower in COVID-19 patients with a high pectoralis muscle index (PMI) (OR =  0.96, 95% CI: 0.92-1.00). In summary, a low PMD is associated with a marginally elevated risk of mortality, whereas a decreased PMI represents a risk factor for intubation in COVID-19 patients. These findings suggest that pectoralis muscle parameters on chest CT may be a useful prognostic tool for COVID-19 patients.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Analysis / Antiviral agents / Biology and Life Sciences / Chest / Computed tomography / Coronaviruses / COVID-19 / COVID-19 - diagnostic imaging / COVID-19 - mortality / COVID-19 - pathology / COVID-19 vaccines / CT imaging / Dosage and administration / Fatalities / Health risks / Heterogeneity / Humans / Intensive care / Intubation / Medical examination / Medical imaging / Medicine and Health Sciences / Meta-analysis / Monoclonal antibodies / Mortality / Mortality risk / Muscles / Musculoskeletal system / Pandemics / Parameter identification / Patients / Pectoralis muscles / Pectoralis Muscles - diagnostic imaging / Pectoralis Muscles - pathology / Physical Sciences / Prognosis / Research and Analysis Methods / Risk factors / Sarcopenia / SARS-CoV-2 / Severe acute respiratory syndrome coronavirus 2 / Systematic review / Testing / Tomography, X-Ray Computed - methods