Sarcopenia augments the risk of excess weight on COVID-19 hospitalization: a prospective study using Lifelines COVID-19 Cohort

Objectives
We investigated the associations of sarcopenia alone, overweight or obesity (OWO),
and sarcopenic overweight or obesity (SOWO) with COVID-19 hospitalization
Methods
Participants from the Lifelines COVID-19 Cohort who were infected with COVID-19
were included in this study. Sarcopenia was defined as a relative deviation of muscle
mass of ≤ -1.0 SD from the sex-specific mean 24 h urinary creatinine excretion. OWO
was defined as a Body Mass Index ≥25 kg/m2. SOWO was defined as the presence of
OWO and low muscle mass. COVID-19 hospitalization was self-reported. Logistic
regression models were used to analyze the associations of sarcopenia alone, OWO,
and SOWO, with COVID-19 hospitalization.
Results
Of the 3594 participants infected with COVID-19 and recruited in this study (mean age
45 ± 11, 35.5% male), 173 (4.8%) had been admitted to the hospital. Compared with
the reference group, individuals with OWO and SOWO were 1.78 (Odds ratio [95% CI]:
1.78 [1.18-2.68], p<0.01) and 2.09 (Odds ratio [95% CI]: 2.09 [1.04-4.19], p<0.05)
times more likely to have been hospitalized for COVID-19, respectively, while
sarcopenia alone did not increase the risk of COVID-19 hospitalization.
Conclusion
In this middle-aged population, SOWO elevated the risk of hospitalization for COVID19 among those infected with COVID-19 more than OWO alone. These data support
the relevance of SOWO as a risk factor beyond the geriatric setting and should be
considered in risk stratification in future public health and vaccination campaigns.