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

We investigated the associations of sarcopenia alone, overweight or obesity (OWO),
and sarcopenic overweight or obesity (SOWO) with COVID-19 hospitalization
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.
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.
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.

Year of publication





Zhu, Y.
Mierau, J.O.
Bakker, S.J.L.
Dekker, L.H.
Navis, G.J.
Lifelines Corona Research Initiative

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