Rectus Femoris Thickness For Frailty In Covid-19 Survivors

Rationale: Frailty overlaps significantly with sarcopenia (1). There may be also a relationship between frailty and loss of rectus femoris (RF) muscle thickness (2). The study aims to examine the relationship between frailty and RF thickness in the early post-discharge period of COVID-19 survivors. Methods: Between May and August 2021, among the SARS-COV-2 PCR positive patients hospitalized in a university hospital, those who agreed to participate in the study after discharge were included. Muscle assessments were performed two weeks after discharge by ultrasonography. Frailty was assessed using the clinical frailty scale (CFS) version 2.0. Results: Forty-nine patients were included. 53.1% (n=26) of patients were female. The mean age was 59.0±12.4 years. 49.0% (n=24) of patients had multimorbidity. Forty-seven patients (%95.9) were at risk of malnutrition or malnourished according to mini nutritional assessment-short form. 44.9% (n=22) of patients were living with frailty. Seventeen (34.7%) patients had low grip strength. Calf circumference was 35.7±4.7, RF thickness mean was 15.8±3.6, RF-cross sectional area mean was 7.3±2.7 and gastrocnemius thickness mean was 15.6±3.1. In univariate analysis, only RF thickness had a statistically significant relationship with frailty (p=0.001). In multivariate analysis, RF thickness was associated with frailty independent from age and sex (OR: 0.72, 95% CI 0.52-0.99, p=0.04) (Table 1). Clinical frailty scale score correlated inversely with RF thickness (p<0.001).Tabled 1Table 1: Univariate Analysis of Lower Extremity Muscle Measurements According to FrailtyMuscle MeasurementUnivariate AnalysisNot Frail(n=27)Frail (n=22)pCalf circumference (cm) (mean, SD)35.9±4.635.4±4.90.71Rectus femoris thickness (mm) (mean, SD)17.3±3.414.0±3.00.001Rectus femoris cross sectional area (mm2) (mean, SD)7.8±2.86.6±2.50.12Gastrocnemius thickness (mm) (mean, SD)15.2±3.316.0±2.80.37Multivariate Analysis*OR95% CIpRectus femoris thickness0.720.52-0.990.04SD: Standart deviation, OR: Odds ratio, *Model: Age, sex, calf circumference, rectus femoris thickness, rectus femoris cross sectional area and gastrocnemius thickness Open table in a new tab SD: Standart deviation, OR: Odds ratio, *Model: Age, sex, calf circumference, rectus femoris thickness, rectus femoris cross sectional area and gastrocnemius thickness Conclusion: Frailty is a common condition in COVID-19 patients. US-derived RF thickness may be an appropriate option to follow this syndrome in the near term after discharge. References: 1. Cruz-Jentoft AJ, Kiesswetter E, Drey M, Sieber CC. Nutrition, frailty, and sarcopenia. Aging clinical and experimental research. 2017;29(1):43-8. 2. Touge H, Tomita K, Nishii S, Kitaura T, Ueda Y, Matsunami K, et al. Frailty and Loss of Rectus Femoris Muscle Thickness in Hospitalized Elderly Patients with Community-Acquired Pneumonia–A Case-Control Study. Clinical Medicine Research. 2017;6:86. Disclosure of Interest: None declared