The association of decreased thoracic muscle mass with unfavourable outcomes in lung transplant patients with COVID-19: a retrospective cohort study
4 affiliations
- 1Division of Infectious Diseases, Department of Internal Medicine, Yonsei University College of Medicine, 50-1, Yonsei-ro, Seodaemun-gu, Seoul, 03722 Republic of Korea
- 2Division of Infectious Diseases, Department of Internal Medicine, Inha University College of Medicine, Incheon, Republic of Korea
- 3Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Yonsei University College of Medicine, 50-1, Yonsei-ro, Seodaemun-gu, Seoul, 03722 Republic of Korea
- 4Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, 50-1, Yonsei-ro, Seodaemun-gu, Seoul, 03722 Republic of Korea
Abstract
Background: Coronavirus disease 2019 (COVID-19) has become an important issue in immunocompromised patients owing to the high transmissibility of severe acute respiratory syndrome coronavirus 2. Sarcopenia in lung transplant patients is associated with a poor prognosis, and patients who have undergone lung transplant are more vulnerable to COVID-19. This study aimed to investigate the association of sarcopenia with clinical outcomes in lung transplant patients with COVID-19 and the risk factors for sarcopenia following COVID-19 in lung transplant patients.
Methods: We performed a retrospective cohort study of lung transplant patients with COVID-19. Sarcopenia was defined as being within the lower 25% of the thoracic muscle index based on cross-sectional area measurements at the fourth vertebra using computed tomography (CT). Multivariable logistic analysis was conducted to identify factors associated with sarcopenia in lung transplant patients with COVID-19.
Results: Of the 445 patients who received follow-up care after lung transplantation, 81 were diagnosed with COVID-19. Among patients within three years of lung transplantation, the sarcopenia group had a significantly higher rate of hospitalisation (100.0% vs. 46.9%, P = 0.006) and oxygen demand (63.6% vs. 18.8%, P = 0.016) than the non-sarcopenia group. Body mass index before COVID-19 (odds ratio [OR], 0.77; confidence interval [CI], 0.58–0.96; P = 0.040) and serum albumin (OR, 0.12; CI, 0.01–0.79; P = 0.047) were significantly associated with sarcopenia after COVID-19.
Conclusions: Sarcopenia is associated with poor COVID-19 outcomes in patients within three years after lung transplantation. Assessment and intervention for sarcopenia are required to improve the prognosis of patients undergoing lung transplantation for COVID-19.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12890-026-04563-x.
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BibTeX
@article{lee2026association,
title = {{The association of decreased thoracic muscle mass with unfavourable outcomes in lung transplant patients with COVID-19: a retrospective cohort study}},
author = {Se Ju Lee and Ala Woo and Jung Ah Lee and Chang Hyup Kim and Jinnam Kim and Ki Hyun Lee and Ha Eun Kim and Jin Gu Lee and Song Yee Kim and Moo Suk Park and Su Jin Jeong},
journal = {BMC Pulmonary Medicine},
year = {2026},
month = aug,
doi = {10.1186/s12890-026-04563-x},
url = {https://doi.org/10.1186/s12890-026-04563-x},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - The association of decreased thoracic muscle mass with unfavourable outcomes in lung transplant patients with COVID-19: a retrospective cohort study
AU - Se Ju Lee
AU - Ala Woo
AU - Jung Ah Lee
AU - Chang Hyup Kim
AU - Jinnam Kim
AU - Ki Hyun Lee
AU - Ha Eun Kim
AU - Jin Gu Lee
AU - Song Yee Kim
AU - Moo Suk Park
AU - Su Jin Jeong
PY - 2026
DA - 2026/08/01
JO - BMC Pulmonary Medicine
DO - 10.1186/s12890-026-04563-x
UR - https://doi.org/10.1186/s12890-026-04563-x
AB - Background: Coronavirus disease 2019 (COVID-19) has become an important issue in immunocompromised patients owing to the high transmissibility of severe acute respiratory syndrome coronavirus 2. Sarcopenia in lung transplant patients is associated with a poor prognosis, and patients who have undergone lung transplant are more vulnerable to COVID-19. This study aimed to investigate the association of sarcopenia with clinical outcomes in lung transplant patients with COVID-19 and the risk factors for sarcopenia following COVID-19 in lung transplant patients. Methods: We performed a retrospective cohort study of lung transplant patients with COVID-19. Sarcopenia was defined as being within the lower 25% of the thoracic muscle index based on cross-sectional area measurements at the fourth vertebra using computed tomography (CT). Multivariable logistic analysis was conducted to identify factors associated with sarcopenia in lung transplant patients with COVID-19. Results: Of the 445 patients who received follow-up care after lung transplantation, 81 were diagnosed with COVID-19. Among patients within three years of lung transplantation, the sarcopenia group had a significantly higher rate of hospitalisation (100.0% vs. 46.9%, P = 0.006) and oxygen demand (63.6% vs. 18.8%, P = 0.016) than the non-sarcopenia group. Body mass index before COVID-19 (odds ratio [OR], 0.77; confidence interval [CI], 0.58–0.96; P = 0.040) and serum albumin (OR, 0.12; CI, 0.01–0.79; P = 0.047) were significantly associated with sarcopenia after COVID-19. Conclusions: Sarcopenia is associated with poor COVID-19 outcomes in patients within three years after lung transplantation. Assessment and intervention for sarcopenia are required to improve the prognosis of patients undergoing lung transplantation for COVID-19. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12890-026-04563-x.
SN - 1471-2466
ER -