A key risk factor for pneumonia might be a decline in the diaphragm’s muscular mass. For a study, researchers sought to determine if chest computed tomography (CT) measurements of diaphragm thickness (DT) and density were related to clinical outcomes, and mortality in adult patients admitted to the emergency department with coronavirus disease 2019 (COVID-19).
Between September 1 and November 1, 2020, they retrospectively evaluated 404 individuals with pneumonia symptoms on a chest CT and a positive polymerase chain reaction test for COVID-19. At the location of the celiac artery origin, bilateral DT measurements were made, and the total mean diaphragm thickness (TMDT) was calculated. At the origin of the celiac artery, the density of the hemidiaphragm was assessed. Logistic regression analyses were used to examine the connection between demographic traits, comorbidities, TMDT, mean hemidiaphragm density (MHD), and clinical outcomes. Intraclass correlation analyses were used to assess the accuracy of the measurements made by the two observers.
According to intraclass correlation studies, the inter-observer agreement for TMDT and MHD was virtually perfectly consistent. The correlation between having a thinner diaphragm and death was statistically significant (P<0.001). Patients who had died or had severe illness had decreased bilateral diaphragm densities (P<0.001). The threshold values of TMDT for predicting ICU admission and death were 3.67 mm and 3.47 mm, respectively. In the multivariable model, it was discovered that TMDT (odds ratio [OR]: 0.634, 95% CI: 0.447-0.901), age, and MHD (OR: 0.920, 95% CI: 0.883–0.959) were independent predictors of severe disease. Age (OR: 1.040, 95% CI: 1.003-1.078) and MHD (OR: 0.883, 95% CI: 0.827-0.942) were also independent risk factors for death.
The research showed that in COVID-19 individuals, low diaphragm thickness and density values might be viewed as poor prognostic indicators since they were linked to severe illness.