Evidence map›Paper›PMID 40377852›Full record

ArticleInfection2025

Impact of sarcopenia and obesity on mortality in older adults with SARS-CoV-2 infection: automated deep learning body composition analysis in the NAPKON-SUEP cohort.

Sabine Schluessel, Benedikt Mueller, Olivia Tausendfreund, Michaela Rippl, Linda Deissler, Sebastian Martini, Ralf Schmidmaier, Sophia Stoecklein, Michael Ingrisch, Sabine Blaschke and 6 more

Abstract read
In one paragraph

Article in Infection, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Observational
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Sabine SchluesselDepartment of Medicine IV, LMU University Hospital, LMU Munich, Munich, Germany. Sabine.Schluessel@med.uni-muenchen.de.
Benedikt MuellerDepartment of Medicine IV, LMU University Hospital, LMU Munich, Munich, Germany.
Olivia TausendfreundDepartment of Medicine IV, LMU University Hospital, LMU Munich, Munich, Germany.
Michaela RipplDepartment of Medicine IV, LMU University Hospital, LMU Munich, Munich, Germany.
Linda DeisslerDepartment of Medicine IV, LMU University Hospital, LMU Munich, Munich, Germany.
Sebastian MartiniDepartment of Medicine IV, LMU University Hospital, LMU Munich, Munich, Germany.
Ralf SchmidmaierDepartment of Medicine IV, LMU University Hospital, LMU Munich, Munich, Germany.
Sophia StoeckleinDepartment of Radiology, LMU University Hospital, LMU Munich, Munich, Germany.
Michael IngrischDepartment of Radiology, Clinical Data Science, LMU University Hospital, LMU Munich, Munich, Germany.
Sabine BlaschkeEmergency Department, University Medical Center Goettingen, Göttingen, Germany.
Gunnar BrandhorstUniversity Medicine Oldenburg, University Institute for Clinical Chemistry and Laboratory Medicine, Oldenburg, Germany.
Peter SpiethDepartment of Anesthesiology and Intensive Care Medicine, Faculty of Medicine, University Hospital Carl Gustav Carus, TUD Dresden University of Technology, Dresden, Germany.
Kristin LehnertDepartment of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany.
Peter HeuschmannInstitute of Medical Data Science, University Hospital Würzburg, Würzburg, Germany.
Susana M Nunes de MirandaFaculty of Medicine, Institute for Digital Medicine and Clinical Data Science, Goethe University Frankfurt, Frankfurt, Germany.
Michael DreyDepartment of Medicine IV, LMU University Hospital, LMU Munich, Munich, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionSevere respiratory infections pose a major challenge in clinical practice, especially in older adults. Body composition analysis could play a crucial role in risk assessment and therapeutic decision-making. This study investigates whether obesity or sarcopenia has a greater impact on mortality in patients with severe respiratory infections. The study focuses on the National Pandemic Cohort Network (NAPKON-SUEP) cohort, which includes patients over 60 years of age with confirmed severe COVID-19 pneumonia. An innovative approach was adopted, using pre-trained deep learning models for automated analysis of body composition based on routine thoracic CT scans.

methodsThe study included 157 hospitalized patients (mean age 70 ± 8 years, 41% women, mortality rate 39%) from the NAPKON-SUEP cohort at 57 study sites. A pre-trained deep learning model was used to analyze body composition (muscle, bone, fat, and intramuscular fat volumes) from thoracic CT images of the NAPKON-SUEP cohort. Binary logistic regression was performed to investigate the association between obesity, sarcopenia, and mortality.

resultsNon-survivors exhibited lower muscle volume (p = 0.043), higher intramuscular fat volume (p = 0.041), and a higher BMI (p = 0.031) compared to survivors. Among all body composition parameters, muscle volume adjusted to weight was the strongest predictor of mortality in the logistic regression model, even after adjusting for factors such as sex, age, diabetes, chronic lung disease and chronic kidney disease, (odds ratio = 0.516). In contrast, BMI did not show significant differences after adjustment for comorbidities.

conclusionThis study identifies muscle volume derived from routine CT scans as a major predictor of survival in patients with severe respiratory infections. The results underscore the potential of AI supported CT-based body composition analysis for risk stratification and clinical decision making, not only for COVID-19 patients but also for all patients over 60 years of age with severe acute respiratory infections. The innovative application of pre-trained deep learning models opens up new possibilities for automated and standardized assessment in clinical practice.

Indexed as

Body CompositionCOVID-19Deep LearningObesitySarcopeniaAgedAged, 80 and overCohort StudiesFemaleHumansMaleMiddle AgedSARS-CoV-2Tomography, X-Ray ComputedBody compositionComputed tomographyCovid-19Geriatric patientMachine learningMuscle assessmentMuscle fat infiltrationPneumonia

Identifiers

PMID40377852
PMCPMC12460570

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.