The link between nutritional status and outcomes in COVID-19 patients in ICU. Is obesity or sarcopenia the real problem?

Obesity is frequent among COVID-19 patients and data indicate that this condition is associated with poor outcomes. Nutritional status,was often assessed by the calculation of body mass index (BMI) classes, allowing to indicate the presence/absence of overweight or obesity . However, scanty information is available on body composition in COVID-19 pa-tients in ICU and on patient’s muscularity. In fact, most of the studies conducted in these patients indicate a high prevalence of increased adiposity that seems to be able to predict the severity of the disease. Obesity was shown to predict COVID-19 severity also among young patients. In ICU (not COVID-19 patients), recent evidences showed that low skeletal muscle mass as assessed by CT, was a risk factor for reduced survival in mechanically ventilated patients, revealing that BMI was not an independent predictor of mortality when muscularity was considered.