Prevalence and correlates of probable anxiety and depression among young people: A subnational cross-sectional study in Ghana.

Sarcopenia is a progressive skeletal muscle disorder characterized by loss of muscle strength, reduced muscle mass, and impaired physical performance (). Although traditionally defined in the context of aging, it is increasingly recognized to occur in younger individuals as well (, ). It is also a significant public health issue that may result in various adverse outcomes, such as falls, disability, frailty, and reduced quality of life (). It is considered a predictor of all-cause mortality among hospitalized patients (). Given that emerging evidence suggests an immunoregulatory role for skeletal muscle, the potential impact of sarcopenia on inflammatory diseases has been increasingly studied, particularly sepsis, a condition characterized by a dysregulated immunometabolic response to infection. For instance, a meta-analysis showed that septic patients with sarcopenia had a significantly increased risk of acute and post-discharge mortality (). Also, the features of sarcopenia, such as reduced muscle mass and impaired physical function, combined with their impact on immune response, can support sepsis development or progression (–). Conversely, sarcopenia may develop as a consequence of hypermetabolic and inflammatory states, such as sepsis. Septic environments are associated with the release of pro-inflammatory cytokines, activation of the sympathetic nervous system (including the use of intravenous catecholamines), limited nutritional intake, and physical inactivity, leading to muscle loss due to increased catabolism and decreased anabolic signaling (). This profound metabolic dysregulation, particularly the accelerated depletion of amino acids from skeletal muscle, is often conceptualized as septic autocannibalism (), a critical host response aimed at supplying essential substrates for immune function and gluconeogenesis during severe infection. Both sepsis and sarcopenia can culminate in a considerable impact on patient morbidity and mortality across the lifespan. Although traditionally investigated as separate entities - sepsis as an acute dysregulated inflammatory response to infection, and sarcopenia as a chronic, often age-related, loss of muscle mass - their interplay has now been acknowledged (). Indeed, the relationship between these conditions can be bidirectional and is rooted in shared biological, modifiable, and environmental risk factors that may accumulate over time. For instance, advanced age, physical inactivity, chronic disease, obesity, and smoking are interconnected factors that can also drive each other, creating vicious cycles that can trigger and aggravate systemic inflammation and metabolic dysregulation (, ).