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2020 ; 111
(ä): 154319
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Visceral fat shows the strongest association with the need of intensive care in
patients with COVID-19
#MMPMID32712222
Watanabe M
; Caruso D
; Tuccinardi D
; Risi R
; Zerunian M
; Polici M
; Pucciarelli F
; Tarallo M
; Strigari L
; Manfrini S
; Mariani S
; Basciani S
; Lubrano C
; Laghi A
; Gnessi L
Metabolism
2020[Oct]; 111
(ä): 154319
PMID32712222
show ga
BACKGROUND: Obesity was recently identified as a major risk factor for worse
COVID-19 severity, especially among the young. The reason why its impact seems to
be less pronounced in the elderly may be due to the concomitant presence of other
comorbidities. However, all reports only focus on BMI, an indirect marker of body
fat. AIM: To explore the impact on COVID-19 severity of abdominal fat as a marker
of body composition easily collected in patients undergoing a chest CT scan.
METHODS: Patients included in this retrospective study were consecutively
enrolled among those admitted to an Emergency Department in Rome, Italy, who
tested positive for SARS-Cov-2 and underwent a chest CT scan in March 2020. Data
were extracted from electronic medical records. RESULTS: 150 patients were
included (64.7% male, mean age 64?±?16?years). Visceral fat (VAT) was
significantly higher in patients requiring intensive care (p?=?0.032), together
with age (p?=?0.009), inflammation markers CRP and LDH (p?0.0001, p?=?0.003,
respectively), and interstitial pneumonia severity as assessed by a Lung Severity
Score (LSS) (p?0.0001). Increasing age, lymphocytes, CRP, LDH, D-Dimer, LSS,
total abdominal fat as well as VAT were found to have a significant univariate
association with the need of intensive care. A multivariate analysis showed that
LSS and VAT were independently associated with the need of intensive care (OR:
1.262; 95%CI: 1.0171-1.488; p?=?0.005 and OR: 2.474; 95%CI: 1.017-6.019;
p?=?0.046, respectively). CONCLUSIONS: VAT is a marker of worse clinical outcomes
in patients with COVID-19. Given the exploratory nature of our study, further
investigation is needed to confirm our findings and elucidate the mechanisms
underlying such association.