The role of visceral adiposity in the severity of COVID-19: Highlights from a unicenter cross-sectional pilot study in Germany

Autor: Janis L Vahldiek, Alexandra Niehues, Antonia Petersen, Bernd Hamm, Lisa C. Adams, Stefan M. Niehues, Marcus R. Makowski, Jakob Albrecht, Keno K. Bressem, Hans-Martin Thieß
Rok vydání: 2020
Předmět:
VFA
visceral fat area
0301 basic medicine
Cross-sectional study
BMI
body mass index
Endocrinology
Diabetes and Metabolism
medicine.medical_treatment
CAP
Canon Aquilion PRIME
Adipose tissue
Pilot Projects
Overweight
law.invention
PCR
polymerase chain reaction
0302 clinical medicine
Endocrinology
law
Medicine
Adiposity
Aged
80 and over
SFA
subcutaneous fat area
Middle Aged
ICU
intensive care unit
Intensive care unit
CT
computed tomography
IL-6
interleukin 6
GEL
GE Lightspeed VCT
Visceral adipose tissue
medicine.symptom
Coronavirus Infections
medicine.medical_specialty
Intra-Abdominal Fat
Pneumonia
Viral
TFA
total fat area
030209 endocrinology & metabolism
Article
Quantification of adipose tissue
Betacoronavirus
03 medical and health sciences
Internal medicine
Humans
Obesity
Risk factor
Pandemics
Aged
Mechanical ventilation
SARS-CoV-2
severe acute respiratory syndrome corona virus 2
SARS-CoV-2
business.industry
COVID-19
medicine.disease
COVID 19
coronavirus 19
Cross-Sectional Studies
030104 developmental biology
Metabolic syndrome
Tomography
X-Ray Computed
business
Zdroj: Metabolism
ISSN: 0026-0495
DOI: 10.1016/j.metabol.2020.154317
Popis: Background and aims Overall obesity has recently been established as an independent risk factor for critical illness in patients with coronavirus disease 2019 (COVID-19). The role of fat distribution and especially that of visceral fat, which is often associated with metabolic syndrome, remains unclear. Therefore, this study aims at investigating the association between fat distribution and COVID-19 severity. Methods Thirty patients with COVID-19 and a mean age of 65.6 ± 13.1 years from a level-one medical center in Berlin, Germany, were included in the present cross-sectional analysis. COVID-19 was confirmed by polymerase chain reaction (PCR) from nasal and throat swabs. A severe clinical course of COVID-19 was defined by hospitalization in the intensive care unit (ICU) and/or invasive mechanical ventilation. Fat was measured at the level of the first lumbar vertebra on routinely acquired low-dose chest computed tomography (CT). Results An increase in visceral fat area (VFA) by ten square centimeters was associated with a 1.37-fold higher likelihood of ICU treatment and a 1.32-fold higher likelihood of mechanical ventilation (adjusted for age and sex). For upper abdominal circumference, each additional centimeter of circumference was associated with a 1.13-fold higher likelihood of ICU treatment and a 1.25-fold higher likelihood of mechanical ventilation. Conclusions Our proof-of-concept study suggests that visceral adipose tissue and upper abdominal circumference specifically increase the likelihood of COVID-19 severity. CT-based quantification of visceral adipose tissue and upper abdominal circumference in routine chest CTs may therefore be a simple tool for risk assessment in COVID-19 patients.
Highlights • Previous studies suggested an association between obesity and severe COVID-19. • So far, research focused exclusively on body mass index as a measure of obesity. • Routine chest CTs allow quantification of subcutaneous and visceral abdominal fat. • We found a positive association between visceral fat tissue and COVID-19 severity. • Chest CTs may be a simple tool for risk assessment in patients with COVID-19.
Databáze: OpenAIRE
Externí odkaz: