Impact of visceral fat on the prognosis of coronavirus disease 2019: an observational cohort study

BMC Infectious Diseases

Hiroshi Matsuzaki¹  Masahiro Mori²  Yujiro Jingushi³  Kazuhito Taguchi³  Makoto Yoshida³  Aimi Enokizu-Ogawa³  Hiroaki Ogata³  Atsushi Moriwaki³  Akiko Ishimatsu³  Katsuyuki Katahira³ 

[1] Department of Pediatrics, National Hospital Organization Fukuoka National Hospital, 4-39-1 Yakatabaru, Minami-ku, 811-1394, Fukuoka, Japan;Department of Radiology, National Hospital Organization Fukuoka National Hospital, 4-39-1 Yakatabaru, Minami-ku, 811-1394, Fukuoka, Japan;Department of Respiratory Medicine, National Hospital Organization Fukuoka National Hospital, 4-39-1 Yakatabaru, Minami-ku, 811-1394, Fukuoka, Japan;

关键词: Severe acute respiratory syndrome coronavirus 2;    Coronavirus disease 2019;    Computed tomography;    Obesity;    Visceral adipose tissue;   

DOI  :  10.1186/s12879-021-06958-z

来源: Springer

【 摘 要 】

BackgroundClarification of the risk factors for coronavirus disease 2019 (COVID-19) severity is strongly warranted for global health. Recent studies have indicated that elevated body mass index (BMI) is associated with unfavorable progression of COVID-19. This is assumed to be due to excessive deposition of visceral adipose tissue (VAT); however, the evidence investigating the association between intra-abdominal fat and COVID-19 prognosis is sparse. We therefore investigated whether measuring the amount of intra-abdominal fat is useful to predict the prognosis of COVID-19.MethodsThe present study enrolled 53 consecutive cases of COVID-19 patients aged ≥ 20 years with chest computed tomography (CT) scans. The VAT area, total adipose tissue (TAT) area, and VAT/TAT ratio were estimated using axial CT images at the level of the upper pole of the right kidney. Severe COVID-19 was defined as death or acute respiratory failure demanding oxygen at ≥ 6 L per minute, a high-flow nasal cannula, or mechanical ventilation. The association of VAT/TAT with the incidence of progression to a severe state was estimated as a hazard ratio (HR) using Cox regression analysis. To compare the prediction ability for COVID-19 disease progression between BMI and VAT/TAT, the area under the receiver operating characteristic curve (AUC) of each was assessed.ResultsA total of 15 cases (28.3% of the whole study subjects) progressed to severe stages. The incidence of developing severe COVID-19 increased significantly with VAT/TAT (HR per 1% increase = 1.040 (95% CI 1.008–1.074), P = 0.01). After adjustment for potential confounders, the positive association of VAT/TAT with COVID-19 aggravation remained significant (multivariable-adjusted HR = 1.055 (95% CI 1.000–1.112) per 1% increase, P = 0.049). The predictive ability of VAT/TAT for COVID-19 becoming severe was significantly better than that of BMI (AUC of 0.73 for VAT/TAT and 0.50 for BMI; P = 0.0495 for the difference).ConclusionsA higher ratio of VAT/TAT was an independent risk factor for disease progression among COVID-19 patients. VAT/TAT was superior to BMI in predicting COVID-19 morbidity. COVID-19 patients with high VAT/TAT levels should be carefully observed as high-risk individuals for morbidity and mortality.

【 授权许可】

CC BY