tetano
Editor, Senior Moderator
Endocr Connect
. 2022 Aug 1;EC-22-0290.
doi: 10.1530/EC-22-0290. Online ahead of print.
Low muscle mass and high visceral fat mass predict mortality in patients hospitalized with moderate-to-severe COVID-19: a prospective study
Fabyan Esberard de Lima Beltrão[SUP] 1 [/SUP], Daniele Carvalhal de Almeida Beltrão[SUP] 2 [/SUP], Giulia Carvalhal[SUP] 3 [/SUP], Fabyo Napoleão de Lima Beltrão[SUP] 4 [/SUP], Igor Motta de Aquino[SUP] 5 [/SUP], Thaíse da Silva Brito[SUP] 6 [/SUP], Barbara Costa Paulino[SUP] 7 [/SUP], Elisa Aires[SUP] 8 [/SUP], Diana Viegas[SUP] 9 [/SUP], Fabio Hecht[SUP] 10 [/SUP], Bruno Halpern[SUP] 11 [/SUP], Liana Clebia De Morais Pordeus[SUP] 12 [/SUP], Maria da Conceição Rodrigues Gonçalves[SUP] 13 [/SUP], Helton Estrela Ramos[SUP] 14 [/SUP]
Affiliations
Abstract
Introduction: The severity of coronavirus disease 2019 (COVID-19) has been positively correlated with several comorbidities. The primary outcome of the study was to assess the relationship between the mortality and severity of COVID-19 and obesity classes according to body mass index (BMI), visceral (VAT), subcutaneous adipose tissue area (SAT), muscle area (MA), and leptin levels.
Methods: In this prospective cohort study, 200 patients hospitalized with moderate-to-severe COVID-19 underwent an unenhanced computed tomography (CT) of the thorax, laboratory tests, and leptin levels between June and August 2020 were obtained.
Results: Our study included two hundred patients [male 52%; mean age: 62 (49-74) years; obesity (BMI > 30): 51,5%)]. Fifty-eight patients (23.5%) were admitted to the intensive care unit, and 29 (14.5%) died. In multivariate logistic regression (corrected for leptin, sex, age, serum biomarkers) and ROC curve, high VAT > 150 cm² (odds ratio [OR]: 6.15; P < 0.002), MA < 92 cm² (OR: 7.94; P < 0.005), and VAT/MA ratio > 2 (OR: 13.9; P < 0.0001) were independent risk factors for mortality. Indeed, the Kaplan-Meier curves showed that patients with MA < 92 cm² and without obesity (BMI < 30) had a lower survival rate (HR between 3.89 and 9.66; p < 0.0006) than the other groups. Leptin levels were not related to mortality and severity.
Conclusion: This prospective study reports data on the largest number of hospitalized severe COVID-19 patients and pinpoints visceral adipose tissue and muscle area calculated by CT as predictors of COVID-19 mortality.
. 2022 Aug 1;EC-22-0290.
doi: 10.1530/EC-22-0290. Online ahead of print.
Low muscle mass and high visceral fat mass predict mortality in patients hospitalized with moderate-to-severe COVID-19: a prospective study
Fabyan Esberard de Lima Beltrão[SUP] 1 [/SUP], Daniele Carvalhal de Almeida Beltrão[SUP] 2 [/SUP], Giulia Carvalhal[SUP] 3 [/SUP], Fabyo Napoleão de Lima Beltrão[SUP] 4 [/SUP], Igor Motta de Aquino[SUP] 5 [/SUP], Thaíse da Silva Brito[SUP] 6 [/SUP], Barbara Costa Paulino[SUP] 7 [/SUP], Elisa Aires[SUP] 8 [/SUP], Diana Viegas[SUP] 9 [/SUP], Fabio Hecht[SUP] 10 [/SUP], Bruno Halpern[SUP] 11 [/SUP], Liana Clebia De Morais Pordeus[SUP] 12 [/SUP], Maria da Conceição Rodrigues Gonçalves[SUP] 13 [/SUP], Helton Estrela Ramos[SUP] 14 [/SUP]
Affiliations
- PMID: 36040475
- DOI: 10.1530/EC-22-0290
Abstract
Introduction: The severity of coronavirus disease 2019 (COVID-19) has been positively correlated with several comorbidities. The primary outcome of the study was to assess the relationship between the mortality and severity of COVID-19 and obesity classes according to body mass index (BMI), visceral (VAT), subcutaneous adipose tissue area (SAT), muscle area (MA), and leptin levels.
Methods: In this prospective cohort study, 200 patients hospitalized with moderate-to-severe COVID-19 underwent an unenhanced computed tomography (CT) of the thorax, laboratory tests, and leptin levels between June and August 2020 were obtained.
Results: Our study included two hundred patients [male 52%; mean age: 62 (49-74) years; obesity (BMI > 30): 51,5%)]. Fifty-eight patients (23.5%) were admitted to the intensive care unit, and 29 (14.5%) died. In multivariate logistic regression (corrected for leptin, sex, age, serum biomarkers) and ROC curve, high VAT > 150 cm² (odds ratio [OR]: 6.15; P < 0.002), MA < 92 cm² (OR: 7.94; P < 0.005), and VAT/MA ratio > 2 (OR: 13.9; P < 0.0001) were independent risk factors for mortality. Indeed, the Kaplan-Meier curves showed that patients with MA < 92 cm² and without obesity (BMI < 30) had a lower survival rate (HR between 3.89 and 9.66; p < 0.0006) than the other groups. Leptin levels were not related to mortality and severity.
Conclusion: This prospective study reports data on the largest number of hospitalized severe COVID-19 patients and pinpoints visceral adipose tissue and muscle area calculated by CT as predictors of COVID-19 mortality.