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Abdominal obesity phenotype is associated with COVID-19 chest X-ray severity score better than BMI-based obesity.
Malavazos, Alexis Elias; Secchi, Francesco; Basilico, Sara; Capitanio, Gloria; Boveri, Sara; Milani, Valentina; Dubini, Carola; Schiaffino, Simone; Morricone, Lelio; Foschini, Chiara; Gobbo, Giulia; Piccinni, Rosangela; Saibene, Alessandro; Sardanelli, Francesco; Menicanti, Lorenzo; Guazzi, Marco; Dong, Chuanhui; Romanelli, Massimiliano Marco Corsi; Carruba, Michele; Iacobellis, Gianluca.
  • Malavazos AE; Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention Service, IRCCS Policlinico San Donato, Piazza Edmondo Malan 2, San Donato Milanese, 20097, Milan, Italy. alexis.malavazos@gmail.com.
  • Secchi F; Radiology Unit, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.
  • Basilico S; Department of Biomedical Sciences for Health, Università Degli Studi Di Milano, Milan, Italy.
  • Capitanio G; Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention Service, IRCCS Policlinico San Donato, Piazza Edmondo Malan 2, San Donato Milanese, 20097, Milan, Italy.
  • Boveri S; School of Food Science, Università Degli Studi Di Milano, Milan, Italy.
  • Milani V; Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention Service, IRCCS Policlinico San Donato, Piazza Edmondo Malan 2, San Donato Milanese, 20097, Milan, Italy.
  • Dubini C; Scientific Directorate, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.
  • Schiaffino S; Scientific Directorate, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.
  • Morricone L; Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention Service, IRCCS Policlinico San Donato, Piazza Edmondo Malan 2, San Donato Milanese, 20097, Milan, Italy.
  • Foschini C; Radiology Unit, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.
  • Gobbo G; Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention Service, IRCCS Policlinico San Donato, Piazza Edmondo Malan 2, San Donato Milanese, 20097, Milan, Italy.
  • Piccinni R; Radiology Unit, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.
  • Saibene A; General Medicine Unit, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.
  • Sardanelli F; General Medicine Unit, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.
  • Menicanti L; Department of General Medicine, Diabetes and Endocrinology, IRCCS Ospedale San Raffaele, Milan, Italy.
  • Guazzi M; Radiology Unit, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.
  • Dong C; Department of Biomedical Sciences for Health, Università Degli Studi Di Milano, Milan, Italy.
  • Romanelli MMC; Scientific Directorate, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.
  • Carruba M; Department of Biomedical Sciences for Health, Università Degli Studi Di Milano, Milan, Italy.
  • Iacobellis G; Cardiology University Department, Heart Failure Unit, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.
Eat Weight Disord ; 27(1): 345-359, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1169065
ABSTRACT

PURPOSE:

Chest X-ray (CXR) severity score and BMI-based obesity are predictive risk factors for COVID-19 hospital admission. However, the relationship between abdominal obesity and CXR severity score has not yet been fully explored.

METHODS:

This retrospective cohort study analyzed the association of different adiposity indexes, including waist circumference and body mass index (BMI), with CXR severity score in 215 hospitalized patients with COVID-19.

RESULTS:

Patients with abdominal obesity showed significantly higher CXR severity scores and had higher rates of CXR severity scores ≥ 8 compared to those without abdominal obesity (P < 0.001; P = 0.001, respectively). By contrast, patients with normal weight, with overweight and those with BMI-based obesity showed no significant differences in either CXR severity scores or in the rates of CXR severity scores ≥ 8 (P = 0.104; P = 0.271, respectively). Waist circumference and waist-to-height ratio (WHtR) correlated more closely with CXR severity scores than BMI (r = 0.43, P < 0.001; r = 0.41, P < 0.001; r = 0.17, P = 0.012, respectively). The area under the curves (AUCs) for waist circumference and WHtR were significantly higher than that for BMI in identifying a high CXR severity score (≥ 8) (0.68 [0.60-0.75] and 0.67 [0.60-0.74] vs 0.58 [0.51-0.66], P = 0.001). A multivariate analysis indicated abdominal obesity (risk ratio 1.75, 95% CI 1.25-2.45, P < 0.001), bronchial asthma (risk ratio 1.73, 95% CI 1.07-2.81, P = 0.026) and oxygen saturation at admission (risk ratio 0.96, 95% CI 0.94-0.97, P < 0.001) as the only independent factors associated with high CXR severity scores.

CONCLUSION:

Abdominal obesity phenotype is associated with a high CXR severity score better than BMI-based obesity in hospitalized patients with COVID-19. Therefore, when visiting the patient in a hospital setting, waist circumference should be measured, and patients with abdominal obesity should be monitored closely. Level of evidence Cross-sectional descriptive study, Level V.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Obesity, Abdominal / COVID-19 Type of study: Cohort study / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Humans Language: English Journal: Eat Weight Disord Journal subject: Gastroenterology / Metabolism Year: 2022 Document Type: Article Affiliation country: S40519-021-01173-w

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Obesity, Abdominal / COVID-19 Type of study: Cohort study / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Humans Language: English Journal: Eat Weight Disord Journal subject: Gastroenterology / Metabolism Year: 2022 Document Type: Article Affiliation country: S40519-021-01173-w