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Elevated visceral and liver fat content significantly increase risk of hospitalisation following COVID-19 infection
Hepatology ; 74(SUPPL 1):317A, 2021.
Article in English | EMBASE | ID: covidwho-1508765
ABSTRACT

Background:

In patients infected with the SARS-CoV-2 (COVID-19) virus, obesity is associated with an increase in hospital admission, use of mechanical ventilation and patient mortality. Elevated liver fat, body mass index (BMI) and male sex are significant predictors of hospitalisation risk following COVID-19. BMI, however, is a poor indicator of body fat distribution. Here, we aim to characterise body composition and liver health through multiparametric magnetic resonance (mpMR) and compare participants hospitalised and not hospitalised following COVID-19.

Methods:

Participants with laboratory confirmed or clinically suspected SARSCoV-2 infection were recruited to the COVERSCAN study (NCT04369807) and underwent a multi-organ mpMR scan (median time from initial symptom = 177 days). Measures of liver fat (PDFF), liver fibroinflammation (cT1) and body composition (VAT, subcutaneous adipose tissue [SAT], skeletal muscle index [SMI]) were analysed. Differences between hospitalised (n=60) and non-hospitalised participants (n=354) were assessed using Wilcoxon signed-rank tests. Univariate and multivariate analysis were performed on all biomarkers to assess the risk of hospitalisation. Presented data are median values.

Results:

Hospitalised participants were older (50yrs vs 43yrs;p<0.01) and had significantly elevated liver fat (3.5% vs 2.4%;p<0.01) and liver cT1 (734ms vs 708ms;p<0.01). Though hospitalised participants had a significantly elevated BMI (27kg/m2 vs 25kg/m2;p=0.011), it was VAT, but not SAT or SMI, that was significantly elevated in hospitalised participants (131cm2 vs 80 cm2;p<0.01). Univariate analysis revealed male sex, advanced age and elevated BMI, VAT, liver fat and liver cT1 were all significantly predictive of hospitalisation. In multivariate analysis, only age remained significantly predictive of hospitalisation. In obese participants, VAT and liver fat, but not BMI nor cT1, remained significantly elevated in hospitalised participants (VAT 200cm2 vs 159cm2, p=0.041;liver fat 9.8% vs 4.6%, p=0.012).

Conclusion:

mpMR revealed significantly elevated visceral and ectopic liver fat in hospitalised participants following COVID-19 infection. In obese participants, BMI was not significantly different in hospitalised and non-hospitalised patients whereas visceral and liver fat remained significantly elevated. Our work highlights body fat distribution as an important consideration for COVID-19 risk profiling which is not sufficiently evaluated based on BMI alone.

Full text: Available Collection: Databases of international organizations Database: EMBASE Type of study: Etiology study / Prognostic study / Risk factors Language: English Journal: Hepatology Year: 2021 Document Type: Article

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Full text: Available Collection: Databases of international organizations Database: EMBASE Type of study: Etiology study / Prognostic study / Risk factors Language: English Journal: Hepatology Year: 2021 Document Type: Article