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Impact of visceral fat on the prognosis of coronavirus disease 2019: an observational cohort study.
Ogata, Hiroaki; Mori, Masahiro; Jingushi, Yujiro; Matsuzaki, Hiroshi; Katahira, Katsuyuki; Ishimatsu, Akiko; Enokizu-Ogawa, Aimi; Taguchi, Kazuhito; Moriwaki, Atsushi; Yoshida, Makoto.
  • Ogata H; Department of Respiratory Medicine, National Hospital Organization Fukuoka National Hospital, 4-39-1 Yakatabaru, Minami-ku, Fukuoka, 811-1394, Japan. md105020@gmail.com.
  • Mori M; Department of Radiology, National Hospital Organization Fukuoka National Hospital, 4-39-1 Yakatabaru, Minami-ku, Fukuoka, 811-1394, Japan.
  • Jingushi Y; Department of Respiratory Medicine, National Hospital Organization Fukuoka National Hospital, 4-39-1 Yakatabaru, Minami-ku, Fukuoka, 811-1394, Japan.
  • Matsuzaki H; Department of Pediatrics, National Hospital Organization Fukuoka National Hospital, 4-39-1 Yakatabaru, Minami-ku, Fukuoka, 811-1394, Japan.
  • Katahira K; Department of Respiratory Medicine, National Hospital Organization Fukuoka National Hospital, 4-39-1 Yakatabaru, Minami-ku, Fukuoka, 811-1394, Japan.
  • Ishimatsu A; Department of Respiratory Medicine, National Hospital Organization Fukuoka National Hospital, 4-39-1 Yakatabaru, Minami-ku, Fukuoka, 811-1394, Japan.
  • Enokizu-Ogawa A; Department of Respiratory Medicine, National Hospital Organization Fukuoka National Hospital, 4-39-1 Yakatabaru, Minami-ku, Fukuoka, 811-1394, Japan.
  • Taguchi K; Department of Respiratory Medicine, National Hospital Organization Fukuoka National Hospital, 4-39-1 Yakatabaru, Minami-ku, Fukuoka, 811-1394, Japan.
  • Moriwaki A; Department of Respiratory Medicine, National Hospital Organization Fukuoka National Hospital, 4-39-1 Yakatabaru, Minami-ku, Fukuoka, 811-1394, Japan.
  • Yoshida M; Department of Respiratory Medicine, National Hospital Organization Fukuoka National Hospital, 4-39-1 Yakatabaru, Minami-ku, Fukuoka, 811-1394, Japan.
BMC Infect Dis ; 21(1): 1240, 2021 Dec 10.
Article in English | MEDLINE | ID: covidwho-1566511
ABSTRACT

BACKGROUND:

Clarification 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.

METHODS:

The 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.

RESULTS:

A 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).

CONCLUSIONS:

A 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.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Intra-Abdominal Fat / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Limits: Humans Language: English Journal: BMC Infect Dis Journal subject: Communicable Diseases Year: 2021 Document Type: Article Affiliation country: S12879-021-06958-z

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Intra-Abdominal Fat / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Limits: Humans Language: English Journal: BMC Infect Dis Journal subject: Communicable Diseases Year: 2021 Document Type: Article Affiliation country: S12879-021-06958-z