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The impact of body composition on mortality of COVID-19 hospitalized patients: A prospective study on abdominal fat, obesity paradox and sarcopenia.
Graziano, Elena; Peghin, Maddalena; De Martino, Maria; De Carlo, Chiara; Da Porto, Andrea; Bulfone, Luca; Casarsa, Viviana; Sozio, Emanuela; Fabris, Martina; Cifù, Adriana; Grassi, Bruno; Curcio, Francesco; Isola, Miriam; Sechi, Leonardo Alberto; Tascini, Carlo.
  • Graziano E; Division of Infectious Diseases, Department of Medicine, University of Udine, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy; Infectious and Tropical Diseases Unit, Department of Medicine and Surgery, University of Insubria, ASST-Sette Laghi, Varese, Italy.
  • Peghin M; Division of Infectious Diseases, Department of Medicine, University of Udine, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy; Infectious and Tropical Diseases Unit, Department of Medicine and Surgery, University of Insubria, ASST-Sette Laghi, Varese, Italy. Electronic address:
  • De Martino M; Division of Medical Statistic, Department of Medicine, University of Udine, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy.
  • De Carlo C; Division of Infectious Diseases, Department of Medicine, University of Udine, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy.
  • Da Porto A; Division of Internal Medicine, Department of Medicine, University of Udine, Udine, Italy.
  • Bulfone L; Division of Internal Medicine, Department of Medicine, University of Udine, Udine, Italy.
  • Casarsa V; Division of Internal Medicine, Department of Medicine, University of Udine, Udine, Italy.
  • Sozio E; Division of Infectious Diseases, Department of Medicine, University of Udine, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy.
  • Fabris M; Division of Laboratory Medicine, University of Udine, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy.
  • Cifù A; Division of Laboratory Medicine, University of Udine, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy.
  • Grassi B; Department of Medicine, University of Udine, Udine, Italy.
  • Curcio F; Division of Laboratory Medicine, University of Udine, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy.
  • Isola M; Division of Medical Statistic, Department of Medicine, University of Udine, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy.
  • Sechi LA; Division of Internal Medicine, Department of Medicine, University of Udine, Udine, Italy.
  • Tascini C; Division of Infectious Diseases, Department of Medicine, University of Udine, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy.
Clin Nutr ESPEN ; 51: 437-444, 2022 10.
Article in English | MEDLINE | ID: covidwho-1936181
ABSTRACT
BACKGROUND &

AIMS:

Obesity has been described as a predisposing risk factor to severe forms of COVID-19, but conflicting results are emerging on its real impact on the mortality of COVID-19. We aimed to compare clinical outcomes and mortality among COVID-19 patients according to obesity, metabolic syndrome and adiposity distribution.

METHODS:

We conducted a prospective observational study of all consecutive adult patients with a confirmed diagnosis of SARS-CoV-2 infection admitted to the Infectious Diseases Clinic at Udine Hospital, Italy, from January 2021 to February 2021. At admission, the study population was submitted to specific anthropometric, laboratory and bioimpedance analysis (BIA) measurements and divided into five groups according to 1) BMI < or >30 kg/m2; 2) waist circumference (WC) < or >98 cm for women, < or >102 cm for men; 3) presence or absence of metabolic syndrome (MS); 4) visceral adipose tissue (VAT) distribution; and 5) presence or absence of sarcopenia (SP) both based on BIA. We then compared clinical outcomes (ventilatory support, intensive care unit (ICU) admission, ICU length of stay, total hospital length of stay and mortality), immune and inflammatory makers and infectious and non-infectious acute complications within the five groups.

RESULTS:

A total of 195 patients were enrolled in the study. The mean age of patients was 71 years (IQR 61-80) and 64.6% (126) were male. The most common comorbidities were hypertension (55.9%) and MS (55.4%). Overall mortality was 19.5%. Abdominal adiposity, measured both with WC and with BIA, and SP were significantly associated with need for increased ventilator support (p = 0.013 for WC; p = 0.037, 0.027 and 0.009 for VAT; p = 0.004 and 0.036 for FMI; and p = 0.051 for SP), but not with ICU admission (WC p = 0.627, VAT p = 0.153, FMI p = 0.519 and SP p = 0.938), length of stay (WC p = 0.345, VAT p = 0.650, FMI p = 0.159 and SP p = 0.992) and mortality (WC p = 0.277, VAT p = 0.533, FMI p = 0.957 and SP p = 0.211). Obesity and MS did not discriminate for the intensity of ventilatory outcome (p = 0.142 and p = 0.198, respectively), ICU admission (p = 0.802 and p = 0.947, respectively), length of stay (p = 0.471 and p = 0.768, respectively) and mortality (p = 0.495 and p = 0.268, respectively). We did not find significant differences in inflammatory markers and secondary complications within the five groups.

CONCLUSIONS:

In patients admitted with COVID-19, increased WC, visceral abdominal fat and SP are associated with higher need for ventilatory support. However, obesity, MS, SP and abdominal adiposity are not sensitive predictive factors for mortality.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Metabolic Syndrome / Sarcopenia / COVID-19 Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: English Journal: Clin Nutr ESPEN Year: 2022 Document Type: Article Affiliation country: J.clnesp.2022.07.003

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Metabolic Syndrome / Sarcopenia / COVID-19 Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: English Journal: Clin Nutr ESPEN Year: 2022 Document Type: Article Affiliation country: J.clnesp.2022.07.003