Visceral to subcutaneous fat ratio predicts short-term mortality in patients with Covid 19. A multicenter study

• Published in: British journal of radiology 2023-03, Vol.96 (1144), p.20220869-20220869
• Main Authors: Surov, Alexey, Thormann, Maximilian, Kardas, Hakan, Hinnerichs, Mattes, Omari, Jazan, Cingöz, Eda, Cingöz, Mehmet, Dursun, Memduh, Kormaz, İnan, Orhan, Çağrı, Yıldız, Ömer, Hocaoğlu, Elif, Inci, Ercan, Önder, Hakan, Erk, Hamdullah, Chousein, Ougkour, Sasani, Hadi, Gönen, Korcan Aysun, Pech, Maciej, Wienke, Andreas
• Format: Article
• Language: English
• Subjects: Adipose Tissue - diagnostic imaging; COVID-19; Disease Progression; Humans; Intra-Abdominal Fat - diagnostic imaging; Male; Retrospective Studies; Subcutaneous Fat - diagnostic imaging
• ISSN: 0007-1285; 1748-880X
• DOI: 10.1259/bjr.20220869

To evaluate the association of body composition parameters with outcomes in Covid-19. 173 patients hospitalized for Covid-19 infection in 6 European centers were included in this retrospective study. Measurements were performed at L3-level and comprised skeletal muscle index (SMI), muscle density (MD), and adipose tissue measurements [visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), intramuscular adipose tissue (IMAT), visceral-to-subcutaneous-adipose-tissue-area-ratio (VSR)]. The association with mortality, the need for intubation (MV), and the need for admission to ICU within 30 days were evaluated. Higher SAT density was associated with a greater risk of MV (OR = 1.071, 95%CI=(1.034;1.110), < 0.001). Higher VAT density was associated with admission to ICU (OR = 1.068, 95%CI=(1.029;1.109), < 0.001). Higher MD was a protective factor for MV and ICU admission (OR = 0.914, 95%CI=(0.870;0.960), < 0.001; OR = 0.882, 95%CI=(0.832;0.934), = 0.028). Higher VSR was associated with mortality (OR = 2.147, 95%CI=(1.022;4.512), = 0.044). Male sex showed the strongest influence on the risk of ICU admission and MV. SMI was not associated with either parameter. In patients hospitalized for Covid-19 infection, higher VSR seems to be a strong prognostic factor of short-term mortality. Weak associations with clinical course were found for MD and adipose tissue measurements. Male sex was the strongest prognostic factor of adverse clinical course. VSR is a prognostic biomarker for 30-day mortality in patients hospitalized for Covid-19 disease.