Cargando…
The impact of chest CT body composition parameters on clinical outcomes in COVID-19 patients
We assessed the impact of chest CT body composition parameters on outcomes and disease severity at hospital presentation of COVID-19 patients, focusing also on the possible mediation of body composition in the relationship between age and death in these patients. Chest CT scans performed at hospital...
Autores principales: | , , , , , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8121324/ https://www.ncbi.nlm.nih.gov/pubmed/33989341 http://dx.doi.org/10.1371/journal.pone.0251768 |
_version_ | 1783692317448732672 |
---|---|
author | Besutti, Giulia Pellegrini, Massimo Ottone, Marta Cantini, Michele Milic, Jovana Bonelli, Efrem Dolci, Giovanni Cassone, Giulia Ligabue, Guido Spaggiari, Lucia Pattacini, Pierpaolo Fasano, Tommaso Canovi, Simone Massari, Marco Salvarani, Carlo Guaraldi, Giovanni Rossi, Paolo Giorgi |
author_facet | Besutti, Giulia Pellegrini, Massimo Ottone, Marta Cantini, Michele Milic, Jovana Bonelli, Efrem Dolci, Giovanni Cassone, Giulia Ligabue, Guido Spaggiari, Lucia Pattacini, Pierpaolo Fasano, Tommaso Canovi, Simone Massari, Marco Salvarani, Carlo Guaraldi, Giovanni Rossi, Paolo Giorgi |
author_sort | Besutti, Giulia |
collection | PubMed |
description | We assessed the impact of chest CT body composition parameters on outcomes and disease severity at hospital presentation of COVID-19 patients, focusing also on the possible mediation of body composition in the relationship between age and death in these patients. Chest CT scans performed at hospital presentation by consecutive COVID-19 patients (02/27/2020-03/13/2020) were retrospectively reviewed to obtain pectoralis muscle density and total, visceral, and intermuscular adipose tissue areas (TAT, VAT, IMAT) at the level of T7-T8 vertebrae. Primary outcomes were: hospitalization, mechanical ventilation (MV) and/or death, death alone. Secondary outcomes were: C-reactive protein (CRP), oxygen saturation (SO2), CT disease extension at hospital presentation. The mediation of body composition in the effect of age on death was explored. Of the 318 patients included in the study (median age 65.7 years, females 37.7%), 205 (64.5%) were hospitalized, 68 (21.4%) needed MV, and 58 (18.2%) died. Increased muscle density was a protective factor while increased TAT, VAT, and IMAT were risk factors for hospitalization and MV/death. All these parameters except TAT had borderline effects on death alone. All parameters were associated with SO2 and extension of lung parenchymal involvement at CT; VAT was associated with CRP. Approximately 3% of the effect of age on death was mediated by decreased muscle density. In conclusion, low muscle quality and ectopic fat accumulation were associated with COVID-19 outcomes, VAT was associated with baseline inflammation. Low muscle quality partly mediated the effect of age on mortality. |
format | Online Article Text |
id | pubmed-8121324 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-81213242021-05-24 The impact of chest CT body composition parameters on clinical outcomes in COVID-19 patients Besutti, Giulia Pellegrini, Massimo Ottone, Marta Cantini, Michele Milic, Jovana Bonelli, Efrem Dolci, Giovanni Cassone, Giulia Ligabue, Guido Spaggiari, Lucia Pattacini, Pierpaolo Fasano, Tommaso Canovi, Simone Massari, Marco Salvarani, Carlo Guaraldi, Giovanni Rossi, Paolo Giorgi PLoS One Research Article We assessed the impact of chest CT body composition parameters on outcomes and disease severity at hospital presentation of COVID-19 patients, focusing also on the possible mediation of body composition in the relationship between age and death in these patients. Chest CT scans performed at hospital presentation by consecutive COVID-19 patients (02/27/2020-03/13/2020) were retrospectively reviewed to obtain pectoralis muscle density and total, visceral, and intermuscular adipose tissue areas (TAT, VAT, IMAT) at the level of T7-T8 vertebrae. Primary outcomes were: hospitalization, mechanical ventilation (MV) and/or death, death alone. Secondary outcomes were: C-reactive protein (CRP), oxygen saturation (SO2), CT disease extension at hospital presentation. The mediation of body composition in the effect of age on death was explored. Of the 318 patients included in the study (median age 65.7 years, females 37.7%), 205 (64.5%) were hospitalized, 68 (21.4%) needed MV, and 58 (18.2%) died. Increased muscle density was a protective factor while increased TAT, VAT, and IMAT were risk factors for hospitalization and MV/death. All these parameters except TAT had borderline effects on death alone. All parameters were associated with SO2 and extension of lung parenchymal involvement at CT; VAT was associated with CRP. Approximately 3% of the effect of age on death was mediated by decreased muscle density. In conclusion, low muscle quality and ectopic fat accumulation were associated with COVID-19 outcomes, VAT was associated with baseline inflammation. Low muscle quality partly mediated the effect of age on mortality. Public Library of Science 2021-05-14 /pmc/articles/PMC8121324/ /pubmed/33989341 http://dx.doi.org/10.1371/journal.pone.0251768 Text en © 2021 Besutti et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Besutti, Giulia Pellegrini, Massimo Ottone, Marta Cantini, Michele Milic, Jovana Bonelli, Efrem Dolci, Giovanni Cassone, Giulia Ligabue, Guido Spaggiari, Lucia Pattacini, Pierpaolo Fasano, Tommaso Canovi, Simone Massari, Marco Salvarani, Carlo Guaraldi, Giovanni Rossi, Paolo Giorgi The impact of chest CT body composition parameters on clinical outcomes in COVID-19 patients |
title | The impact of chest CT body composition parameters on clinical outcomes in COVID-19 patients |
title_full | The impact of chest CT body composition parameters on clinical outcomes in COVID-19 patients |
title_fullStr | The impact of chest CT body composition parameters on clinical outcomes in COVID-19 patients |
title_full_unstemmed | The impact of chest CT body composition parameters on clinical outcomes in COVID-19 patients |
title_short | The impact of chest CT body composition parameters on clinical outcomes in COVID-19 patients |
title_sort | impact of chest ct body composition parameters on clinical outcomes in covid-19 patients |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8121324/ https://www.ncbi.nlm.nih.gov/pubmed/33989341 http://dx.doi.org/10.1371/journal.pone.0251768 |
work_keys_str_mv | AT besuttigiulia theimpactofchestctbodycompositionparametersonclinicaloutcomesincovid19patients AT pellegrinimassimo theimpactofchestctbodycompositionparametersonclinicaloutcomesincovid19patients AT ottonemarta theimpactofchestctbodycompositionparametersonclinicaloutcomesincovid19patients AT cantinimichele theimpactofchestctbodycompositionparametersonclinicaloutcomesincovid19patients AT milicjovana theimpactofchestctbodycompositionparametersonclinicaloutcomesincovid19patients AT bonelliefrem theimpactofchestctbodycompositionparametersonclinicaloutcomesincovid19patients AT dolcigiovanni theimpactofchestctbodycompositionparametersonclinicaloutcomesincovid19patients AT cassonegiulia theimpactofchestctbodycompositionparametersonclinicaloutcomesincovid19patients AT ligabueguido theimpactofchestctbodycompositionparametersonclinicaloutcomesincovid19patients AT spaggiarilucia theimpactofchestctbodycompositionparametersonclinicaloutcomesincovid19patients AT pattacinipierpaolo theimpactofchestctbodycompositionparametersonclinicaloutcomesincovid19patients AT fasanotommaso theimpactofchestctbodycompositionparametersonclinicaloutcomesincovid19patients AT canovisimone theimpactofchestctbodycompositionparametersonclinicaloutcomesincovid19patients AT massarimarco theimpactofchestctbodycompositionparametersonclinicaloutcomesincovid19patients AT salvaranicarlo theimpactofchestctbodycompositionparametersonclinicaloutcomesincovid19patients AT guaraldigiovanni theimpactofchestctbodycompositionparametersonclinicaloutcomesincovid19patients AT rossipaologiorgi theimpactofchestctbodycompositionparametersonclinicaloutcomesincovid19patients AT theimpactofchestctbodycompositionparametersonclinicaloutcomesincovid19patients AT besuttigiulia impactofchestctbodycompositionparametersonclinicaloutcomesincovid19patients AT pellegrinimassimo impactofchestctbodycompositionparametersonclinicaloutcomesincovid19patients AT ottonemarta impactofchestctbodycompositionparametersonclinicaloutcomesincovid19patients AT cantinimichele impactofchestctbodycompositionparametersonclinicaloutcomesincovid19patients AT milicjovana impactofchestctbodycompositionparametersonclinicaloutcomesincovid19patients AT bonelliefrem impactofchestctbodycompositionparametersonclinicaloutcomesincovid19patients AT dolcigiovanni impactofchestctbodycompositionparametersonclinicaloutcomesincovid19patients AT cassonegiulia impactofchestctbodycompositionparametersonclinicaloutcomesincovid19patients AT ligabueguido impactofchestctbodycompositionparametersonclinicaloutcomesincovid19patients AT spaggiarilucia impactofchestctbodycompositionparametersonclinicaloutcomesincovid19patients AT pattacinipierpaolo impactofchestctbodycompositionparametersonclinicaloutcomesincovid19patients AT fasanotommaso impactofchestctbodycompositionparametersonclinicaloutcomesincovid19patients AT canovisimone impactofchestctbodycompositionparametersonclinicaloutcomesincovid19patients AT massarimarco impactofchestctbodycompositionparametersonclinicaloutcomesincovid19patients AT salvaranicarlo impactofchestctbodycompositionparametersonclinicaloutcomesincovid19patients AT guaraldigiovanni impactofchestctbodycompositionparametersonclinicaloutcomesincovid19patients AT rossipaologiorgi impactofchestctbodycompositionparametersonclinicaloutcomesincovid19patients AT impactofchestctbodycompositionparametersonclinicaloutcomesincovid19patients |