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Impact of visceral fat on the prognosis of coronavirus disease 2019: an observational cohort study

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 dep...

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Autores principales: Ogata, Hiroaki, Mori, Masahiro, Jingushi, Yujiro, Matsuzaki, Hiroshi, Katahira, Katsuyuki, Ishimatsu, Akiko, Enokizu-Ogawa, Aimi, Taguchi, Kazuhito, Moriwaki, Atsushi, Yoshida, Makoto
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8660963/
https://www.ncbi.nlm.nih.gov/pubmed/34893021
http://dx.doi.org/10.1186/s12879-021-06958-z
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author Ogata, Hiroaki
Mori, Masahiro
Jingushi, Yujiro
Matsuzaki, Hiroshi
Katahira, Katsuyuki
Ishimatsu, Akiko
Enokizu-Ogawa, Aimi
Taguchi, Kazuhito
Moriwaki, Atsushi
Yoshida, Makoto
author_facet Ogata, Hiroaki
Mori, Masahiro
Jingushi, Yujiro
Matsuzaki, Hiroshi
Katahira, Katsuyuki
Ishimatsu, Akiko
Enokizu-Ogawa, Aimi
Taguchi, Kazuhito
Moriwaki, Atsushi
Yoshida, Makoto
author_sort Ogata, Hiroaki
collection PubMed
description 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12879-021-06958-z.
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spelling pubmed-86609632021-12-10 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 BMC Infect Dis Research 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12879-021-06958-z. BioMed Central 2021-12-10 /pmc/articles/PMC8660963/ /pubmed/34893021 http://dx.doi.org/10.1186/s12879-021-06958-z Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Ogata, Hiroaki
Mori, Masahiro
Jingushi, Yujiro
Matsuzaki, Hiroshi
Katahira, Katsuyuki
Ishimatsu, Akiko
Enokizu-Ogawa, Aimi
Taguchi, Kazuhito
Moriwaki, Atsushi
Yoshida, Makoto
Impact of visceral fat on the prognosis of coronavirus disease 2019: an observational cohort study
title Impact of visceral fat on the prognosis of coronavirus disease 2019: an observational cohort study
title_full Impact of visceral fat on the prognosis of coronavirus disease 2019: an observational cohort study
title_fullStr Impact of visceral fat on the prognosis of coronavirus disease 2019: an observational cohort study
title_full_unstemmed Impact of visceral fat on the prognosis of coronavirus disease 2019: an observational cohort study
title_short Impact of visceral fat on the prognosis of coronavirus disease 2019: an observational cohort study
title_sort impact of visceral fat on the prognosis of coronavirus disease 2019: an observational cohort study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8660963/
https://www.ncbi.nlm.nih.gov/pubmed/34893021
http://dx.doi.org/10.1186/s12879-021-06958-z
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