Faiella Eliodoro, Castiello Gennaro, Santucci Domiziana, Pacella Giuseppina, Bernetti Caterina, Muley Villamu Moises, Antonelli Incalzi Raffaele, Beomonte Zobel Bruno, Quattrocchi Carlo Cosimo, Grasso Rosario Francesco
Department of Radiology, Campus Bio-Medico University, Via Alvaro del Portillo, 21-00128 Rome, Italy.
Department of Radiology, Sant'Anna Hospital, Via Ravona, 22042 San Fermo della Battaglia CO, Italy.
J Clin Med Res. 2022 May;14(5):188-195. doi: 10.14740/jocmr4708. Epub 2022 May 31.
The aim of the study was to analyze the relationship between patient characteristics, including anagraphic and laboratoristic data and amount of adipose tissue measured in computed tomography (CT) scans in coronavirus disease 2019 (COVID-19) patients, and incidence of soft tissue bleeding requiring medical and/or interventional radiology management.
A total of 132 patients hospitalized for COVID-19 pathology from October 2020 to May 2021 were included in the study and divided into two groups: a bleeding group of 70 cases with soft tissue bleeding occurring during hospitalization, and a control group of 62 hospitalized COVID-19 patients without bleeding events. In the bleeding group, two subgroups were considered: an embolization group including soft tissue bleeding cases requiring interventional radiology with transarterial embolization (TAE) (16/70; 22.9%) and a non-embolization group, clinically managed without TAE (54/70; 77.1%). Demographics and clinical data, visceral adipose tissue (VAT) area and subcutaneous adipose tissue (SAT) area measured on CT images and VAT/SAT ratio were compared between bleeding and control groups and between embolization and non-embolization subgroups.
Bleeding and control groups did not significantly differ for sex distribution, COVID-19, platelet (PLT) count, international normalized ratio (INR), SAT area, VAT area, and VAT/SAT ratio. Embolization and non-embolization groups did not significantly differ for age, COVID-19, PLT count, INR, SAT area, and VAT/SAT ratio. Bleeding group had lower body mass index (BMI) than control group as well as embolization group compared to non-embolization group. A statistically significant difference was observed between embolization and non-embolization groups for VAT area, with smaller values in embolization group (mean difference: 64.2 cm, 95% confidence interval: 8.3 - 120.1; P < 0.05).
Soft tissue bleeding in COVID-19 is more frequent and severe in patients with low amount of VAT, demonstrating that fat mass may have a containing function on bleeding, limiting its progression in surrounding structures. There are some other factors that influence the risk of bleeding, such as age, thromboprophylaxis therapy and BMI.
本研究旨在分析2019冠状病毒病（COVID-19）患者的特征（包括人口统计学和实验室数据以及计算机断层扫描（CT）中测量的脂肪组织量）与需要医学和/或介入放射学处理的软组织出血发生率之间的关系。
本研究纳入了2020年10月至2021年5月因COVID-19病理住院的132例患者，并将其分为两组：出血组70例，在住院期间发生软组织出血；对照组62例，为未发生出血事件的COVID-19住院患者。在出血组中，考虑两个亚组：栓塞组，包括需要经动脉栓塞（TAE）进行介入放射学治疗的软组织出血病例（16/70；22.9%）和非栓塞组，未进行TAE的临床处理（54/70；77.1%）。比较出血组和对照组之间以及栓塞组和非栓塞组亚组之间的人口统计学和临床数据、CT图像上测量的内脏脂肪组织（VAT）面积和皮下脂肪组织（SAT）面积以及VAT/SAT比值。
出血组和对照组在性别分布、COVID-19、血小板（PLT）计数、国际标准化比值（INR）、SAT面积、VAT面积和VAT/SAT比值方面无显著差异。栓塞组和非栓塞组在年龄、COVID-19、PLT计数、INR、SAT面积和VAT/SAT比值方面无显著差异。出血组的体重指数（BMI）低于对照组，栓塞组的BMI也低于非栓塞组。栓塞组和非栓塞组在VAT面积方面存在统计学显著差异，栓塞组的值较小（平均差异：64.2平方厘米，95%置信区间：8.3 - 120.1；P < 0.05）。
COVID-19患者中，VAT量低的患者软组织出血更频繁且更严重，表明脂肪量可能对出血有容纳作用，限制其在周围结构中的进展。还有其他一些因素会影响出血风险，如年龄、血栓预防治疗和BMI。
