Beltrão Fabyan Esberard de Lima, Beltrão Daniele Carvalhal de Almeida, Carvalhal Giulia, Beltrão Fabyo Napoleão de Lima, de Aquino Igor Motta, Brito Thaíse da Silva, Paulino Barbara Costa, Aires Elisa, Viegas Diana, Hecht Fabio, Halpern Bruno, Pordeus Liana Clebia De Morais, Gonçalves Maria da Conceição Rodrigues, Ramos Helton Estrela
Lauro Wanderley University Hospital, Federal University of Paraíba, João Pessoa, Paraíba, Brazil.
Postgraduate Program in Nutritional Sciences, Department of Nutrition, Center for Health Sciences, Federal University of Paraíba, João Pessoa, Paraíba, Brazil.
Endocr Connect. 2022 Sep 26;11(10). doi: 10.1530/EC-22-0290. Print 2022 Oct 1.
The severity of coronavirus disease 2019 (COVID-19) has been positively correlated with several comorbidities. The primary outcome of the study was to assess the relationship between the mortality and severity of COVID-19 and obesity classes according to BMI, visceral adipose tissue (VAT) area, s.c. adipose tissue area, muscle area (MA), and leptin levels.
In this prospective cohort study, 200 patients hospitalized with moderate-to-severe COVID-19 underwent an unenhanced CT of the thorax and laboratory tests, and leptin levels between June and August 2020 were obtained.
Our study included 200 patients (male 52%; mean age: 62 (49-74) years; obesity (BMI > 30): 51.5%)). Fifty-eight patients (23.5%) were admitted to the intensive care unit and 29 (14.5%) died. In multivariate logistic regression (corrected for leptin, sex, age, and serum biomarkers) and receiver operating characteristic curve analyses, high VAT > 150 cm2 (odds ratio (OR): 6.15; P < 0.002), MA < 92 cm2 (OR: 7.94; P < 0.005), and VAT/MA ratio > 2 (OR: 13.9; P < 0.0001) were independent risk factors for mortality. Indeed, the Kaplan-Meier curves showed that patients with MA < 92 cm2 and without obesity (BMI < 30) had a lower survival rate (hazard ratio between 3.89 and 9.66; P < 0.0006) than the other groups. Leptin levels were not related to mortality and severity.
This prospective study reports data on the largest number of hospitalized severe COVID-19 patients and pinpoints VAT area and MA calculated by CT as predictors of COVID-19 mortality.
2019冠状病毒病（COVID-19）的严重程度与多种合并症呈正相关。本研究的主要结果是根据体重指数（BMI）、内脏脂肪组织（VAT）面积、皮下脂肪组织面积、肌肉面积（MA）和瘦素水平，评估COVID-19的死亡率和严重程度与肥胖类别之间的关系。
在这项前瞻性队列研究中，200例中重度COVID-19住院患者接受了胸部平扫CT检查和实验室检查，并获取了2020年6月至8月期间的瘦素水平。
我们的研究纳入了200例患者（男性占52%；平均年龄：62（49-74）岁；肥胖（BMI>30）：51.5%）。58例患者（23.5%）入住重症监护病房，29例（14.5%）死亡。在多因素逻辑回归分析（校正了瘦素、性别、年龄和血清生物标志物）和受试者工作特征曲线分析中，高VAT>150 cm²（比值比（OR）：6.15；P<0.002）、MA<92 cm²（OR：7.94；P<0.005）以及VAT/MA比值>2（OR：13.9；P<0.0001）是死亡的独立危险因素。实际上，Kaplan-Meier曲线显示，MA<92 cm²且无肥胖（BMI<30）的患者的生存率低于其他组（风险比在3.89至9.66之间；P<0.0006）。瘦素水平与死亡率和严重程度无关。
这项前瞻性研究报告了大量住院的重症COVID-19患者的数据，并指出CT计算的VAT面积和MA是COVID-19死亡率的预测指标。
