Epicardial fat inflammation response to COVID-19 therapies.

Abstract

ObjectiveAdipose tissue plays a role in the novel coronavirus disease 2019 (COVID‐19). Epicardial adipose tissue (EAT), a unique visceral fat, presents with a high degree of inflammation in severe COVID‐19. Whether and how adipose tissue may respond to the COVID‐19 therapies is unknown.MethodsThe difference in computed tomography‐measured EAT and subcutaneous (SAT) attenuation, defined as mean attenuation expressed in Hounsfield units (HU), was retrospectively analyzed in 72 patients (mean [SD] age was 59.6 [12.4] years, 50 patients [69%] were men) at the hospital admission for COVID‐19 and 99 days (interquartile range = 71‐129) after discharge.ResultsAt the admission, EAT‐HU was significantly correlated with blood glucose levels, interleukin 6, troponin T levels, and waist circumference. EAT‐HU decreased from −87.21 (16.18) to −100.0 (11) (p < 0.001), whereas SAT‐HU did not change (−110.21 [12.1] to −111.11 [27.82]; p = 0.78) after therapy. Changes in EAT‐HU (expressed as ∆) significantly correlated with dexamethasone therapy (r = −0.46, p = 0.006) and when dexamethasone was combined with tocilizumab (r = −0.24, p = 0.04).ConclusionsDexamethasone therapy was associated with significant reduction of EAT inflammation in COVID‐19 patients, whereas SAT showed no changes. Anti‐inflammatory therapies targeting visceral fat may be helpful in COVID‐19.