Abstract
Background: We investigated the prognostic significance of visceral and subcutaneous adiposity in octogenarians with COVID-19. Methods: This paper presents a monocentric retrospective study that was conducted in acute geriatric wards with 64 hospitalized patients aged 80+ who had a diagnosis of COVID-19 and who underwent a chest CT scan. A quantification of the subcutaneous, visceral, and total fat areas was performed after segmentations on the first abdominal slice caudal to the deepest pleural recess on a soft-tissue window setting. Logistic regression models were applied to investigate the association with in-hospital mortality and the extent of COVID-19 pneumonia. Results: The patients had a mean age of 86.4 ± 6.0 years, and 46.9% were male, with a mean BMI of 24.1 ± 4.4Kg/m2 and mortality rate of 32.8%. A higher subcutaneous fat area had a protective effect against mortality (OR 0.416; 0.183–0.944 95% CI; p = 0.036), which remained significant after adjustments for age, sex, and BMI (OR 0.231; 0.071–0.751 95% CI; p = 0.015). Inversely, higher abdominal circumference, total fat area, subcutaneous fat area, and visceral fat were associated with worse COVID-19 pneumonia, with the latter presenting the strongest association after adjustments for age, sex, and BMI (OR 2.862; 1.523–5.379 95% CI; p = 0.001). Conclusion: Subcutaneous and visceral fat areas measured on chest CT scans were associated with prognosis in octogenarians with COVID-19.
Highlights
Before the launch of the current vaccination campaigns around the world, older people were the most severely affected by the COVID-19 pandemic [1]
Obesity is associated with a higher prevalence of other risk factors that are related to the COVID-19 severity, such as hypertension and diabetes, but is recognized as a source of chronic inflammation and as a modulator of the immune response [8,9]
This study, which was conducted in a population of hospitalized octogenarians with COVID-19, demonstrated that the subcutaneous and visceral fat areas had a significant effect on prognosis, albeit different effects
Summary
Before the launch of the current vaccination campaigns around the world, older people were the most severely affected by the COVID-19 pandemic [1]. Older patients show reduced muscle strength and an increased proportion of fat tissue [2,3] that is independent of body mass index (BMI) [4]. These body composition characteristics have been described as independent determinants of bad prognosis in the course of COVID-19 by different studies [5,6,7]. Higher abdominal circumference, total fat area, subcutaneous fat area, and visceral fat were associated with worse COVID-19 pneumonia, with the latter presenting the strongest association after adjustments for age, sex, and BMI (OR 2.862; 1.523–5.379 95% CI; p = 0.001). Conclusion: Subcutaneous and visceral fat areas measured on chest CT scans were associated with prognosis in octogenarians with COVID-19
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