Subcutaneous Adipose Tissue Attenuation as Marker of Prognosis in Patients Admitted with Covid-19

Abstract

Objective: To investigate the association of Computed Tomography (CT) Subcutaneous Adipose Tissue (SAT) attenuation with outcome in patients admitted due to SARS-CoV-2 infection. Background: Obesity is associated with worse outcomes in coronavirus disease 2019 (COVID 19) but the underlying mechanisms are not well known. It is thought that the adipose tissue promotes a proinflammatory state that affects negatively these patients. Methods: We retrospectively analyzed chest CT scans of 75 patients admitted for SARS-CoV-2 infection. SAT attenuation was measured. Clinical and prognostic variables were collected from the medical reports. A statistical analysis was performed to determine the association of SAT attenuation CT measurements with the prognosis of COVID 19. Results: Mean age of patients was 71 years and 56% were male. Comorbidities included hypertension (54.7%), cancer history (27%), diabetes mellitus (25%) and obesity (8.7%). During admission 10 patients required intensive care (13.3%), all of them with mechanical ventilation and 7 patients needed vasopressor support (9.3%). In-hospital mortality occurred in 18 patients (24%). SAT attenuation was higher in hypertensive patients (-106.3±14.4 vs. -114.7±13.4 HU, p=0.011) in patients with cancer history (-102.6±13.8 vs. -112.8±13.9 HU, p=0.006 and in patients who died (-99.9 vs. -113.3 HU, p<0.001). Conclusion: SAT attenuation was associated with death in admitted patients with COVID-19. SAT attenuation is a broadly available marker that may indicate poor prognosis in COVID-19 patients.