The impact of chest CT body composition parameters on clinical outcomes in COVID-19 patients

We assessed the impact of chest CT body composition parameters on outcomes and disease severity at hospital presentation of COVID-19 patients, focusing also on the possible mediation of body composition in the relationship between age and death in these patients. Chest CT scans performed at hospital...

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Bibliographic Details
Published in:PloS one Vol. 16; no. 5; p. e0251768
Main Authors: Besutti, Giulia, Pellegrini, Massimo, Ottone, Marta, Cantini, Michele, Milic, Jovana, Bonelli, Efrem, Dolci, Giovanni, Cassone, Giulia, Ligabue, Guido, Spaggiari, Lucia, Pattacini, Pierpaolo, Fasano, Tommaso, Canovi, Simone, Massari, Marco, Salvarani, Carlo, Guaraldi, Giovanni, Rossi, Paolo Giorgi
Format: Journal Article
Language:English
Published: United States Public Library of Science 14.05.2021
Public Library of Science (PLoS)
Subjects:
Abdomen
Adipose tissue
Bioelectricity
Biology and Life Sciences
Body composition
Body composition (biology)
Body fat
Body mass
Body mass index
Body size
Chemistry
Chest
Clinical nutrition
Clinical outcomes
Computed tomography
Coronaviruses
COVID-19
Cytokines
Data analysis
Diabetes mellitus
Diabetes mellitus (non-insulin dependent)
Diagnostic imaging
Diagnostic systems
Draft (gas flow)
Editing
Emergency medical care
Endocrinology
Epidemics
Epidemiology
Evaluation
Fatalities
Health aspects
Health risks
Health surveillance
HIV
Hospitalization
Human immunodeficiency virus
Infectious diseases
Inflammation
Insulin
Insulin resistance
Laboratories
Mechanical ventilation
Medical imaging
Medicine
Medicine and Health Sciences
Metabolism
Muscles
Musculoskeletal system
Nutrition
Nutrition therapy
Parameters
Patients
Pneumonia
Radiology
Research and Analysis Methods
Respiratory diseases
Rheumatology
Sarcopenia
Skeletal muscle
Thorax
Ventilation
Ventilators
Working groups
Italy
ISSN:1932-6203, 1932-6203
Online Access:Get full text
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Summary:We assessed the impact of chest CT body composition parameters on outcomes and disease severity at hospital presentation of COVID-19 patients, focusing also on the possible mediation of body composition in the relationship between age and death in these patients. Chest CT scans performed at hospital presentation by consecutive COVID-19 patients (02/27/2020-03/13/2020) were retrospectively reviewed to obtain pectoralis muscle density and total, visceral, and intermuscular adipose tissue areas (TAT, VAT, IMAT) at the level of T7-T8 vertebrae. Primary outcomes were: hospitalization, mechanical ventilation (MV) and/or death, death alone. Secondary outcomes were: C-reactive protein (CRP), oxygen saturation (SO2), CT disease extension at hospital presentation. The mediation of body composition in the effect of age on death was explored. Of the 318 patients included in the study (median age 65.7 years, females 37.7%), 205 (64.5%) were hospitalized, 68 (21.4%) needed MV, and 58 (18.2%) died. Increased muscle density was a protective factor while increased TAT, VAT, and IMAT were risk factors for hospitalization and MV/death. All these parameters except TAT had borderline effects on death alone. All parameters were associated with SO2 and extension of lung parenchymal involvement at CT; VAT was associated with CRP. Approximately 3% of the effect of age on death was mediated by decreased muscle density. In conclusion, low muscle quality and ectopic fat accumulation were associated with COVID-19 outcomes, VAT was associated with baseline inflammation. Low muscle quality partly mediated the effect of age on mortality.
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Competing Interests: The authors have declared that no competing interests exist.
Membership of the Reggio Emilia COVID-19 Working Group is provided in the Acknowledgments.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0251768