Body composition predictors of outcome in patients with COVID-19.
Body composition predictors of outcome in patients with COVID-19.
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DOI：
10.1038/s41366-021-00907-1
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发表时间：
2021-10
期刊：
影响因子：
--
通讯作者：
Bredella MA
中科院分区：
文献类型：
--
作者：
Bunnell KM;Thaweethai T;Buckless C;Shinnick DJ;Torriani M;Foulkes AS;Bredella MA
肥胖是2019冠状病毒病住院患者不良后果的一个重要危险因素，但脂肪分布和肌肉量比体重指数更准确。本研究的目的是评估通过机会性腹部ct获得的体成分测量作为COVID-19住院患者预后的预测因子。我们假设内脏和肌间脂肪组织升高与不良结果有关。我们的回顾性研究是irb批准的，符合hipaa标准。研究组包括124名患者（中位年龄：68岁，IQR: 56,77； 59周，65个月），他们因COVID-19入住一家医院，并为临床目的接受了腹部CT检查。评估了内脏脂肪组织（VAT）、皮下脂肪组织（SAT）、肌间脂肪组织（IMAT）以及棘旁和腹肌横截面积（CSA）。临床信息包括预后因素、入住重症监护病房（ICU）时间和28天内死亡时间。拟合多变量时间-事件竞争风险模型，以估计与每个身体组成测量增加一个标准差相关的ICU入院/死亡率复合结局的风险比（HR）。每个模型都根据年龄、性别、种族、BMI和心脏代谢合并症进行了调整。有50例患者在入院后1天内入院或死亡[IQR 1,6]。在调整后的模型中，较高的VAT/SAT比值（HR为1.30；95% CI为1.04-1.62,p = 0.022）和较高的IMAT CSA （HR为1.44；95% CI为1.10-1.89,p = 0.008）与入住ICU的时间缩短或死亡相关。VAT/SAT和IMAT是COVID-19住院患者不良结局的预测因子，独立于其他已确定的预后因素。这表明身体成分测量可以作为COVID-19患者预后的新型生物标志物。
Obesity is a strong risk factor for adverse outcomes in patients hospitalized with COVID-19, however, the distribution of fat and the amount of muscle mass are more accurate risk factors than BMI. The objective of this study was to assess body composition measures obtained on opportunistic abdominal CTs as predictors of outcome in patients hospitalized with COVID-19. We hypothesized that elevated visceral and intermuscular adipose tissue would be associated with adverse outcome. Our retrospective study was IRB-approved and HIPAA-compliant. The study group comprised 124 patients (median age: 68 years, IQR: 56, 77; 59 weeks, 65 months) who were admitted with COVID-19 to a single hospital and who had undergone abdominal CT for clinical purposes. Visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), intermuscular adipose tissue (IMAT), and paraspinal and abdominal muscle cross-sectional areas (CSA) were assessed. Clinical information including prognostic factors, time of admission to the intensive care unit (ICU) and time of death within 28 days were obtained. Multivariate time-to-event competing risk models were fitted to estimate the hazard ratio (HR) for a composite outcome of ICU admission/mortality associated with a one standard deviation increase in each body compositional measure. Each model was adjusted for age, sex, race, BMI, and cardiometabolic comorbidities. There were 50 patients who were admitted to the ICU or deceased over a median time of 1 day [IQR 1, 6] from hospital admission. Higher VAT/SAT ratio (HR of 1.30; 95% CI 1.04–1.62, p = 0.022) and higher IMAT CSA (HR of 1.44; 95% CI 1.10–1.89, p = 0.008) were associated with a reduced time to ICU admission or death in adjusted models. VAT/SAT and IMAT are predictors of adverse outcome in patients hospitalized with COVID-19, independent of other established prognostic factors. This suggests that body composition measures may serve as novel biomarkers of outcome in patients with COVID-19.
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影响因子：
5.8
作者：
Granados, Andrea;Gebremariam, Achamyeleh;Lee, Joyce M.
通讯作者：
Lee, Joyce M.
DOI：
10.1093/gerona/glr022
发表时间：
2012-01-01
影响因子：
5.1
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作者：
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通讯作者：
Foulkes AS
DOI：
10.1016/j.clnu.2016.03.028
发表时间：
2016-12
期刊：
Clinical nutrition (Edinburgh, Scotland)
影响因子：
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作者：
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通讯作者：
Bartels SJ
影响因子：
4.5
作者：
Park YS;Kwon HT;Hwang SS;Choi SH;Cho YM;Lee J;Yim JJ
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