The impact of body and visceral fat on the disease course and outcome of hospitalized COVID-19 patients

[Đ. R. Stevanović]

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Uvod: tačan uticaj gojaznosti na tok i ishod COVID-19 ostaje nedovoljno ispitan, a kao jedno od glavnih objašnjenja navodi se samostalna upotreba ITM u definisanju gojaznosti u većini istraživanja, čime se zanemaruje uticaj zastupljenosti i raspodele masnog tkiva. Ciljevi: primarni cilj studije bio je ispitivanje uticaja telesnih i visceralnih masti na razvoj kritične forme bolesti i mortalitet hospitalizovanih COVID-19 pacijenata. Metodologija: klinička opservaciona, prospektivna studija sprovedena je na 216 adultnih, SARS-CoV-2 pozitivnih pacijenata, hospitalizovanih u Univerzitetskom Kliničkom Centru Kragujevac (Kragujevac, Srbija) u periodu od oktobra 2021. do januara 2022. godine. Unutar 24 časa od prijema u bolnicu, pacijenti su rutinski uzrokovani za arterijske gasne analize i laboratorijske analize. Dodatno, unutar 72 časa od prijema, pacijentima su sprovedena somatometrijska merenja, koja su, osim ITM, uključivala i parametre dobijene analizom bioelektrične imdedance - %TM i nivo VM. Pacijenti su praćeni tokom trajanja hospitalnog lečenja. Rezultati: većina pacijenata imala je narušen status uhranjenosti u smeru gojaznosti: 39,3% po ITM, odnosno 50,9% po %TM, dok je veoma visok nivo VM imalo 38,4% ispitanika. Veoma visok nivo %TM i VM bili su nezavisni prediktori razvoja kritične forme bolesti (aOR 6,55, odnosno 2,10) i mortaliteta (aOR 3,36, odnosno 2,54). Iako je postojanje gojaznosti po ITM nosilo tri puta veći rizik od razvoja kritične forme (aOR 3,14), ITM se nije izdvojio kao nezavisni prediktor mortaliteta. Zaključak: procena statusa uhranjenosti metodom bioelektrične impedance može biti korisna u ranoj proceni visoko-rizičnih COVID-19 pacijenata

Introduction: the data regarding the exact impact of obesity on COVID-19 are inconsistent. One of the possible explanations are sole use of BMI in defining obesity, thus neglecting the presence and distribution of adipose tissue. Aim: the primary aim was to examine the impact of total body and visceral fat on mortality and critical form development among hospitalized COVID-19 patients. Method: observational, prospective study was conducted on 216 adult, SARS-CoV-2 positive patients, hospitalized in the University Clinical Center Kragujevac, between October 2021. and January 2022. Within 24 hours upon admission patients were routinely sampled for laboratory and blood gas analysis. Additionally, within 72 hours upon admission, somatometric measurements were performed. They included BMI and parameters obtained from bioelectrical impedance analysis - BF% and VF levels. Patients were followed during the hospitalization period. Results: majority of patients had disturbed body composition in terms of obesity: 39.3% according to BMI and 50.9% according to BF%, while 38.4% of patients had very high VF levels. Very high BF% and VF were independent predictors of critical form development (aOR 6.55 and 2.10, respectively) and mortality (aOR 3.36 and 2.54, respectively). Although the presence of obesity according to BMI carried a three time greater risk of critical form development (aOR 3.14), BMI was not singled out as an independent predictor of mortality. Conclusion: accessing body composition using the bioelectrical impedance method could be useful in early recognition of high-risk hospitalized COVID-19 patients.

analiza bioelektrične impedance; visceralne masti; gojaznost; indeks telesne mase; telesne masti; COVID-19.

bioelectrical impedance analysis; body fat; body mass index; COVID-19; obesity; visceral fat.

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Interna medicina

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