Prognostic Role of Subcutaneous and Visceral Adiposity in Hospitalized Octogenarians with COVID-19

Max Scheffler; Laurence Genton; Christophe E Graf; Jorge Remuinan; Gabriel Gold; Dina Zekry; Christine Serratrice; François R Herrmann; Aline Mendes

doi:10.3390/jcm10235500

Prognostic Role of Subcutaneous and Visceral Adiposity in Hospitalized Octogenarians with COVID-19

J Clin Med. 2021 Nov 24;10(23):5500. doi: 10.3390/jcm10235500.

Authors

Max Scheffler¹, Laurence Genton², Christophe E Graf³, Jorge Remuinan¹, Gabriel Gold⁴, Dina Zekry⁵, Christine Serratrice⁵, François R Herrmann⁴, Aline Mendes⁴

Affiliations

¹ Division of Radiology, Diagnostic Department, University Hospitals of Geneva, 1205 Geneva, Switzerland.
² Unit of Clinical Nutrition, Faculty of Medicine, University Hospitals of Geneva, 1205 Geneva, Switzerland.
³ Division of Internal Medicine and Rehabilitation, Department of Rehabilitation and Geriatrics, Faculty of Medicine, University Hospitals of Geneva, 1205 Geneva, Switzerland.
⁴ Division of Geriatrics, Department of Rehabilitation and Geriatrics, Faculty of Medicine, University Hospitals of Geneva, 1205 Geneva, Switzerland.
⁵ Division of Internal Medicine for the Aged, Department of Rehabilitation and Geriatrics, Faculty of Medicine, University Hospitals of Geneva, 1205 Geneva, Switzerland.

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.

Keywords: COVID-19; chest CT; mortality; subcutaneous fat; visceral fat.