Visceral to subcutaneous fat ratio predicts short-term mortality in patients with Covid 19. A multicenter study

Surov A., Thormann M., Kardas H., Hinnerichs M., Omari J., Cingöz E., ...More

The British journal of radiology, vol.96, no.1144, pp.20220869, 2023 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Volume: 96 Issue: 1144
  • Publication Date: 2023
  • Doi Number: 10.1259/bjr.20220869
  • Journal Name: The British journal of radiology
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, CAB Abstracts, CINAHL, EMBASE, MEDLINE, Veterinary Science Database
  • Page Numbers: pp.20220869
  • Istanbul University Affiliated: Yes


OBJECTIVE: To evaluate the association of body composition parameters with outcomes in Covid-19. METHODS: 173 patients hospitalized for Covid-19 infection in 6 European centers were included in this retrospective study. Measurements were performed at L3-level and comprised skeletal muscle index (SMI), muscle density (MD), and adipose tissue measurements [visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), intramuscular adipose tissue (IMAT), visceral-to-subcutaneous-adipose-tissue-area-ratio (VSR)]. The association with mortality, the need for intubation (MV), and the need for admission to ICU within 30 days were evaluated. RESULTS: Higher SAT density was associated with a greater risk of MV (OR = 1.071, 95%CI=(1.034;1.110), p < 0.001). Higher VAT density was associated with admission to ICU (OR = 1.068, 95%CI=(1.029;1.109), p < 0.001). Higher MD was a protective factor for MV and ICU admission (OR = 0.914, 95%CI=(0.870;0.960), p < 0.001; OR = 0.882, 95%CI=(0.832;0.934), p = 0.028). Higher VSR was associated with mortality (OR = 2.147, 95%CI=(1.022;4.512), p = 0.044). Male sex showed the strongest influence on the risk of ICU admission and MV. SMI was not associated with either parameter. CONCLUSION: In patients hospitalized for Covid-19 infection, higher VSR seems to be a strong prognostic factor of short-term mortality. Weak associations with clinical course were found for MD and adipose tissue measurements. Male sex was the strongest prognostic factor of adverse clinical course. ADVANCES IN KNOWLEDGE: VSR is a prognostic biomarker for 30-day mortality in patients hospitalized for Covid-19 disease.