Elsevier

Obesity Medicine

Volume 25, August 2021, 100358
Obesity Medicine

Anthropometric analysis of body habitus and outcomes in critically ill COVID-19 patients

https://doi.org/10.1016/j.obmed.2021.100358Get rights and content

Highlights

  • Anthropometric measurements on thoracic CT scans can be useful to analyse body composition in COVID-19 patients on ICU.

  • Thoracic skeletal muscle area was positively correlated with ventilator- and ICU-free days.

  • Moreover, deceased patients had a reduced thoracic skeletal muscle area compared to survivors.

  • Increased visceral fat and fat/muscle proportions were associated with worse outcomes in critically ill Covid-19 patients.

Abstract

Aims

This study aimed to determine whether anthropometric markers of thoracic skeletal muscle and abdominal visceral fat tissue correlate with outcome parameters in critically ill COVID-19 patients.

Methods

We retrospectively analysed thoracic CT-scans of 67 patients in four ICUs at a university hospital. Thoracic skeletal muscle (total cross-sectional area (CSA); pectoralis muscle area (PMA)) and abdominal visceral fat tissue (VAT) were quantified using a semi-automated method. Point-biserial-correlation-coefficient, Spearman-correlation-coefficient, Wilcoxon rank-sum test and logistic regression were used to assess the correlation and test for differences between anthropometric parameters and death, ventilator- and ICU-free days and initial inflammatory laboratory values.

Results

Deceased patients had lower CSA and PMA values, but higher VAT values (p < 0.001). Male patients with higher CSA values had more ventilator-free days (p = 0.047) and ICU-free days (p = 0.017). Higher VAT/CSA and VAT/PMA values were associated with higher mortality (p < 0.001), but were negatively correlated with ICU length of stay in female patients only (p < 0.016). There was no association between anthropometric parameters and initial inflammatory biomarker levels. Logistic regression revealed no significant independent predictor for death.

Conclusion

Our study suggests that pathologic body composition assessed by planimetric measurements using thoracic CT-scans is associated with worse outcome in critically ill COVID-19 patients.

Keywords

COVID-19
Anthropometry
Critical care
muscle(skeletal)
Adipose tissue

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