Body composition on low dose chest CT is a significant predictor of poor clinical outcome in COVID-19 disease - A multicenter feasibility study.
Betacoronavirus
Body Composition
COVID-19
Coronavirus Infections
/ complications
Feasibility Studies
Female
Humans
Lung
/ diagnostic imaging
Male
Middle Aged
Obesity
/ complications
Pandemics
Pilot Projects
Pneumonia, Viral
/ complications
Predictive Value of Tests
Prognosis
Radiation Dosage
Risk Factors
SARS-CoV-2
Tomography, X-Ray Computed
/ methods
Body composition
COVID-19
Low-dose computed tomography
Obesity
Journal
European journal of radiology
ISSN: 1872-7727
Titre abrégé: Eur J Radiol
Pays: Ireland
ID NLM: 8106411
Informations de publication
Date de publication:
Nov 2020
Nov 2020
Historique:
received:
15
06
2020
revised:
02
09
2020
accepted:
05
09
2020
pubmed:
23
9
2020
medline:
25
11
2020
entrez:
22
9
2020
Statut:
ppublish
Résumé
Low-dose computed tomography (LDCT) of the chest is a recommended diagnostic tool in early stage of COVID-19 pneumonia. High age, several comorbidities as well as poor physical fitness can negatively influence the outcome within COVID-19 infection. We investigated whether the ratio of fat to muscle area, measured in initial LDCT, can predict severe progression of COVID-19 in the follow-up period. We analyzed 58 individuals with confirmed COVID-19 infection that underwent an initial LDCT in one of two included centers due to COVID-19 infection. Using the ratio of waist circumference per paravertebral muscle circumference (FMR), the body composition was estimated. Patient outcomes were rated on an ordinal scale with higher numbers representing more severe progression or disease associated complications (hospitalization/ intensive care unit (ICU)/ tracheal intubation/ death) within a follow-up period of 22 days after initial LDCT. In the initial LDCT a significantly higher FMR was found in patients requiring intensive care treatment within the follow-up period. In multivariate logistic regression analysis, FMR (p < .001) in addition to age (p < .01), was found to be a significant predictor of the necessity for ICU treatment of COVID-19 patients. FMR as potential surrogate of body composition and obesity can be easily determined in initial LDCT of COVID-19 patients. Within the multivariate analysis, in addition to patient age, low muscle area in proportion to high fat area represents an additional prognostic information for the patient outcome and the need of an ICU treatment during the follow-up period within the next 22 days. This multicentric pilot study presents a method using an initial LDCT to screen opportunistically for obese patients who have an increased risk for the need of ICU treatment. While clinical capacities, such as ICU beds and ventilators, are more crucial than ever to help manage the current global corona pandemic, this work introduces an approach that can be used for a cost-effective way to help determine the amount of these rare clinical resources required in the near future.
Identifiants
pubmed: 32961451
pii: S0720-048X(20)30463-0
doi: 10.1016/j.ejrad.2020.109274
pmc: PMC7480673
pii:
doi:
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
109274Informations de copyright
Copyright © 2020 Elsevier B.V. All rights reserved.
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