Cardiac adipose tissue volume assessed by computed tomography is a specific and independent predictor of early mortality and critical illness in COVID-19 in type 2-diabetic patients.
COVID-19
Cardiac adipose tissue
Computed tomography
Intensive care
Mortality
Type 2 diabetes (T2D)
Journal
Cardiovascular diabetology
ISSN: 1475-2840
Titre abrégé: Cardiovasc Diabetol
Pays: England
ID NLM: 101147637
Informations de publication
Date de publication:
31 12 2022
31 12 2022
Historique:
received:
27
09
2022
accepted:
06
12
2022
entrez:
31
12
2022
pubmed:
1
1
2023
medline:
4
1
2023
Statut:
epublish
Résumé
Patients with type 2-diabetes mellitus (T2D), are characterized by visceral and ectopic adipose tissue expansion, leading to systemic chronic low-grade inflammation. As visceral adiposity is associated with severe COVID-19 irrespective of obesity, we aimed to evaluate and compare the predictive value for early intensive care or death of three fat depots (cardiac, visceral and subcutaneous) using computed tomography (CT) at admission for COVID-19 in consecutive patients with and without T2D. Two hundred and two patients admitted for COVID-19 were retrospectively included between February and June 2020 and distributed in two groups: T2D or non-diabetic controls. Chest CT with cardiac (CATi), visceral (VATi) and subcutaneous adipose tissue (SATi) volume measurements were performed at admission. The primary endpoint was a composite outcome criteria including death or ICU admission at day 21 after admission. Threshold values of adipose tissue components predicting adverse outcome were determined. One hundred and eight controls [median age: 76(IQR:59-83), 61% male, median BMI: 24(22-27)] and ninety-four T2D patients [median age: 70(IQR:61-77), 70% male, median BMI: 27(24-31)], were enrolled in this study. At day 21 after admission, 42 patients (21%) had died from COVID-19, 48 (24%) required intensive care and 112 (55%) were admitted to a conventional care unit (CMU). In T2D, CATi was associated with early death or ICU independently from age, sex, BMI, dyslipidemia, CRP and coronary calcium (CAC). (p = 0.005). Concerning T2D patients, the cut-point for CATi was > 100 mL/m Cardiac adipose tissue volume measured in CT at admission was independently predictive of early intensive care or death in T2D patients with COVID-19 but not in non-diabetics. Such automated CT measurement could be used in routine in diabetic patients presenting with moderate to severe COVID-19 illness to optimize individual management and prevent critical evolution.
Sections du résumé
BACKGROUND
Patients with type 2-diabetes mellitus (T2D), are characterized by visceral and ectopic adipose tissue expansion, leading to systemic chronic low-grade inflammation. As visceral adiposity is associated with severe COVID-19 irrespective of obesity, we aimed to evaluate and compare the predictive value for early intensive care or death of three fat depots (cardiac, visceral and subcutaneous) using computed tomography (CT) at admission for COVID-19 in consecutive patients with and without T2D.
METHODS
Two hundred and two patients admitted for COVID-19 were retrospectively included between February and June 2020 and distributed in two groups: T2D or non-diabetic controls. Chest CT with cardiac (CATi), visceral (VATi) and subcutaneous adipose tissue (SATi) volume measurements were performed at admission. The primary endpoint was a composite outcome criteria including death or ICU admission at day 21 after admission. Threshold values of adipose tissue components predicting adverse outcome were determined.
RESULTS
One hundred and eight controls [median age: 76(IQR:59-83), 61% male, median BMI: 24(22-27)] and ninety-four T2D patients [median age: 70(IQR:61-77), 70% male, median BMI: 27(24-31)], were enrolled in this study. At day 21 after admission, 42 patients (21%) had died from COVID-19, 48 (24%) required intensive care and 112 (55%) were admitted to a conventional care unit (CMU). In T2D, CATi was associated with early death or ICU independently from age, sex, BMI, dyslipidemia, CRP and coronary calcium (CAC). (p = 0.005). Concerning T2D patients, the cut-point for CATi was > 100 mL/m
CONCLUSIONS
Cardiac adipose tissue volume measured in CT at admission was independently predictive of early intensive care or death in T2D patients with COVID-19 but not in non-diabetics. Such automated CT measurement could be used in routine in diabetic patients presenting with moderate to severe COVID-19 illness to optimize individual management and prevent critical evolution.
Identifiants
pubmed: 36587209
doi: 10.1186/s12933-022-01722-2
pii: 10.1186/s12933-022-01722-2
pmc: PMC9805370
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
294Investigateurs
Romain Tilmont
(R)
Romain Chenu
(R)
Louise Meyfroit
(L)
Nicoletta Pasi
(N)
Schahrazed Larbi-Messaoud
(S)
Suzanne Laroche
(S)
Cécile Ciangura
(C)
Marc Popelier
(M)
Sophie Jacqueminet
(S)
Marine Halbron
(M)
Agnès Hartemann
(A)
Informations de copyright
© 2022. The Author(s).
Références
J Clin Virol. 2020 Jun;127:104392
pubmed: 32361327
J Infect Dis. 2020 May 11;221(11):1762-1769
pubmed: 32227123
JAMA. 2020 Apr 28;323(16):1574-1581
pubmed: 32250385
Clin Infect Dis. 2020 Nov 19;71(16):2167-2173
pubmed: 32444880
Diabetes Care. 2021 Feb;44(2):526-532
pubmed: 33268335
Cytokine. 2021 May;141:155428
pubmed: 33550165
Metabolism. 2020 Oct;111:154319
pubmed: 32712222
J Exp Med. 2000 Nov 6;192(9):1353-64
pubmed: 11067883
Pharmacol Res. 2020 Aug;158:104931
pubmed: 32446978
Int J Infect Dis. 2022 Jul;120:33-40
pubmed: 35421580
Rev Med Virol. 2021 Jan;31(1):1-10
pubmed: 32845042
Cardiovasc Diabetol. 2021 Aug 12;20(1):165
pubmed: 34384426
Circulation. 2003 Nov 18;108(20):2460-6
pubmed: 14581396
BMJ. 2020 May 22;369:m1985
pubmed: 32444460
Cardiovasc Diabetol. 2019 Aug 30;18(1):114
pubmed: 31470858
Cardiovasc Diabetol. 2019 Jan 10;18(1):3
pubmed: 30630489
Cardiovasc Diabetol. 2021 Jul 20;20(1):147
pubmed: 34284784
JAMA. 2020 May 26;323(20):2052-2059
pubmed: 32320003
Lancet. 2020 Mar 28;395(10229):1054-1062
pubmed: 32171076
J Am Coll Cardiol. 2022 Jul 26;80(4):299-312
pubmed: 35863846
Biology (Basel). 2022 Feb 23;11(3):
pubmed: 35336728
Cells. 2020 Nov 19;9(11):
pubmed: 33228225
Circulation. 2009 Mar 31;119(12):1661-70
pubmed: 19289637
Cardiovasc Diabetol. 2021 May 7;20(1):99
pubmed: 33962629
J Am Heart Assoc. 2014 Mar 04;3(2):e000582
pubmed: 24595191
Obesity (Silver Spring). 2021 Sep;29(9):1427-1433
pubmed: 34028990
J Cardiovasc Comput Tomogr. 2018 May - Jun;12(3):185-191
pubmed: 29793848