Abstract
Background & aims: Adipose tissue is a biologically active organ with pro-immunogenic properties. We aimed to evaluate the prognostic value of epicardial adipose tissue (EAT) in COVID-19 and its correlation with other inflammatory biomarkers.
Material and methods: One-hundred patients with COVID-19 were enrolled. C-reactive protein (CRP), lactate dehydrogenase (LDH), neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-CRP ratio (LCR), and platelet-to-lymphocyte ratio (PLR) were evaluated on admission. EAT volume and density were measured by computed tomography. Patients were followed until death or discharge. Univariate and multivariate analysis was performed and ROC curve analysis was used to assess the ability of inflammatory markers in predicting survival. The relationship between EAT and other inflammatory markers was also investigated.
Results: The mean ± SD age of patients was 55.5 ± 15.2 years old; 68% were male. Univariate analysis revealed that increased lung involvement, blood urea nitrogen, LDH and NLR, and decreased platelet count were significantly associated with death. After adjustment, LDH was independently predictive of death (OR = 1.013, p-value = 0.03). Among inflammatory markers, LCR had the best ability for predicting survival with 79.7% sensitivity and 64.3% specificity at an optimal cut-off value of 20.8 (AUC = 0.744, 95% CI = 0.612-0.876, p-value = 0.004). EAT volume demonstrated positive correlation with NLR and PLR (p = 0.001 and 0.01), and a negative correlation with LCR (p = 0.02). EAT density was significantly different between decedents and survivors (p = 0.008).
Conclusion: Routine laboratory tests that represent status of inflammation can be used as cost-effective prognostic markers of COVID-19. Also, the significant association between EAT volume and other inflammatory biomarkers might explain the more severe disease in obese patients.
Keywords: COVID-19; Computed tomography; Epicardial adipose tissue; Inflammation; Obesity; Prognosis.
【저자키워드】 COVID-19, Inflammation, Prognosis, obesity, Computed tomography, Epicardial adipose tissue, 【초록키워드】 Prognosis, obesity, lung involvement, neutrophil, inflammatory markers, LDH, C-reactive protein, CRP, Laboratory tests, lactate dehydrogenase, discharge, Neutrophil-to-lymphocyte ratio, Computed tomography, lymphocyte, sensitivity, specificity, survival, male, Patient, death, Platelet, Prognostic marker, age, Inflammatory marker, correlation, Admission, Platelet count, Adipose tissue, association, Multivariate analysis, inflammatory biomarkers, NLR, LCR, Lactate, Inflammatory biomarker, Analysis, severe disease, ROC Curve, AUC, Laboratory test, best, on admission, Predictive, nitrogen, urea, Volume, Blood urea nitrogen, Prognostic value, P-value, 95% CI, tissue, status, positive correlation, density, obese, obese patients, negative correlation, cut-off value, material, routine, Univariate analysis, organ, survivor, adipose, enrolled, was used, evaluate, significantly, investigated, evaluated, was performed, can be used, demonstrated, explain, were measured, patients with COVID-19, 【제목키워드】 Adipose tissue, Inflammatory biomarker, tissue, adipose,