Abstract
Background & aims: Gaining insight into readily obtainable baseline characteristics that allow prediction of adverse outcome in COVID-19 aids both treatment and healthcare planning. Bioelectric impedance (BIA) Phase Angle (PhA) is correlated with outcome in a multitude of diseases and may be of added value in predicting adverse outcome of COVID-19. We aimed to associate baseline body composition parameters with 90-day adverse outcome of COVID-19 including ICU-admission and to explore the added predictive value of baseline PhA.
Methods: We performed a prospective observational study, conducting BIA amongst COVID-19 patients within 24 hours of hospital admission, with a follow-up of 90 days. Data were compared between ward-only and ICU-patients. Regression models were used to assess the associations between baseline characteristics, body composition and 90-day adverse outcome, including a composite outcome score of morbidity, ICU-admission, and mortality. An ROC-curve was used to explore the added predictive value of PhA to other clinical parameters at baseline for the prediction of adverse outcome.
Results: One-hundred-and-fifty patients were included. Mean age was 68 (66-70) years, 67% were male. Forty-one (27%) patients were admitted to ICU and 77 (51%) met the criteria of the composite outcome score. In multiple regression, PhA was independently, inversely correlated with risk of ICU-admission (OR .531, p = .021), complications (OR .579, p = .031), hospital length of stay (OR .875, p = .037) and the composite outcome score (OR .502, p = .012). An ROC-curve showed that the incorporation of PhA in a composite risk-score improved the discriminative power for the composite outcome from poor to fair, compared to individual predictors (AUC 0.79 (95% CI 0.71-0.87)).
Conclusion: BIA measurements including Phase Angle are independently correlated with an adverse outcome of COVID-19. Interpretation of Phase Angle can be a valuable addition to risk assessment of adverse outcome of COVID-19 at hospital admission.
Clinical trial registration: Netherlands Trial Register number NL8562, registered 2020-04-21.
Keywords: Bioelectric impedance; Body composition; COVID-19; Intensive care; Phase angle; SARS-CoV-2.
【저자키워드】 COVID-19, SARS-CoV-2, intensive care, body composition, Bioelectric impedance, Phase angle, 【초록키워드】 Treatment, SARS-CoV-2, Mortality, Trial, prospective observational study, hospital, risk, outcome, adverse outcome, clinical, healthcare, morbidity, male, Patient, Complication, age, Hospital admission, Follow-up, predictor, disease, association, phase, Regression, COVID-19 patient, AUC, criteria, Predictive, 95% CI, baseline characteristics, Multiple regression, Registered, angle, clinical parameter, parameter, performed, was used, addition, Netherland, were used, added, correlated, 24 hour, admitted to ICU, baseline, Body, 【제목키워드】 ICU, adverse outcome, hospitalized COVID-19,