Abstract
Background/Objectives
The aim of this post-hoc analysis was to evaluate if epicardial adipose tissue (EAT) quantity and quality, as evaluated by computed tomography (CT), have a different role in the risk of mortality and pulmonary embolism in critically ill COVID-19 patients admitted to an intensive care unit (ICU).
Subjects/Methods
CT derived EAT volume and density, as well as anthropometric and blood biomarkers, were evaluated in a sample of 138 subjects, 109 men and 29 women, for whom CT images and information on pulmonary embolism were available from a total of 313 subjects who were consecutively admitted to the ICU for COVID-19 from the REINSURE-ARDS prospective registry.
Results
A total of 28 patients (20.3%) died during the first 28 days after ICU admission. 26 subjects out of 138 had pulmonary embolism (18.8%). Age, weight, BMI, IL-6 levels and pulmonary embolism prevalence were significantly higher across EAT volume tertiles. Subjects who died in the first 28 days from ICU admission were older, had higher EAT volume, D-dimer, LDH and IL-6 level.
After adjustment for age and gender, participants in tertile 3 of EAT volume had lower survival at 28 days from ICU admission as compared to subjects in the tertile 1, HR 2.95 (95% C.I. 1.02–8.49), but after adjusting for potential confounders the relation was no longer significant. No relation between EAT density and mortality was observed.
From a binary logistic regression, subjects in tertile 3 of EAT volume and in tertile 1 of EAT density showed a 4 times and 3.6 times increased risk of pulmonary embolism, respectively.
Conclusions
ICU subjects affected by severe COVID-19 with higher EAT volume and low EAT density should be carefully monitored and managed with a prompt and aggressive approach, to prevent serious and life-threatening consequences and the increase of hospital treatment costs.
【초록키워드】 COVID-19, Treatment, Biomarkers, Mortality, intensive care, severe COVID-19, IL-6, hospital, LDH, risk, D-dimer, ICU, Prevalence, Computed tomography, survival, Critically ill, Patient, ICU admission, Logistic regression, women, BMI, information, Blood, COVID-19 patient, Volume, Older, tissue, increased risk, subject, post-hoc analysis, life-threatening, participant, adipose, men, approach, Prevent, confounder, consequence, Result, affected, evaluate, died, evaluated, subjects, significantly higher, age and gender, IL-6 level, 【제목키워드】 COVID-19, Mortality, Prognostic factor, Critically ill patient, Volume, tissue, adipose, affected,