Epicardial and pericoronary adipose tissue in severe COVID-19 infection

To investigate the association between epicardial and pericoronary adipose tissue thicknesses measured with computed tomography (CT) and severity of COVID-19 infection.

We recruited 504 patients admitted with RT-PCR-proven diagnosis of COVID-19 infection and underwent simultaneous Chest CT scanning. Epicardial adipose tissue thickness (EAT) and pericardial adipose tissue thickness (PCAT) were measured by CT. Comparisons were performed between ICU admitting and non-ICU admitting patients were performed.

Of 504 patients, 423 patients were hospitalised in normal wards or followed as outpatient, and 81 patients were admitted to ICU. EAT and PCAT were significantly increased in ICU patients (5.98[5.06-7.13] mm vs. 8.05[6.90-9.89] mm, p < 0.001 and 9.3[7.4-11.5] mm vs. 11.2[10.3-13.2] mm, p < 0.001, respectively). In multiple logistic regression analyses, EAT and PCAT were independent predictors of ICU admission. A cut-off point of 6.64 mm EAT has a sensitivity of 82.7% and a specificity of 66.7% (AUC = 0.789, 95% CI: 0.744-0.833, p < 0.001) and a cut-off point of 9.85 mm PCAT has a sensitivity of 91.4% and a specificity of 61.2% (AUC = 0.744, 95% CI: 0.700-0.788, p < 0.001).

We found that both increased EAT and PCAT were associated with the severity of COVID-19 infection defined as the need for ICU admission.