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Published on: October 14, 2016
The predictive value of epicardial fat volume for clinical severity of COVID-19
Mehmet Akif Erdöl1, Fatma Civelek Eser2, Abdullah Nabi Aslan1
1Cardiology Unit; Ministry of Health, Ankara City Hospital, Turkey.
Insights
Epicardial fat volume (EFV) and inflammatory markers are linked to COVID-19 severity. Higher EFV independently predicts intensive care unit (ICU) admission in COVID-19 patients.
Area of Science:
- Cardiology
- Infectious Diseases
- Radiology
Background:
- Epicardial adipose tissue (EAT) releases inflammatory cytokines, contributing to cytokine storms in COVID-19.
- Cytokine storms are a major cause of morbidity and mortality in COVID-19 patients.
Purpose of the Study:
- To investigate the association between epicardial fat volume (EFV), inflammatory biomarkers, and COVID-19 clinical severity.
- To determine if EFV can predict adverse outcomes in COVID-19 patients.
Main Methods:
- Retrospective study of 101 COVID-19 patients.
- Measurement of serum inflammatory biomarkers: C-reactive protein (CRP), interleukin-6 (IL-6), procalcitonin (PCT), and ferritin.
- Semi-automated CT-based measurement of epicardial fat volume (EFV).
- Primary endpoint: Intensive Care Unit (ICU) admission or death.
Main Results:
- Patients admitted to the ICU had significantly higher EFV, CRP, PCT, ferritin, and IL-6 levels.
- Positive correlations were found between EFV and CRP, PCT, ferritin, and IL-6.
- EFV independently predicted ICU admission (OR: 1.02, p=0.025).
- EFV >102 cm³ was associated with a higher likelihood of severe complications.
Conclusions:
- EFV and serum inflammatory markers (CRP, IL-6, PCT, ferritin) can assess COVID-19 severity and predict outcomes.
- EFV is an independent predictor of ICU admission in hospitalized COVID-19 patients.
Introduction:
Epicardial adipose tissue serves as a source of inflammatory cytokines and mediators. Cytokine storm is an important cause of morbidity and mortality in coronavirus disease 2019 (COVID-19).
Objectives:
To investigate the association between epicardial fat volume (EFV), inflammatory biomarkers and clinical severity of COVID-19.
Methods:
This retrospective study included 101 patients who were infected with COVID-19. Serum inflammatory biomarkers including C-reactive protein (CRP), interleukin-6 (IL-6), procalcitonin (PCT) and ferritin levels were measured. Computed tomography images were analyzed and semi-automated measurements for EFV were obtained. The primary composite endpoint was admission to the intensive care unit (ICU) or death.
Results:
The primary composite endpoint occurred in 25.1% (n=26) of patients (mean age 64.8±14.8 years, 14 male). A total of 10 patients died. EFV, CRP, PCT, ferritin and IL-6 levels were significantly higher in ICU patients. Moreover, a positive correlation was determined between EFV and CRP (r: 0.494, p<0.001), PCT (r: 0.287, p=0.005), ferritin (r: 0.265, p=0.01) and IL-6 (r: 0.311, p=0.005). On receiver operating characteristic analysis, patients with EFV >102 cm3 were more likely to have severe complications. In multivariate logistic regression analysis, EFV independently predicted admission to the ICU at a significant level (OR: 1.02, 95% CI: 1.01-1.03, p=0.025).
Conclusion:
EFV and serum CRP, IL-6, PCT and ferritin levels can effectively assess disease severity and predict the outcome in patients with COVID-19. EFV is an independent predictor of admission to the ICU in hospitalized COVID-19 patients.
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