Understanding the significance of adipose tissue in the inflammatory response to COVID-19

Aim

Abdominal adipose tissue is closely related to inflammatory parameters. During the Coronavirus disease (COVID-19) pandemic, inflammatory markers determined the prognosis of the patients. The study aims to investigate the prognostic value of abdominal adipose tissue and its compartments, CRP (C-reactive protein), and NLR (neutrophil to lymphocyte ratio) in patients with COVID-19.

Materials and methods

A retrospective analysis was conducted on 381 patient records with positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Reverse transcription polymerase chain reaction (RT-PCR) results and low-dose chest computerized tomography (CT) scans between January 1, 2021, and May 30, 2021, at a single center. The study included 270 patients after excluding those under 18 years, with contrast-enhanced CT scans, inappropriate CT images, existing lung masses, or a history of abdomen/thorax operations. Patient demographics, chronic diseases, laboratory results, adipose tissue measurements, and the presence and score of findings on chest CT were noted.

Results

To evaluate the prognosis of the patient group, the group was divided into two groups, hospitalized and non-hospitalized individuals. The group of hospitalized individuals had significantly higher levels of total severity score (TSS), total adipose tissue (TAT), visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), CRP, and NLR parameters compared to the non-hospitalized group (p < 0.05). In the multivariate logistic regression analysis, age, TSS, SAT, and CRP levels were found to independently have a significant effect (p < 0.05) in discriminating between hospitalized and non-hospitalized patients.

Conclusion

Our study shows that abdominal adipose tissue, especially subcutaneous compartment and related comorbidities increase the risk of hospitalization for COVID-19 infection. In the current era of widespread COVID-19 variants, healthcare professionals can use these parameters to assess hospitalized patients and provide a prognostic tool.

Advances in knowledge

This study analyzed abdominal adipose tissue and inflammatory parameters associated with COVID-19 infection. The contrast with other studies is that SAT value was determined as a significant independent variable. This indicates that there is a need for more studies on this subject.