Journal Article

Modifications of Chest CT Body Composition Parameters at Three and Six Months after Severe COVID-19 Pneumonia: A Retrospective Cohort Study

Fugazzaro, Stefania, Fasano, Tommaso, Canovi, Simone, Croci, Stefania, Giorgi Rossi, Paolo, Ligabue, Guido, Bonelli, Efrem, Milic, Jovana, Guaraldi, Giovanni, Besutti, Giulia, Pattacini, Pierpaolo, Monelli, Filippo, Farì, Roberto, Costi, Stefania, Dolci, Giovanni, Massari, Marco, Pellegrini, Massimo, Ottone, Marta, Salvarani, Carlo

2022

Overview

We aimed to describe body composition changes up to 6–7 months after severe COVID-19 and to evaluate their association with COVID-19 inflammatory burden, described by the integral of the C-reactive protein (CRP) curve. The pectoral muscle area (PMA) and density (PMD), liver-to-spleen (L/S) ratio, and total, visceral, and intermuscular adipose tissue areas (TAT, VAT, and IMAT) were measured at baseline (T0), 2–3 months (T1), and 6–7 months (T2) follow-up CT scans of severe COVID-19 pneumonia survivors. Among the 208 included patients (mean age 65.6 ± 11 years, 31.3% females), decreases in PMA [mean (95%CI) −1.11 (−1.72; −0.51) cm2] and in body fat areas were observed [−3.13 (−10.79; +4.52) cm2 for TAT], larger from T0 to T1 than from T1 to T2. PMD increased only from T1 to T2 [+3.07 (+2.08; +4.06) HU]. Mean decreases were more evident for VAT [−3.55 (−4.94; −2.17) cm2] and steatosis [L/S ratio increase +0.17 (+0.13; +0.20)] than for TAT. In multivariable models adjusted by age, sex, and baseline TAT, increasing the CRP interval was associated with greater PMA reductions, smaller PMD increases, and greater VAT and steatosis decreases, but it was not associated with TAT decreases. In conclusion, muscle loss and fat loss (more apparent in visceral compartments) continue until 6–7 months after COVID-19. The inflammatory burden is associated with skeletal muscle loss and visceral/liver fat loss.

• Publisher: MDPI AG,MDPI
• Subject: adipose tissue / Adipose tissues / Aged / Bacterial pneumonia / Body composition / Body Composition - physiology / body fat / Body mass index / C-reactive protein / C-Reactive Protein - metabolism / chest / Cohort analysis / cohort studies / Complications and side effects / Coronaviruses / COVID-19 / COVID-19 infection / Data collection / Development and progression / Diabetes / Enteral nutrition / Ethics / Female / Health aspects / Health surveillance / Hospitals / Humans / Inflammation / Intra-Abdominal Fat - metabolism / liver / Male / Malnutrition / Medical imaging / Medical records / Middle Aged / Muscles / Overweight / Pandemics / pectoralis muscle / Physiological aspects / Pneumonia / Retrospective Studies / Risk factors / Sarcopenia / Severe acute respiratory syndrome coronavirus 2 / Tomography, X-Ray Computed / Ventilators