CORRELATION OF THE VISCERAL AND SUBCUTANEOUS FAT AREAS AND LUNG DAMAGE ACCORDING TO CT DATA IN OBESE PATIENTS AFTER

COVID-19 ASSOCIATED PNEUMONIA

 

Buchneva A.V., Chichkova N.V., Serova N.S., Shchekoturov I.O., Fomin V.V.

 

I.M. Sechenov First Moscow State Medical University (Sechenov University). Moscow, Russia.

P

urpose. To study the correlation of visceral and subcutaneous fat areas measured by multi-spiral computed tomography (MSCT) with the clinical characteristics and severity of lung damage in obese patients in the acute period and 3 months after COVID-associated pneumonia.

Materials and methods. We examined 59 patients (32 women, 27 men), which were divided into two groups: the 1st – 23 non-obese patients (BMI < 30 kg/m²); the 2nd – 36 obese patients (BMI > 30 kg/m²). All patients underwent a standard examination, anthropometry with BMI measurement, MSCT of the lungs with contrast enhancement of the pulmonary vessels and MSCT of the abdominal cavity for measurement of the visceral (VAT) and subcutaneous adipose tissue (SAT) at the level of the L4-L5 vertebrae.

Results. During the acute illness the condition of patients in both groups did not differ, but after 12 weeks patients with BMI > 30 kg/m² were associated with shortness of breath (p=0.001), general weakness (p=0.05), cough (p=0.05), more lung involvements in MSCT examination: ground-glass opacity (OR 6.5 [95% 2-21,7]) and lung perfusion abnormalities (OR 4,2 [95% 1,1-17]). VAT area ≥ 263,5 cm² is a predictably unfavorable factor for the ground glass opacity 12 weeks after discharge from the hospital. VAT area ≥ 272 cm² or SAT area ≥ 265 cm² are significantly associated with lung perfusion abnormalities according to the MSCT in obese patients after COVID-associated pneumonia.

During the acute period of COVID-19, the clinical and radiological disease manifestations did not differ significantly in patients of both groups; after 12 weeks, obese patients were significantly more likely to have dyspnea (p=0.001), general weakness (p=0.05) and cough (p=0.05), and according to the MSCT of the lungs, the “ground glass opacity” pattern persisted (OR 6 .5 [95% 2-21.7]) and thrombosis of small branches of the pulmonary artery appeared (OR 4.2 [95% 1.1-17]). An increase of VAT area ≥ 263.5 cm² is an unfavorable prognostic factor for the persistence of the "ground glass opacity" pattern 12 weeks after discharge from the hospital. It has been shown that areas of VAT ≥ 272 cm² or PVT ≥ 265 cm² are statistically significantly associated with the detection of small branch thromboembolism according to MSCT with contrast enhancement in obese patients who have had COVID-associated pneumonia.

Conclusions. The areas of visceral and subcutaneous adipose tissue determined by MSCT are prognostically significant values for assessing of thromboembolic complications and the duration (more than 12 weeks) of persistent changes in the lung parenchyma in patients after COVID-associated pneumonia.

 

Keywords: COVID-19, multispiral computed computed tomography, obesity, body mass index, visceral adipose tissue, subcutaneous adipose tissue.

 

Corresponding author: Beliaevskaia A.A., e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript .

 

For citation: Buchneva A.V., Chichkova N.V., Serova N.S., Shchekoturov I.O., Fomin V.V. Correlation of the visceral and subcutaneous fat areas and lung damage according to CT data in obese patients after COVID-19 associated pneumonia. REJR 2023; 13(4):78-91. DOI: 10.21569/2222-7415-2023-13-4-78-91.

Received: 15.02.23                 Accepted: 30.10.23