Universität zu Köln

Kottlors, Jonathan, Zopfs, David, Fervers, Philipp, Bremm, Johannes, Abdullayev, Nuran, Maintz, David, Tritt, Stephanie and Persigehl, Thorsten (2020). Body composition on low dose chest CT is a significant predictor of poor clinical outcome in COVID-19 disease - A multicenter feasibility study. Eur. J. Radiol., 132. CLARE: ELSEVIER IRELAND LTD. ISSN 1872-7727

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Abstract

Purpose: Low-dose computed tomography (LDCT) of the chest is a recommended diagnostic tool in early stage of COVID-19 pneumonia. High age, several comorbidities as well as poor physical fitness can negatively influence the outcome within COVID-19 infection. We investigated whether the ratio of fat to muscle area, measured in initial LDCT, can predict severe progression of COVID-19 in the follow-up period. Method: We analyzed 58 individuals with confirmed COVID-19 infection that underwent an initial LDCT in one of two included centers due to COVID-19 infection. Using the ratio of waist circumference per paravertebral muscle circumference (FMR), the body composition was estimated. Patient outcomes were rated on an ordinal scale with higher numbers representing more severe progression or disease associated complications (hospitalization/intensive care unit (ICU)/tracheal intubation/death) within a follow-up period of 22 days after initial LDCT. Results: In the initial LDCT a significantly higher FMR was found in patients requiring intensive care treatment within the follow-up period. In multivariate logistic regression analysis, FMR (p < .001) in addition to age (p < .01), was found to be a significant predictor of the necessity for ICU treatment of COVID-19 patients. Conclusion: FMR as potential surrogate of body composition and obesity can be easily determined in initial LDCT of COVID-19 patients. Within the multivariate analysis, in addition to patient age, low muscle area in proportion to high fat area represents an additional prognostic information for the patient outcome and the need of an ICU treatment during the follow-up period within the next 22 days. This multicentric pilot study presents a method using an initial LDCT to screen opportunistically for obese patients who have an increased risk for the need of ICU treatment. While clinical capacities, such as ICU beds and ventilators, are more crucial than ever to help manage the current global corona pandemic, this work introduces an approach that can be used for a cost-effective way to help determine the amount of these rare clinical resources required in the near future.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Kottlors, Jonathan UNSPECIFIED UNSPECIFIED UNSPECIFIED Zopfs, David UNSPECIFIED UNSPECIFIED UNSPECIFIED Fervers, Philipp UNSPECIFIED UNSPECIFIED UNSPECIFIED Bremm, Johannes UNSPECIFIED UNSPECIFIED UNSPECIFIED Abdullayev, Nuran UNSPECIFIED UNSPECIFIED UNSPECIFIED Maintz, David UNSPECIFIED UNSPECIFIED UNSPECIFIED Tritt, Stephanie UNSPECIFIED UNSPECIFIED UNSPECIFIED Persigehl, Thorsten UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-312873
DOI:	10.1016/j.ejrad.2020.109274
Journal or Publication Title:	Eur. J. Radiol.
Volume:	132
Date:	2020
Publisher:	ELSEVIER IRELAND LTD
Place of Publication:	CLARE
ISSN:	1872-7727
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language BIOELECTRICAL-IMPEDANCE ANALYSIS; OBESITY Multiple languages Radiology, Nuclear Medicine & Medical Imaging Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/31287