Visceral fat area measured by electrical bioimpedance as an aggravating factor of COVID-19: a study on body composition

Abstract

Introduction: Severe forms of COVID-19 are more common in patients with abnormal fat distribution, particularly high visceral adiposity. The patient's muscle strength may be reduced during the acute phase of the infection. Electrical bioimpedance (BIA) is a non-invasive method for measuring body compartments and estimating visceral fat area (VFA) that can be used at the bedside. Objective: To assess the relationship between several body composition parameters, primarily adipose tissue and VFA, in patients with and without a diagnosis of COVID-19 infection, as well as its role in disease severity. Methods: This is a retrospective study that was conducted in a private hospital in the city of São Paulo from March 2020 to August 2021. The Student's T test was used to compare the results of quantitative variables in the groups with and without COVID-19. The non-parametric Mann-Whitney test was used where normality could not be established. When dealing with categorical data, Pearson's Chi-square test or Fisher's exact test are used to analyze relationships. Results: A total of 96 patients with a mean age of 69.1 years (SD 15) were divided into two groups of 48 individuals, with and without COVID-19 infection. Body mass index (p=0.000), fat mass (p=0.052), and VFA (p=0.042) were all higher in the infection group. When COVID-19 patients were evaluated, those with higher VFA had longer hospital stays (p=0.020) and used more vasoactive drugs (p=0.043). Patients with COVID-19 with poor handgrip strength were 4.38 times more likely to require a prolonged intensive care unit (ICU) stay. Conclusion:The study concluded that excess weight and body fat are significantly associated with COVID-19 involvement, but the severity is primarily related to a greater area of visceral fat. The use of bioimpedance for visceral fat measurement was effective, as it is a simple method performed in the hospital setting that does not require the use of radiation.

Transforming body composition with semaglutide in adults with obesity and type 2 diabetes mellitus

“…VFA plays a key role in metabolic and cardiovascular disease. Visceral adipose tissue secretes inflammatory mediators leading to a chronic low grade inflammation state ( 46 , 47 ), which induces a constellation of metabolic abnormalities and diseases ( 46 ). Adiposity is an independent risk factor for glycometabolism disorder, since fat accumulation affects insulin’s action by different mechanisms including insulin resistance in organs such as the liver and muscle tissue ( 46 , 48 ).…”