Abdominal obesity phenotype is associated with COVID-19 chest X-ray severity score better than BMI-based obesity
Creators
- 1. Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention Service, IRCCS Policlinico San Donato, Piazza Edmondo Malan 2, San Donato Milanese, 20097, Milan, Italy. alexis.malavazos@gmail.com.
- 2. Radiology Unit, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.
- 3. Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention Service, IRCCS Policlinico San Donato, Piazza Edmondo Malan 2, San Donato Milanese, 20097, Milan, Italy.
- 4. Scientific Directorate, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.
- 5. General Medicine Unit, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.
- 6. Cardiology University Department, Heart Failure Unit, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.
- 7. Operative Unit of Laboratory Medicine1-Clinical Pathology, Department of Pathology and Laboratory Medicine, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.
- 8. Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Miami, Coral Gables, FL, USA.
Description
Malavazos AE, Secchi F, Basilico S, Capitanio G, Boveri S, Milani V, Dubini C, Schiaffino S, Morricone L, Foschini C, Gobbo G, Piccinni R, Saibene A, Sardanelli F, Menicanti L, Guazzi M, Dong C, Romanelli MMC, Carruba M, Iacobellis G. Abdominal obesity phenotype is associated with COVID-19 chest X-ray severity score better than BMI-based obesity. Eat Weight Disord. 2022 Feb;27(1):345-359. doi: 10.1007/s40519-021-01173-w. Epub 2021 Apr 5. PMID: 33821453; PMCID: PMC8020829.
Abstract
Purpose: Chest X-ray (CXR) severity score and BMI-based obesity are predictive risk factors for COVID-19 hospital admission. However, the relationship between abdominal obesity and CXR severity score has not yet been fully explored.
Methods: This retrospective cohort study analyzed the association of different adiposity indexes, including waist circumference and body mass index (BMI), with CXR severity score in 215 hospitalized patients with COVID-19.
Results: Patients with abdominal obesity showed significantly higher CXR severity scores and had higher rates of CXR severity scores ≥ 8 compared to those without abdominal obesity (P < 0.001; P = 0.001, respectively). By contrast, patients with normal weight, with overweight and those with BMI-based obesity showed no significant differences in either CXR severity scores or in the rates of CXR severity scores ≥ 8 (P = 0.104; P = 0.271, respectively). Waist circumference and waist-to-height ratio (WHtR) correlated more closely with CXR severity scores than BMI (r = 0.43, P < 0.001; r = 0.41, P < 0.001; r = 0.17, P = 0.012, respectively). The area under the curves (AUCs) for waist circumference and WHtR were significantly higher than that for BMI in identifying a high CXR severity score (≥ 8) (0.68 [0.60-0.75] and 0.67 [0.60-0.74] vs 0.58 [0.51-0.66], P = 0.001). A multivariate analysis indicated abdominal obesity (risk ratio: 1.75, 95% CI: 1.25-2.45, P < 0.001), bronchial asthma (risk ratio: 1.73, 95% CI: 1.07-2.81, P = 0.026) and oxygen saturation at admission (risk ratio: 0.96, 95% CI: 0.94-0.97, P < 0.001) as the only independent factors associated with high CXR severity scores.
Conclusion: Abdominal obesity phenotype is associated with a high CXR severity score better than BMI-based obesity in hospitalized patients with COVID-19. Therefore, when visiting the patient in a hospital setting, waist circumference should be measured, and patients with abdominal obesity should be monitored closely. Level of evidence Cross-sectional descriptive study, Level V.