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    Visceral to subcutaneous fat ratio predicts short- term mortality in patients with Covid 19. A multicenter study
    (British Inst Radiology, 2023) Surov, Alexey; Thormann, Maximilian; Kardas, Hakan; Hinnerichs, Mattes; Omari, Jazan; Cingoz, Eda; Cingoz, Mehmet
    Objective: To evaluate the association of body composi-tion parameters with outcomes in Covid- 19.Methods:173 patients hospitalized for Covid- 19 infection in 6 European centers were included in this retrospective study. Measurements were performed at L3 -level and comprised skeletal muscle index (SMI), muscle density (MD), and adipose tissue measurements [visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), intramuscular adipose tissue (IMAT), visceral -to-subcutaneous-adipose-tissue-area-ratio (VSR)]. The association with mortality, the need for intubation (MV), and the need for admission to ICU within 30 days were evaluated.Results: Higher SAT density was associated with a greater risk of MV (OR = 1.071, 95%CI=(1.034;1.110), p < 0.001). Higher VAT density was associated with admission to ICU (OR = 1.068, 95%CI=(1.029;1.109), p < 0.001). Higher MD was a protective factor for MV and ICU admission (OR = 0.914, 95%CI=(0.870;0.960), p < 0.001; OR = 0.882, 95%CI=(0.832;0.934), p = 0.028). Higher VSR was associated with mortality (OR = 2.147, 95%CI=(1.022;4.512), p = 0.044). Male sex showed the strongest influence on the risk of ICU admission and MV. SMI was not associated with either parameter.Conclusion: In patients hospitalized for Covid- 19 infec-tion, higher VSR seems to be a strong prognostic factor of short -term mortality. Weak associations with clinical course were found for MD and adipose tissue measure-ments. Male sex was the strongest prognostic factor of adverse clinical course.Advances in knowledge: VSR is a prognostic biomarker for 30 -day mortality in patients hospitalized for Covid- 19 disease.