The study conducted in collaboration between theUniversità Campus Bio-Medico di Roma and the Bufalini Hospital in Cesena where it was demonstrated that, for the same degree of obesity, those hospitalized in intensive care for the new Coronavirus have a higher quantity of visceral fat than less serious cases.
Rome, 06 August 2020 – An important new contribution to the knowledge of the clinical situations that can affect the prognosis in people affected by COVID-19 comes from an Italian study. If overweight, diabetes and obesity are recognized as risk elements, the type of fat the patient has also makes a difference in the case of COVID-19. Researchers from theUniversità Campus Bio-Medico di Roma and the Bufalini Hospital in Cesena which, in a study published in the journal Diabetes Care (https://doi.org/10.2337/dc20-1333), have shown how the accumulation of visceral fat, i.e. the fat that surrounds the internal organs, is associated with a greater risk of hospitalization in intensive care in patients with COVID-19. This is independent of the degree of obesity defined by the body mass index.
The study involved more than 400 people evaluated at the Bufalini Hospital on suspicion of COVID-19 and it was found that subjects with COVID-19 admitted to intensive care had a higher amount of visceral fat than less severe patients.
“In particular, by comparing the CT scans of these patients, we found that every millimeter of excess visceral fat thickness corresponded to a 16% risk of hospitalization in intensive care. Considering that on average patients with severe COVID-19 had 4 millimeters more visceral fat than non-severe patients, this would equate to nearly 65% more likely to receive intensive treatments,” says Rocky Strollo, endocrinologist and researcher ofUniversità Campus Bio-Medico di Roma.
This demonstrates that it is not only obesity, but also the distribution of fat in the patient that confers the need for ICU care. This is due to the fact that visceral fat produces two to three times more cytokines, such as interleukin 6, which are involved in the immunopathogenesis of COVID-19. It is therefore this specific type of fat that could facilitate the development of the cytokine storm that produces hyperinflammation in the most severe subjects.
“The CT examination was used in the acute phase to evaluate the extent and severity of the disease. Retrospectively, it is allowing us to analyze and identify subjects with a phenotype at risk, characterized by an abdominal fat distribution, who should be better protected", concludes Sofia Battisti, radiologist at the Bufalini Hospital in Cesena and research doctorate at IRST under the patronage of the 'University of Bologna.
