Table_3_The Role of Bioelectrical Impedance Analysis in Predicting COVID-19 Outcome.DOCX

BackgroundPublished data regarding the impact of obesity on COVID-19 outcomes are inconsistent. However, in most studies, body composition was assessed using body mass index (BMI) alone, thus neglecting the presence and distribution of adipose tissue. Therefore, we aimed to investigate the impact of body and visceral fat on COVID-19 outcomes.
MethodsObservational, prospective cohort study included 216 consecutive COVID-19 patients hospitalized at University Clinical Center Kragujevac (Serbia) from October to December 2021. Body composition was assessed using the BMI, body fat percentage (�), and visceral fat (VF) via bioelectrical impedance analysis (BIA). In addition to anthropometric measurements, variables in the research were socio-demographic and medical history data, as well as admission inflammatory biomarkers. Primary end-points were fatal outcomes and intensive care unit (ICU) admission.
ResultsThe overall prevalence of obesity was 39.3% according to BMI and 50.9% according to % BF, while 38.4% of patients had very high VF levels. After adjusting odds ratio values for cofounding variables and obesity-related conditions, all three anthropometric parameters were significant predictors of primary end-points. However, we note that % BF and VF, compared to BMI, were stronger predictors of both mortality (aOR 3.353, aOR 3.05, and aOR 2.387, respectively) and ICU admission [adjusted odds ratio (aOR) 7.141, aOR 3.424, and aOR 3.133, respectively].
ConclusionObesity is linked with COVID-19 mortality and ICU admission, with BIA measurements being stronger predictors of outcome compared to BMI use alone.

背景 现有关于肥胖对新型冠状病毒肺炎（COVID-19）预后影响的研究结论并不一致。然而，绝大多数现有研究仅通过体质量指数（body mass index, BMI）评估身体成分，却忽略了脂肪组织的存在与分布特征。因此，本研究旨在探究体脂与内脏脂肪（visceral fat, VF）对COVID-19预后的影响。
方法 本研究为观察性前瞻性队列研究，纳入2021年10月至12月期间在塞尔维亚克拉古耶瓦茨大学临床中心住院的216例连续性新型冠状病毒肺炎患者。采用体质量指数、体脂百分比（body fat percentage, BF%）以及生物电阻抗分析（bioelectrical impedance analysis, BIA）检测的内脏脂肪评估患者身体成分。除人体测量学指标外，本研究收集的变量还包括社会人口学资料、病史数据以及入院时的炎症生物标志物。研究的主要终点为死亡结局与重症监护病房（intensive care unit, ICU）收治情况。
结果 依据体质量指数评估，肥胖总体患病率为39.3%；依据体脂百分比评估，该患病率为50.9%，另有38.4%的患者内脏脂肪水平显著升高。在对混杂变量及肥胖相关疾病进行比值比校正后，三项人体测量学指标均为主要终点的显著预测因子。值得注意的是，与体质量指数相比，体脂百分比与内脏脂肪均为死亡率与ICU收治率更强的预测因子，其中死亡率对应的调整后比值比（adjusted odds ratio, aOR）分别为3.353、3.05及2.387，ICU收治率对应的调整后比值比分别为7.141、3.424及3.133。
结论 肥胖与新型冠状病毒肺炎患者的死亡率及ICU收治率相关，且相较于单纯使用体质量指数，生物电阻抗分析检测指标可更好地预测患者预后。