How covid-19 affects the stomach
December 19, 2020 | Source: MedRxiv
Overview:
When the first outbreak of COVID 19 hit the world, people all over the world started to get-sick: fever, flu cases, vomiting, coughing, sore throat, weakened muscles, and other symptoms started to emerge. The infected people started to get hospitalized as the world health was at risk. The scientists started to investigate the role played by several factors that might affect the result.
A new study was published in May 2020 on the preprint server medRxiv* to investigate the role played by abdominal fat (Visceral obesity, VO) in the outbreak of COVID 19.
aim of the study
In this research, the researchers used Computed tomography-based measurements of subcutaneous and visceral fat in order to measure the body fat and link it with the contagious COVID-19.
It was noted that obesity, especially abdominal fat, is a high-risk factor for severe COVID-19. The abdominal fat is linked with metabolic syndrome that tends to increase the risk of cardiovascular disease, and type 2 diabetes, and other several medical conditions. The body mass index is used to identify the obesity in adults, but it cannot properly identify the excessive fat mass, nor indicate where the body fat is located.
The present study was targeted at positively evaluating the subcutaneous and visceral fat to help describing the distribution of body fat.
Evaluating Visceral Fat Vs. Body Mass Index and COVID-19 Sternness:
Survey analysis was done among 30 patients, all of who were infected from COVID 19, with a mean age of 66 years, located in Germany. The presence of COVID 19 was confirmed through deep nasal swabs, made at the time of admission of infected patients at the hospital.
It was examined that all infected patients hospitalized confirmed with COVID 19 required urgent ventilators. During the procedure at the hospital, patients were also examined for abdominal fat at the level of the first lumbar vertebra using low-dose chest CT. The examiners evaluated that the infected patients with a risk of COVID 19 were augmented with abdominal fat.
During the treatment, there was 43 percent of infected patients with COVID 19 were shifted to the intensive care unit, among which the majority were males. In Intensive care unit admissions among 13, 7 were on a ventilator, 6 of them were males.
According to regression analysis, an increase in VFA by 1 dm2 was noted; the risk of infected patients in the intensive care unit was increased by 23 times. An increase by one centimeter related to 1.1-fold, greater upper abdominal circumference, increase the risk for Intensive care unit admissions.
Through data analysis, the Body Mass Index mean the number was 26, with the mean number of 28 for women and 26 for men. Though, the Body Mass Index number was higher for infected patients who were hospitalized to the Intensive care unit at 27 as compared to non-intensive care unit infected patients at 26.
In research, it was noted that the visceral fat area was higher among men (0.95 dm2) as compared to women and higher than the median (0.82 dm2) in all infected COVID 19 patients. Infected patients hospitalized in the intensive care unit had a higher total fat as compared to others, VFA value was much high at 1.12 dm2 vs 0.2 dm2 in the non-Intensive care unit.
The upper abdominal circumference at 107 cm for intensive care unit infected patients vs 99 cm for non -ICU infected patients was observed. Furthermore, the patients on ventilators had a higher VFA at 1.24 dm2 as compared to those who could breathe easily (0.77 dm2). The upper abdominal circumference was 110 cm vs. 100 cm, correspondingly.
There was a reasonable correlation found between the VFA and Body Mass Index (lower for women and higher for men) and for Body Mass Index and upper abdominal circumference, lower for women and higher for men was observed.
Inferences of the current Study:
This is an alarming situation in the Western Hemisphere, bearing in mind the great number of obese adults at around 650 million widespread are at a higher risk of COVID-19. Using VFA instead of Body Mass Index to assess the accumulated body fat distribution improves the accuracy of correlation of COVID 19 severity with the abdominal fat.
The low-grade inflammation promotes the development of metabolic dysfunction due to obesity promoting type 2 diabetes and various other infections. Visceral obesity is the main factor for cardiovascular infection and other infections too.
This research study is the first one that recognizes upper abdominal circumference along with visceral fat as the major reasons for COVID 19 widespread infection.
According to this study the CT- based upper abdominal circumference and quantification of visceral adipose tissue is in routinely acquired the CTs of the chest, a simple and easier tool for risk assessment in SARS-CoV-2-patients.
Journal references:
Petersen, A. et al. (2020). Obesity And COVID-19: The Role of Visceral Adipose Tissue. medRxiv preprint. doi: https://doi.org/10.1101/2020.05.14.20101998. http://medrxiv.org/cgi/content/short/2020.05.14.20101998
Petersen, A., Bressem, K., Albrecht, J., Thieß, H. M., Vahldiek, J., Hamm, B., Makowski, M. R., Niehues, A., Niehues, S. M., & Adams, L. C. (2020). The role of visceral adiposity in the severity of COVID-19: Highlights from a unicenter cross-sectional pilot study in Germany. Metabolism: clinical and experimental, 110, 154317. https://doi.org/10.1016/j.metabol.2020.154317