학술논문
Cardiac adipose tissue volume and IL-6 level at admission are complementary predictors of severity and short-term mortality in COVID-19 diabetic patients
Document Type
article
Author
Franck Phan; Samia Boussouar; Olivier Lucidarme; Mohamed Zarai; Joe-Elie Salem; Nadjia Kachenoura; Khaoula Bouazizi; Etienne Charpentier; Yasmine Niati; Hasnae Bekkaoui; Zahir Amoura; Alexis Mathian; Olivier Benveniste; Patrice Cacoub; Yves Allenbach; David Saadoun; Jean-Marc Lacorte; Salma Fourati; Suzanne Laroche; Agnes Hartemann; Olivier Bourron; Fabrizio Andreelli; Alban Redheuil; COVID-19 APHP.SU Group
Source
Cardiovascular Diabetology, Vol 20, Iss 1, Pp 1-10 (2021)
Subject
Language
English
ISSN
1475-2840
Abstract
Abstract Background COVID-19 diabetic adults are at increased risk of severe forms irrespective of obesity. In patients with type-II diabetes, fat distribution is characterized by visceral and ectopic adipose tissues expansion, resulting in systemic inflammation, which may play a role in driving the COVID-19 cytokine storm. Our aim was to determine if cardiac adipose tissue, combined to interleukin-6 levels, could predict adverse short-term outcomes, death and ICU requirement, in COVID-19 diabetic patients during the 21 days after admission. Methods Eighty one consecutive patients with type-II diabetes admitted for COVID-19 were included. Interleukin-6 measurement and chest computed tomography with total cardiac adipose tissue index (CATi) measurement were performed at admission. The primary outcome was death during the 21 days following admission while intensive care requirement with or without early death (ICU-R) defined the secondary endpoint. Associations of CATi and IL-6 and threshold values to predict the primary and secondary endpoints were determined. Results Of the enrolled patients (median age 66 years [IQR: 59–74]), 73% male, median body mass index (BMI) 27 kg/m2 [IQR: 24–31]) 20 patients had died from COVID-19, 20 required intensive care and 41 were in conventional care at day 21 after admission. Increased CATi and IL-6 levels were both significantly related to increased early mortality (respectively OR = 6.15, p = 0.002; OR = 18.2, p