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    Visceral to subcutaneous fat ratio predicts short-term mortality in patients with Covid 19. A multicenter study
    (British Institute of Radiology, 2023) Surov, A.; Thormann, M.; Kardaş, H.; Hinnerichs, M.; Omari, J.; Cingöz, E.; Cingöz, M.; Chousein, O.; Sasani, Hadi; Gönen, Korcan Aysun
    Objective: To evaluate the association of body composition 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 infection, 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 measurements. 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. © 2023 The Authors.