A new study out of New York University shows that being overweight is a serious risk factor for hospitalisation with Covid-19. In particular, the researchers have revealed that levels of visceral fat are strongly associated with severity of infection.
The new study is further evidence that being overweight is one of the most serious important factors that predisposes patients to severe illness. Among the risk factors already identified apart from obesity, age, diabetes, high blood pressure and existing heart and lung conditions are the most prominent.
Male sex has also been suggested as a risk factor; although the role of testosterone in either combatting or aiding Covid-19 infection is disputed, as we’ve already examined.
In the new study, the researchers assessed visceral fat (VAT), subcutaneous fat (SAT) and total body fat levels (TAT) in 51 patients with Covid-19 infection.
The researchers were particularly interested in visceral fat – the fat that surrounds the organs – because unlike subcutaneous (under-skin) fat, visceral fat plays an important role in metabolism and, in particular, in inflammation and immune response.
As the researchers explain,
‘All fat depot[s] in the body are not created equal; they confer different cardiovascular and metabolic risks. Subcutaneous adipose tissue (SAT) is relatively indolent, whereas visceral adipose tissue (VAT) is metabolically more active tissue that secretes inflammatory cytokines. VAT is linked to metabolic syndrome, cardiovascular impairment, and increased susceptibility to infection and sepsis. Hence, it is of interest to analyze the relationship between the amount of visceral fat and the severity of COVID-19 infection. VAT and SAT can be measured and classified rapidly and accurately using MRI or CT. While it is possible to quantify the amount of adipose tissue within the whole abdomen, several studies have demonstrated that the single-slice measurement made rapidly at the vertebral body L3 or L4 level is an excellent estimate of the abdominal VAT and SAT in both men and women and across the spectrum of obesity.’
The researchers wanted to see if there was a direct relationship between amount of visceral fat and severity of infection with Covid-19.
The results showed that visceral fat, as well as visceral fat as a proportion of total fat, was significantly higher in hospitalized patients compared to outpatients (i.e. patients who were not hospitalized).
The researchers note that although body-mass index is a readily available method of assessing obesity, it ‘does not capture all elements of obesity’, and this new study shows that a more nuanced metric is likely to involve assessment of relative levels of different kinds of body fat.
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