Erector Spinae Muscle to Epicardial Visceral Fat Ratio on Chest CT Predicts the Severity of Coronavirus Disease 2019

ABSTRACT Background Chest computed tomography (CT) is a valuable tool for diagnosing and predicting the severity of coronavirus disease 2019 (COVID‐19) and assessing extrapulmonary organs. Reduced muscle mass and visceral fat accumulation are important features of a body composition phenotype in whi...

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Main Authors: Takashi Shimada, Tomoki Maetani, Shotaro Chubachi, Naoya Tanabe, Takanori Asakura, Ho Namkoong, Hiromu Tanaka, Shuhei Azekawa, Shiro Otake, Kensuke Nakagawara, Takahiro Fukushima, Mayuko Watase, Yusuke Shiraishi, Hideki Terai, Mamoru Sasaki, Soichiro Ueda, Yukari Kato, Norihiro Harada, Shoji Suzuki, Shuichi Yoshida, Hiroki Tateno, Kaoruko Shimizu, Susumu Sato, Yoshitake Yamada, Masahiro Jinzaki, Toyohiro Hirai, Yukinori Okada, Ryuji Koike, Makoto Ishii, Akinori Kimura, Seiya Imoto, Satoru Miyano, Seishi Ogawa, Takanori Kanai, Koichi Fukunaga
Format: Article
Language:English
Published: Wiley 2025-02-01
Series:Journal of Cachexia, Sarcopenia and Muscle
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Online Access:https://doi.org/10.1002/jcsm.13721
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author Takashi Shimada
Tomoki Maetani
Shotaro Chubachi
Naoya Tanabe
Takanori Asakura
Ho Namkoong
Hiromu Tanaka
Shuhei Azekawa
Shiro Otake
Kensuke Nakagawara
Takahiro Fukushima
Mayuko Watase
Yusuke Shiraishi
Hideki Terai
Mamoru Sasaki
Soichiro Ueda
Yukari Kato
Norihiro Harada
Shoji Suzuki
Shuichi Yoshida
Hiroki Tateno
Kaoruko Shimizu
Susumu Sato
Yoshitake Yamada
Masahiro Jinzaki
Toyohiro Hirai
Yukinori Okada
Ryuji Koike
Makoto Ishii
Akinori Kimura
Seiya Imoto
Satoru Miyano
Seishi Ogawa
Takanori Kanai
Koichi Fukunaga
author_facet Takashi Shimada
Tomoki Maetani
Shotaro Chubachi
Naoya Tanabe
Takanori Asakura
Ho Namkoong
Hiromu Tanaka
Shuhei Azekawa
Shiro Otake
Kensuke Nakagawara
Takahiro Fukushima
Mayuko Watase
Yusuke Shiraishi
Hideki Terai
Mamoru Sasaki
Soichiro Ueda
Yukari Kato
Norihiro Harada
Shoji Suzuki
Shuichi Yoshida
Hiroki Tateno
Kaoruko Shimizu
Susumu Sato
Yoshitake Yamada
Masahiro Jinzaki
Toyohiro Hirai
Yukinori Okada
Ryuji Koike
Makoto Ishii
Akinori Kimura
Seiya Imoto
Satoru Miyano
Seishi Ogawa
Takanori Kanai
Koichi Fukunaga
author_sort Takashi Shimada
collection DOAJ
description ABSTRACT Background Chest computed tomography (CT) is a valuable tool for diagnosing and predicting the severity of coronavirus disease 2019 (COVID‐19) and assessing extrapulmonary organs. Reduced muscle mass and visceral fat accumulation are important features of a body composition phenotype in which obesity and muscle loss coexist, but their relationship with COVID‐19 outcomes remains unclear. In this study, we aimed to investigate the association between the erector spinae muscle (ESM) to epicardial adipose tissue (EAT) ratio (ESM/EAT) on chest CT and disease severity in patients with COVID‐19. Methods We analysed data from 1074 COVID‐19 patients enrolled in the Japan COVID‐19 Task Force database. The primary outcome was the rate of critical outcomes (requiring high‐flow oxygen therapy, invasive ventilator support or death). The incidence of critical outcomes was compared between patients with high and low ESM/EAT ratios. Results The low ESM/EAT group (n = 353) had a higher incidence of critical outcomes (13.3% vs. 5.13%, p < 0.001) and mortality (2.55% vs. 0.69%, p = 0.019) than the high ESM/EAT group (n = 721). In multivariable analysis, the low ESM/EAT ratio was associated with critical outcomes (adjusted odds ratio [aOR] 2.11, 95% confidence interval [CI] 1.22–3.66) independently of the known COVID‐19 severity factors including age, sex, body mass index (BMI), smoking history, lifestyle‐related comorbidities and pneumonia volume. Conclusion The low ESM/EAT ratio in COVID‐19 patients can be obtained on chest CT and used to predict critical outcomes after disease onset, demonstrating the importance of detailed body composition assessments in COVID‐19 practice.
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spelling doaj-art-32cadef8cd784cddb2b1ceeb88fc3d782025-08-20T02:57:35ZengWileyJournal of Cachexia, Sarcopenia and Muscle2190-59912190-60092025-02-01161n/an/a10.1002/jcsm.13721Erector Spinae Muscle to Epicardial Visceral Fat Ratio on Chest CT Predicts the Severity of Coronavirus Disease 2019Takashi Shimada0Tomoki Maetani1Shotaro Chubachi2Naoya Tanabe3Takanori Asakura4Ho Namkoong5Hiromu Tanaka6Shuhei Azekawa7Shiro Otake8Kensuke Nakagawara9Takahiro Fukushima10Mayuko Watase11Yusuke Shiraishi12Hideki Terai13Mamoru Sasaki14Soichiro Ueda15Yukari Kato16Norihiro Harada17Shoji Suzuki18Shuichi Yoshida19Hiroki Tateno20Kaoruko Shimizu21Susumu Sato22Yoshitake Yamada23Masahiro Jinzaki24Toyohiro Hirai25Yukinori Okada26Ryuji Koike27Makoto Ishii28Akinori Kimura29Seiya Imoto30Satoru Miyano31Seishi Ogawa32Takanori Kanai33Koichi Fukunaga34Division of Pulmonary Medicine, Department of Medicine Keio University School of Medicine Tokyo JapanDepartment of Respiratory Medicine, Graduate School of Medicine Kyoto University Kyoto JapanDivision of Pulmonary Medicine, Department of Medicine Keio University School of Medicine Tokyo JapanDepartment of Respiratory Medicine, Graduate School of Medicine Kyoto University Kyoto JapanDivision of Pulmonary Medicine, Department of Medicine Keio University School of Medicine Tokyo JapanDivision of Pulmonary Medicine, Department of Medicine Keio University School of Medicine Tokyo JapanDivision of Pulmonary Medicine, Department of Medicine Keio University School of Medicine Tokyo JapanDivision of Pulmonary Medicine, Department of Medicine Keio University School of Medicine Tokyo JapanDivision of Pulmonary Medicine, Department of Medicine Keio University School of Medicine Tokyo JapanDivision of Pulmonary Medicine, Department of Medicine Keio University School of Medicine Tokyo JapanDivision of Pulmonary Medicine, Department of Medicine Keio University School of Medicine Tokyo JapanDivision of Pulmonary Medicine, Department of Medicine Keio University School of Medicine Tokyo JapanDepartment of Respiratory Medicine, Graduate School of Medicine Kyoto University Kyoto JapanDivision of Pulmonary Medicine, Department of Medicine Keio University School of Medicine Tokyo JapanInternal Medicine JCHO (Japan Community Health Care Organization) Saitama Medical Center Saitama JapanInternal Medicine JCHO (Japan Community Health Care Organization) Saitama Medical Center Saitama JapanDepartment of Respiratory Medicine Juntendo University Faculty of Medicine and Graduate School of Medicine Tokyo JapanDepartment of Respiratory Medicine Juntendo University Faculty of Medicine and Graduate School of Medicine Tokyo JapanDepartment of Pulmonary Medicine Saitama City Hospital Saitama JapanDepartment of Pulmonary Medicine Saitama City Hospital Saitama JapanDepartment of Pulmonary Medicine Saitama City Hospital Saitama JapanDepartment of Respiratory Medicine, Graduate School of Medicine Hokkaido University Sapporo JapanDepartment of Respiratory Medicine, Graduate School of Medicine Kyoto University Kyoto JapanDepartment of Radiology Keio University School of Medicine Tokyo JapanDepartment of Radiology Keio University School of Medicine Tokyo JapanDepartment of Respiratory Medicine, Graduate School of Medicine Kyoto University Kyoto JapanDepartment of Statistical Genetics Osaka University Graduate School of Medicine Suita JapanHealth Science Research and Development Center Tokyo Medical and Dental University Tokyo JapanDivision of Pulmonary Medicine, Department of Medicine Keio University School of Medicine Tokyo JapanInstitute of Research Tokyo Medical and Dental University Tokyo JapanDivision of Health Medical Intelligence, Human Genome Center, Institute of Medical Science University of Tokyo Tokyo JapanM&D Data Science Center Tokyo Medical and Dental University Tokyo JapanDepartment of Pathology and Tumor Biology Kyoto University Kyoto JapanDivision of Gastroenterology and Hepatology, Department of Internal Medicine Keio University School of Medicine Tokyo JapanDivision of Pulmonary Medicine, Department of Medicine Keio University School of Medicine Tokyo JapanABSTRACT Background Chest computed tomography (CT) is a valuable tool for diagnosing and predicting the severity of coronavirus disease 2019 (COVID‐19) and assessing extrapulmonary organs. Reduced muscle mass and visceral fat accumulation are important features of a body composition phenotype in which obesity and muscle loss coexist, but their relationship with COVID‐19 outcomes remains unclear. In this study, we aimed to investigate the association between the erector spinae muscle (ESM) to epicardial adipose tissue (EAT) ratio (ESM/EAT) on chest CT and disease severity in patients with COVID‐19. Methods We analysed data from 1074 COVID‐19 patients enrolled in the Japan COVID‐19 Task Force database. The primary outcome was the rate of critical outcomes (requiring high‐flow oxygen therapy, invasive ventilator support or death). The incidence of critical outcomes was compared between patients with high and low ESM/EAT ratios. Results The low ESM/EAT group (n = 353) had a higher incidence of critical outcomes (13.3% vs. 5.13%, p < 0.001) and mortality (2.55% vs. 0.69%, p = 0.019) than the high ESM/EAT group (n = 721). In multivariable analysis, the low ESM/EAT ratio was associated with critical outcomes (adjusted odds ratio [aOR] 2.11, 95% confidence interval [CI] 1.22–3.66) independently of the known COVID‐19 severity factors including age, sex, body mass index (BMI), smoking history, lifestyle‐related comorbidities and pneumonia volume. Conclusion The low ESM/EAT ratio in COVID‐19 patients can be obtained on chest CT and used to predict critical outcomes after disease onset, demonstrating the importance of detailed body composition assessments in COVID‐19 practice.https://doi.org/10.1002/jcsm.13721computed tomographyCOVID‐19epicardial adipose tissueerector spinae musclesobesitysarcopenia
spellingShingle Takashi Shimada
Tomoki Maetani
Shotaro Chubachi
Naoya Tanabe
Takanori Asakura
Ho Namkoong
Hiromu Tanaka
Shuhei Azekawa
Shiro Otake
Kensuke Nakagawara
Takahiro Fukushima
Mayuko Watase
Yusuke Shiraishi
Hideki Terai
Mamoru Sasaki
Soichiro Ueda
Yukari Kato
Norihiro Harada
Shoji Suzuki
Shuichi Yoshida
Hiroki Tateno
Kaoruko Shimizu
Susumu Sato
Yoshitake Yamada
Masahiro Jinzaki
Toyohiro Hirai
Yukinori Okada
Ryuji Koike
Makoto Ishii
Akinori Kimura
Seiya Imoto
Satoru Miyano
Seishi Ogawa
Takanori Kanai
Koichi Fukunaga
Erector Spinae Muscle to Epicardial Visceral Fat Ratio on Chest CT Predicts the Severity of Coronavirus Disease 2019
Journal of Cachexia, Sarcopenia and Muscle
computed tomography
COVID‐19
epicardial adipose tissue
erector spinae muscles
obesity
sarcopenia
title Erector Spinae Muscle to Epicardial Visceral Fat Ratio on Chest CT Predicts the Severity of Coronavirus Disease 2019
title_full Erector Spinae Muscle to Epicardial Visceral Fat Ratio on Chest CT Predicts the Severity of Coronavirus Disease 2019
title_fullStr Erector Spinae Muscle to Epicardial Visceral Fat Ratio on Chest CT Predicts the Severity of Coronavirus Disease 2019
title_full_unstemmed Erector Spinae Muscle to Epicardial Visceral Fat Ratio on Chest CT Predicts the Severity of Coronavirus Disease 2019
title_short Erector Spinae Muscle to Epicardial Visceral Fat Ratio on Chest CT Predicts the Severity of Coronavirus Disease 2019
title_sort erector spinae muscle to epicardial visceral fat ratio on chest ct predicts the severity of coronavirus disease 2019
topic computed tomography
COVID‐19
epicardial adipose tissue
erector spinae muscles
obesity
sarcopenia
url https://doi.org/10.1002/jcsm.13721
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