The Role of Epicardial and Visceral Fat in Severe Respiratory Infections: Associations With Adverse Outcomes.

Excess adipose tissue has been extensively studied due to its role in the development of chronic diseases and inflammatory conditions. Obesity and visceral adipose tissue (VAT, fat stored within the abdominal cavity and around organs) are associated with increased susceptibility to respiratory infections and chronic low-grade systemic inflammation. This study investigates the relationship among VAT, epicardial adipose tissue (EAT, fat surrounding the heart), and mortality in critically ill patients diagnosed with COVID-19, aiming to identify which measure is more strongly associated with adverse outcomes. A retrospective observational cohort study was conducted with patients admitted to the Intensive Care Unit (ICU) who underwent chest computed tomography (CT). Measurements of VAT and EAT were obtained from contrast-free CT images. Statistical analysis included the Mann-Whitney U test and logistic regression. Individuals who died had a larger EAT area. In patients with BMI < 30 Kg/m2, an increase in EAT was associated with a higher risk of mortality (OR = 1.06, 95% CI 1.015-1.107, p < 0.01). EAT area measurement was associated with mortality risk in critically ill individuals without obesity (BMI < 30 kg/m2) diagnosed with COVID-19 and may serve as a prognostic marker for risk stratification in this population.