An analysis of factors associated with the severity of the novel coronavirus infection caused by SARS-CoV-2

I n t r o d u c t i o n. Data from clinical studies indicate that the most severe course of the novel coronavirus infection (NСI) caused by the SARS-CoV-2 virus is observed in people with obesity and associated metabolic and cardiovascular diseases, then, in elderly patients with comorbidities, the disease proceeds in an even more severe form.

A i m. To study the association of anthropometric and clinical laboratory parameters characterizing obesity with the course of the NСI in order to identify the most sensitive markers of the disease severity.

M a t e r i a l s a n d m e t h o d. 172 patients (men and women) aged from 33 to 86 years (mean age 62.2 ± 12.1 year) who were under inpatient treatment for the NСI in an infectious hospital during 2020–2021 were examined. The patients were divided into two groups: group 1, patients with the moderate course of the NСI (n = 127), and group 2, patients – with the severe (n = 45). There were no patients with the mild course of the NСI among those hospitalized. All patients underwent anthropometric, laboratory and clinical examinations, including echocardiographic assessment of the structural and functional parameters of the heart with the epicardial fat thickness (EFT) assessment.

R e s u l t s. In patients with severe NCI, the Cumulative Illness Rating Scale for Geriatrics (CIRS-G) score was significantly higher than in patients with moderate NСI (p < 0.05). Patients with the severe NCI also had more pronounced visceral obesity, as evidenced by statistically much higher values of such indicators as waist circumference (WC), the waist and hip circumference (WC/HC) ratio and EFT. A correlation analysis was performed to identify factors associated with the severity of the NCI. A number of statistically significant correlations (positive and negative) were identified between key indicators characterizing the severity of NCI and the factors affecting them. The largest number of correlations was identified with the EFT, which had a statistically significant direct correlation with the duration of hospitalization, levels of C-reactive protein, fibrinogen, as well as the volume of lung damage. A negative correlation was found with the levels of saturation, total protein and albumin. The number of correlations with EFT was almost 2 times higher than with other indicators, and the correlation strength was higher. EFT was followed by WC and the WC/HC ratio. In third place was the CIRS-G score.

C o n c l u s i o n. Visceral obesity is a predictor of the hospitalization duration and the NCI progression, and the EFT turned out to be the most sensitive marker of the severity of the studied infectious disease.

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