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. 2023 Apr 18;11(4):1199.
doi: 10.3390/biomedicines11041199.

Anthropometric Measurements and Admission Parameters as Predictors of Acute Respiratory Distress Syndrome in Hospitalized COVID-19 Patients

Vladimir Zdravković  1   2 , Đorđe Stevanović  1   2 , Neda Ćićarić  1 , Nemanja Zdravković  3 , Ivan Čekerevac  2   4 , Mina Poskurica  1 , Ivan Simić  1   2 , Vladislava Stojić  5 , Tomislav Nikolić  2   6 , Marina Marković  2   7 , Marija Popović  1 , Ana Divjak  8   9 , Dušan Todorović  10   11 , Marina Petrović  2   3
Affiliations

Anthropometric Measurements and Admission Parameters as Predictors of Acute Respiratory Distress Syndrome in Hospitalized COVID-19 Patients

Vladimir Zdravković et al. Biomedicines. .

Abstract

Aim: We aimed to single out admission predictors of acute respiratory distress syndrome (ARDS) in hospitalized COVID-19 patients and investigate the role of bioelectrical impedance (BIA) measurements in ARDS development. Method: An observational, prospective cohort study was conducted on 407 consecutive COVID-19 patients hospitalized at the University Clinical Center Kragujevac between September 2021 and March 2022. Patients were followed during the hospitalization, and ARDS was observed as a primary endpoint. Body composition was assessed using the BMI, body fat percentage (BF%), and visceral fat (VF) via BIA. Within 24 h of admission, patients were sampled for blood gas and laboratory analysis. Results: Patients with BMI above 30 kg/m2, very high BF%, and/or very high VF levels were at a significantly higher risk of developing ARDS compared to nonobese patients (OR: 4.568, 8.892, and 2.448, respectively). In addition, after performing multiple regression analysis, six admission predictors of ARDS were singled out: (1) very high BF (aOR 8.059), (2) SaO2 < 87.5 (aOR 5.120), (3) IL-6 > 59.75 (aOR 4.089), (4) low lymphocyte count (aOR 2.880), (5) female sex (aOR 2.290), and (6) age < 68.5 (aOR 1.976). Conclusion: Obesity is an important risk factor for the clinical deterioration of hospitalized COVID-19 patients. BF%, assessed through BIA measuring, was the strongest independent predictor of ARDS in hospitalized COVID-19 patients.

Keywords: ARDS; COVID-19; bioelectrical impedance analysis; body fat percentage; obesity.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Percentage distribution of body composition categories for (a) BMI, (b) %BF, and (c) VF level, with regard to ARDS development. Abbreviations: ARDS—acute respiratory distress syndrome; BMI—body mass index; VF—visceral fat; %BF—body fat percentage. * Statistical significance at <0.05.
Figure 2
Figure 2
Receiver operator characteristics (ROC) curve of multiple regression analysis model in predicting ARDS. Legend: Blue line—ROC curve, red line—diagonal reference line.
See this image and copyright information in PMC

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