Key result
Elevated para-aortic adipose tissue volume predicts severe COVID-19 with ~67% specificity in hospitalized patients.
Why the study?
Although obesity is a well-established risk factor for severe COVID-19 via adipose tissue inflammation, the specific role of para-aortic adipose tissue (PAT) volume in predicting acute SARS-CoV-2 infection severity remains poorly understood.
Does para-aortic adipose tissue volume measured on chest CT predict severe COVID-19 in hospitalized patients with confirmed COVID-19 pneumonia?
Cross-Sectional (n=279)
No
Does para-aortic adipose tissue volume measured on chest CT predict severe COVID-19 in hospitalized patients with confirmed COVID-19 pneumonia?
Para-aortic adipose tissue volume measured on chest CT is independently associated with severe COVID-19, with values above 0.35 cm³ serving as a potential predictor of disease severity in hospitalized patients.
Answers are grounded in this paper and cite their sources.
Log-transformed PAT volume was independently associated with severe COVID-19; extends adipose-inflammation evidence but remains hypothesis-generating and should not yet change practice.
Background/Objectives: Obesity is a well-established risk factor for severe COVID-19, largely mediated by chronic inflammation originating from adipose tissue. The role of para-aortic adipose tissue (PAT)—a component of perivascular adipose tissue in COVID-19 severity remains poorly understood. This study aimed to investigate the association between PAT volume and the severity of acute SARS-CoV-2 infection and to evaluate its potential as a predictor of severe COVID-19. Methods: This retrospective single-center cohort study included 279 hospitalized patients with confirmed COVID-19 pneumonia. Based on disease severity, patients were divided into moderate and severe groups. PAT volume was measured around the aorta semi-automatically on a single chest computed tomography. Clinical, laboratory, and imaging data were analyzed. Logistic regression and receiver operating characteristic curve analysis were performed to assess the predictive value of PAT volume. Results: Patients with severe COVID-19 were significantly older, had higher body mass index. PAT volume differed significantly between groups, with a greater proportion of higher values in the severe group. Severe cases also exhibited significantly elevated levels of C-reactive protein, ferritin, and D-dimer, and lower oxygen saturation. Correlation analysis revealed significant associations between PAT volume and age, BMI, ferritin, the extent of lung involvement and SpO₂. Multivariable logistic regression confirmed that log-transformed PAT volume was independently associated with severe COVID-. The optimal threshold for initial PAT volume was 0.35 cm³ (sensitivity: 51.2%, specificity: 67.1%). Conclusions: PAT volume is independently associated with severe COVID-19, and values exceeding 0.35 cm³ may serve as a predictor of disease severity in hospitalized patients.
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Bragina et al. (2026) conducted a cross-sectional in COVID-19 pneumonia (n=279). Para-aortic adipose tissue (PAT) volume vs. Lower PAT volume / moderate COVID-19 group was evaluated on Severe COVID-19. Para-aortic adipose tissue volume >0.35 cm³ predicted severe COVID-19 in hospitalized patients with 51.2% sensitivity and 67.1% specificity.
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