Epicardial fat inflammation response to COVID‐19 therapies

Iacobellis, Gianluca; Malavazos, Alexis Elias; Basilico, Sara; Tresoldi, Silvia; Rinaldo, Rocco Francesco; Dubini, Carola; Capitanio, Gloria; Serpi, Francesca; Schiaffino, Simone; Oliva, Omar Alessandro; Cariati, Maurizio; Morricone, Lelio; Centanni, Stefano; Sardanelli, Francesco; Carruba, Michele; Corsi Romanelli, Massimiliano Marco; Secchi, Francesco

OBJECTIVE: Adipose tissue plays a role in the novel coronavirus disease 2019 (COVID‐19). Epicardial adipose tissue (EAT), a unique visceral fat, presents with high degree of inflammation in severe COVID‐19 disease. Whether and how adipose tissue may respond to the COVID‐19 therapies is unknown. METHODS: We retrospectively analyzed the difference in computed tomography (CT) measured EAT and subcutaneous (SAT) attenuation, defined as mean attenuation expressed in Hounsfield units (HU), in 72 patients [mean±SD age was 59.6±12.4 years, 50 (69%) were men] at the hospital admission for COVID‐19 and 99 days [IQR (71‐129)] after discharge. RESULTS: At the admission, EAT HU was significantly correlated with blood glucose levels, interleukin 6 , troponin T levels and waist circumference. EAT HU decreased from ‐87.21±16.18 to ‐100.0±11 (p<0.001) whereas SAT HU did not change (‐110.21±12.1 to ‐111.11±27.82, p=0.78) after therapy. Changes in EAT HU (expressed as ∆) significantly correlated with dexamethasone therapy (r= ‐ 0.46, p= 0.006), and when dexamethasone was combined with tocilizumab (r= ‐0.24, p=0.04). CONCLUSIONS: Dexamethasone therapy was associated with significant reduction of EAT inflammation in COVID‐19 patients, whereas SAT showed no changes. Anti‐inflammatory therapies targeting visceral fat may be helpful in COVID‐19 diseases.