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.

COVID‐19, Dexamethasone, Epicardial adipose tissue (EAT), computed tomography scan (CT)