Endocrine Abstracts

Introduction: COVID-19 has taken on pandemic proportions. Phase angle (PhA) and Standardized phase angle (SPhA) have been related to mortality and severity in several diseases.

Objetives: To determine the predictive role of PhA and SPhA on 90 days survival of adults with COVID-19.

Methods: A longitudinal cohort study with 127 consecutive patients diagnosed with COVID-19. We collected PhA, SPhA, body composition (fat mass, fat free mass, hydration) and laboratory markers (CRP, D-dimer or albumin).

Results: COVID-19 patients in the lowest SPhA quartile (Q1) had increased (P<0.001) mortality and hospital stay (P=0.009). Q1 patients have hyperhydration status (P<0.001), decreased nutritional parameters [body mass cell index [BCMI (P<0.001)]and increased inflammation biomarkers [CRP (P<0.001), albumin (P<0.001), D-dimer (P=0.002)]. Multivariate analysis (Cox regression) revealed that PhA, adjusted for age, sex, BMI, and comorbidities (diabetes, hypertension, dyslipidaemia or heart disease), were associated (P<0.001) with increased mortality. The HR was 2.48 (95% CI, 1.60-3.84, P< 0.001). PhA <3.95° was the cut-off for predicting mortality in acute COVID-19 with 93.8% sensitivity and 66.7% specificity. Non-surviving COVID-19 patients had significantly lower PhA and SPhA values (P<0.001) and increased hydration (P<0.001) compared to surviving patients.

Conclusions: PhA may play a role in assessing mortality risk in COVID-19, independently of age, sex, BMI, and comorbidities. The HR was 2.48 times for each degree that PhA decrease. SPhA quartiles are related to median survival (70 days in Q1 vs. more than 90 days in Q2 and Q3). PhA <3.95° could be considered as a cut-off point for mortality risk prognosis in acute SARS-CoV2 infection.