Discriminatory Value of Adiponectin to Leptin Ratio for Covid-19 Pneumonia

Abstract Purpose Obesity is a risk factor for severe coronavirus disease 2019 (Covid-19). Circulating adipokines have been associated with inflammatory burden and amplified or dysregulated immune responses. This study aimed to evaluate the discriminatory ability of adipokines to identify Covid-19 pneumonia and to assess disease severity. Methods we conducted an observa-tional case-control study, with a prospective design, and recruited patients with diagnosis of Covid-19 pneumonia (n=48) and healthy controls (n=36), who were matched by age, sex and BMI. Leptin, adiponectin, IL-6 and TNF-α were measured by ELISA. Results patients with Covid-19 pneumonia had higher levels of leptin, lower adiponectin/leptin (Adpn/Lep) ratio, and higher expression of IL-6. Leptin had an acceptable discriminatory accuracy for Covid-19 pneumonia in patients with BMI >30 (AUC 0.74 [0.58, 0.90]) with a cutoff of 7852 pg/mL and it was associated with maximum respiratory support. By contrast, Adpn/Lep had an excellent discriminatory accuracy for Covid-19 pneumonia in patients with BMI 2.23) in lean patients is con-sistent with a state of good health, which decreases in case of inflammatory states, ranging from adipose tissue dysfunction with low-grade inflammation to Covid-19 pneumonia.