Meltem Agca1, Eylem Tuncay2, Elif Yıldırım3, Reyhan Yıldız3, Tülin Sevim3, Dilek Ernam3, Nermin Ozer Yılmaz4, Nazlı Huma Teke3, Simge Yavuz3, Zuhal Karakurt3, Ipek Ozmen3. 1. Department of Pulmonology, University of Health Sciences, Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey. agcameltem@yahoo.com. 2. Department of Respiratory Intensive Care Unit, University of Health Sciences, Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey. 3. Department of Pulmonology, University of Health Sciences, Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey. 4. Department of Infectious Diseases, University of Health Sciences, Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey.
Abstract
BACKGROUND: Coronavirus disease 2019 (COVID-19) continues to cause major mortality and morbidity worldwide even after a year of its emergence. In its early days, hypertension, diabetes, and cardiovascular diseases were noted as poor prognostic factors, while obesity gained attention at a later stage. In the present study, unfavorable clinical outcomes (transfer to the intensive care unit, invasive mechanical ventilation, and mortality) were investigated in obese patients with COVID-19. MATERIALS AND METHODS: In this retrospective study we analyzed patients with positive polymerase chain reaction test in tertiary care hospital between March-May 2020. They were divided into 3 groups according to body mass index (BMI) as normal, overweight, and obese (BMI: 18.5 - 24.99 kg/m², 25 - 29.99 kg/m², and ≥ 30 kg/m², respectively). We compared clinical features and laboratory findings of these groups and recorded adverse clinical outcomes. Multivariate logistic analysis was performed for unfavorable outcomes. RESULTS: There were 99 patients (35%), 116 (41%), and 69 patients (24%) in the normal-weight, overweight, and obese group, respectively. Among all patients, 52 (18%) patients were transferred to the intensive care unit (ICU), 30 (11%) patients received invasive mechanical ventilation (IMV), and 22 patients (8%) died. Obese patients had minimum 1 more comorbidity than normal BMI patients (73% vs. 50%, P = 0.002), and a longer median (interquartile range [IQR]) duration of hospitalization (8 [5 - 12] vs. 6 [5 - 9]) days, P = 0.006). Obese participants had higher concentrations of serum C-reactive protein, procalcitonin, ferritin than non-obese patients (P <0.05 in all). In a multivariate analysis, obesity was associated with ICU admission (adjusted odds ratio [aOR]: 2.99, 95% confidence interval [CI]: 1.26 - 7.04, P = 0.012). Moreover, IMV requirement was associated with obesity (aOR: 8.73, 95% CI: 2.44 - 31.20, P = 0.001). Mortality occurred in 16%, 9%, and 1% of the obese group, overweight group, and normal-weight group, respectively (Chi-square trend analysis, P = 0.002). CONCLUSION: Obesity is a risk factor for adverse outcomes and caused increased mortality, hence requiring close follow-up.
BACKGROUND:Coronavirus disease 2019 (COVID-19) continues to cause major mortality and morbidity worldwide even after a year of its emergence. In its early days, hypertension, diabetes, and cardiovascular diseases were noted as poor prognostic factors, while obesity gained attention at a later stage. In the present study, unfavorable clinical outcomes (transfer to the intensive care unit, invasive mechanical ventilation, and mortality) were investigated in obesepatients with COVID-19. MATERIALS AND METHODS: In this retrospective study we analyzed patients with positive polymerase chain reaction test in tertiary care hospital between March-May 2020. They were divided into 3 groups according to body mass index (BMI) as normal, overweight, and obese (BMI: 18.5 - 24.99 kg/m², 25 - 29.99 kg/m², and ≥ 30 kg/m², respectively). We compared clinical features and laboratory findings of these groups and recorded adverse clinical outcomes. Multivariate logistic analysis was performed for unfavorable outcomes. RESULTS: There were 99 patients (35%), 116 (41%), and 69 patients (24%) in the normal-weight, overweight, and obese group, respectively. Among allpatients, 52 (18%) patients were transferred to the intensive care unit (ICU), 30 (11%) patients received invasive mechanical ventilation (IMV), and 22 patients (8%) died. Obesepatients had minimum 1 more comorbidity than normal BMI patients (73% vs. 50%, P = 0.002), and a longer median (interquartile range [IQR]) duration of hospitalization (8 [5 - 12] vs. 6 [5 - 9]) days, P = 0.006). Obeseparticipants had higher concentrations of serum C-reactive protein, procalcitonin, ferritin than non-obesepatients (P <0.05 in all). In a multivariate analysis, obesity was associated with ICU admission (adjusted odds ratio [aOR]: 2.99, 95% confidence interval [CI]: 1.26 - 7.04, P = 0.012). Moreover, IMV requirement was associated with obesity (aOR: 8.73, 95% CI: 2.44 - 31.20, P = 0.001). Mortality occurred in 16%, 9%, and 1% of the obese group, overweight group, and normal-weight group, respectively (Chi-square trend analysis, P = 0.002). CONCLUSION:Obesity is a risk factor for adverse outcomes and caused increased mortality, hence requiring close follow-up.
Authors: J Wu; W Li; X Shi; Z Chen; B Jiang; J Liu; D Wang; C Liu; Y Meng; L Cui; J Yu; H Cao; L Li Journal: J Intern Med Date: 2020-04-20 Impact factor: 8.989
Authors: S D Neidich; W D Green; J Rebeles; E A Karlsson; S Schultz-Cherry; T L Noah; S Chakladar; M G Hudgens; S S Weir; M A Beck Journal: Int J Obes (Lond) Date: 2017-06-06 Impact factor: 5.095
Authors: Christopher M Petrilli; Simon A Jones; Jie Yang; Harish Rajagopalan; Luke O'Donnell; Yelena Chernyak; Katie A Tobin; Robert J Cerfolio; Fritz Francois; Leora I Horwitz Journal: BMJ Date: 2020-05-22