BMI and mortality in critically ill patients with COVID-19: another brick in the wall of the obesity paradox

IF 4.2 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Obesity Pub Date : 2024-06-30 DOI:10.1002/oby.24069

Amanda Vilaverde Perez, Marina Verçoza Viana, Ludmilla Dall'Orto Thomazini, Sérgio Henrique Loss, Fernanda Cassanta Richa de Machado, Aline Graziele do Nascimento, Amanda Pinto Kropidlofscky, Fernando Gerchman, Cristiane Bauermann Leitão, Tatiana Helena Rech, José Augusto Santos Pellegrini

{"title":"BMI and mortality in critically ill patients with COVID-19: another brick in the wall of the obesity paradox","authors":"Amanda Vilaverde Perez, Marina Verçoza Viana, Ludmilla Dall'Orto Thomazini, Sérgio Henrique Loss, Fernanda Cassanta Richa de Machado, Aline Graziele do Nascimento, Amanda Pinto Kropidlofscky, Fernando Gerchman, Cristiane Bauermann Leitão, Tatiana Helena Rech, José Augusto Santos Pellegrini","doi":"10.1002/oby.24069","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Objective</h3>\n \n <p>The objective of this study was to assess the existence of the obesity paradox in patients with COVID-19 admitted to the intensive care unit.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>This was a multicentric retrospective cohort study including individuals aged 18 years or older admitted to the intensive care unit with SARS-CoV-2. Data were obtained from electronic medical records. The primary outcome was in-hospital mortality. Multiple logistic regression and restricted cubic splines analyses were conducted to assess the association between BMI and mortality.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>From March 2020 to December 2021, 977 patients met the inclusion criteria, and 868 were included in the analysis. Obesity was identified in 382 patients (44%). Patients with obesity more often underwent prone positioning (42% vs. 28%; <i>p</i> < 0.001), although they used less vasoactive medications (57% vs. 68%; <i>p</i> < 0.001). The overall in-hospital mortality was 48%, with 44% observed in the subgroup of individuals with obesity and 50% in those without obesity (<i>p</i> = 0.06). Patients with BMI < 25 kg/m<sup>2</sup> had the highest mortality.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Obesity was not associated with higher mortality rates in critically ill patients with COVID-19. Moreover, patients with BMI < 25 kg/m<sup>2</sup> had a higher mortality rate compared with those in higher BMI categories.</p>\n </section>\n </div>","PeriodicalId":215,"journal":{"name":"Obesity","volume":"32 8","pages":"1474-1482"},"PeriodicalIF":4.2000,"publicationDate":"2024-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Obesity","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/oby.24069","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}

引用次数: 0

Abstract

Objective

The objective of this study was to assess the existence of the obesity paradox in patients with COVID-19 admitted to the intensive care unit.

Methods

This was a multicentric retrospective cohort study including individuals aged 18 years or older admitted to the intensive care unit with SARS-CoV-2. Data were obtained from electronic medical records. The primary outcome was in-hospital mortality. Multiple logistic regression and restricted cubic splines analyses were conducted to assess the association between BMI and mortality.

Results

From March 2020 to December 2021, 977 patients met the inclusion criteria, and 868 were included in the analysis. Obesity was identified in 382 patients (44%). Patients with obesity more often underwent prone positioning (42% vs. 28%; p < 0.001), although they used less vasoactive medications (57% vs. 68%; p < 0.001). The overall in-hospital mortality was 48%, with 44% observed in the subgroup of individuals with obesity and 50% in those without obesity (p = 0.06). Patients with BMI < 25 kg/m² had the highest mortality.

Conclusions

Obesity was not associated with higher mortality rates in critically ill patients with COVID-19. Moreover, patients with BMI < 25 kg/m² had a higher mortality rate compared with those in higher BMI categories.

查看原文本刊更多论文

COVID-19重症患者的体重指数和死亡率：肥胖悖论的又一块砖。

研究目的本研究旨在评估入住重症监护室的 COVID-19 患者是否存在肥胖悖论：这是一项多中心回顾性队列研究，研究对象包括因感染 SARS-CoV-2 而入住重症监护室的 18 岁及以上患者。数据来自电子病历。主要结果是院内死亡率。研究采用多元逻辑回归和限制性立方样条分析来评估体重指数与死亡率之间的关系：从 2020 年 3 月到 2021 年 12 月，共有 977 例患者符合纳入标准，其中 868 例纳入分析。382名患者（44%）被确认为肥胖。肥胖患者多采用俯卧位（42% 对 28%；P 2），死亡率最高：结论：肥胖与COVID-19重症患者死亡率升高无关。结论：肥胖与 COVID-19 重症患者死亡率升高无关。此外，体重指数小于 25 kg/m2 的患者死亡率高于体重指数较高的患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Obesity 医学-内分泌学与代谢

CiteScore

11.70

自引率

1.40%

发文量

261

审稿时长

2-4 weeks

期刊介绍： Obesity is the official journal of The Obesity Society and is the premier source of information for increasing knowledge, fostering translational research from basic to population science, and promoting better treatment for people with obesity. Obesity publishes important peer-reviewed research and cutting-edge reviews, commentaries, and public health and medical developments.