{"title":"Is obesity paradox valid for critically-ill COVID-19 patients with respiratory failure?","authors":"Havva Sezer, Hande Bulut Canbaz, Fatma Yurdakul, Boğaç Özserezli, Dilek Yazıcı","doi":"10.5152/TurkThoracJ.2022.21139","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>We aimed to analyze the association between body mass index and mortality in patients with coronavirus disease 2019 induced acute respiratory distress syndrome.</p><p><strong>Material and methods: </strong>In this retrospective cohort study, we analyzed 108 consecutive patients admitted in the intensive care unit for coronavirus disease 2019-induced lung disease in a single center between March 2020 and February 2021. Coronavirus disease 2019 infection was confirmed by real-time reverse transcription-polymerase chain reaction assay of nasal swabs or lower respiratory tract samples. Acute respiratory distress syndrome was defined using Berlin criteria. Acute respiratory distress syndrome severity was assessed with partial pressure of arterial oxygen/fraction of inspired oxygen ratio. We categorized patients according to the body mass index as underweight, <18.5 kg/m2; normal weight, from 18.5 kg/m2 to <25 kg/m2; overweight, from 25 kg/m2 to <30 kg/m2; obese, ≥30 kg/m2. Clinical characteristics and mortality were compared among groups. Demographic and clinical data were collected from electronic medical records of the hospital system.</p><p><strong>Results: </strong>The mean age was 67.3 ± 13.3 years. Study participants were predominantly males (66.7%). The mean BMI was 28.2 ± 5.6 kg/m2. There were 2 patients (2%), 28 (26%), 42 (39%), and 36 patients (33%) in the underweight, normal-weight, overweight, and obese groups, respectively. The hospital mortality was 40.7%. There was no association between body mass index and mortality (P = .09). In multivariate analysis, mortality was associated with the presence of cancer [odds ratio = 7.338 (1.636-32.914), P = .009], and time between diagnosis and intubation [odds ratio = 1.318 (1.150-1.509), P ≤ .001].</p><p><strong>Conclusion: </strong>Neither acute respiratory distress syndrome severity nor mortality was higher in patients with higher body mass index compared to the ones with normal body mass index.</p>","PeriodicalId":37452,"journal":{"name":"Turkish Thoracic Journal","volume":"23 4","pages":"268-276"},"PeriodicalIF":0.8000,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/aa/75/ttj-23-4-268.PMC9361167.pdf","citationCount":"3","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Turkish Thoracic Journal","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5152/TurkThoracJ.2022.21139","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}
引用次数: 3
Abstract
Objective: We aimed to analyze the association between body mass index and mortality in patients with coronavirus disease 2019 induced acute respiratory distress syndrome.
Material and methods: In this retrospective cohort study, we analyzed 108 consecutive patients admitted in the intensive care unit for coronavirus disease 2019-induced lung disease in a single center between March 2020 and February 2021. Coronavirus disease 2019 infection was confirmed by real-time reverse transcription-polymerase chain reaction assay of nasal swabs or lower respiratory tract samples. Acute respiratory distress syndrome was defined using Berlin criteria. Acute respiratory distress syndrome severity was assessed with partial pressure of arterial oxygen/fraction of inspired oxygen ratio. We categorized patients according to the body mass index as underweight, <18.5 kg/m2; normal weight, from 18.5 kg/m2 to <25 kg/m2; overweight, from 25 kg/m2 to <30 kg/m2; obese, ≥30 kg/m2. Clinical characteristics and mortality were compared among groups. Demographic and clinical data were collected from electronic medical records of the hospital system.
Results: The mean age was 67.3 ± 13.3 years. Study participants were predominantly males (66.7%). The mean BMI was 28.2 ± 5.6 kg/m2. There were 2 patients (2%), 28 (26%), 42 (39%), and 36 patients (33%) in the underweight, normal-weight, overweight, and obese groups, respectively. The hospital mortality was 40.7%. There was no association between body mass index and mortality (P = .09). In multivariate analysis, mortality was associated with the presence of cancer [odds ratio = 7.338 (1.636-32.914), P = .009], and time between diagnosis and intubation [odds ratio = 1.318 (1.150-1.509), P ≤ .001].
Conclusion: Neither acute respiratory distress syndrome severity nor mortality was higher in patients with higher body mass index compared to the ones with normal body mass index.
期刊介绍:
Turkish Thoracic Journal (Turk Thorac J) is the double-blind, peer-reviewed, open access, international publication organ of Turkish Thoracic Society. The journal is a quarterly publication, published on January, April, July, and October and its publication language is English. Turkish Thoracic Journal started its publication life following the merger of two journals which were published under the titles “Turkish Respiratory Journal” and “Toraks Journal” until 2007. Archives of both journals were passed on to the Turkish Thoracic Journal. The aim of the journal is to convey scientific developments and to create a dynamic discussion platform about pulmonary diseases. With this intent, the journal accepts articles from all related scientific areas that address adult and pediatric pulmonary diseases, as well as thoracic imaging, environmental and occupational disorders, intensive care, sleep disorders and thoracic surgery. Clinical and research articles, reviews, statements of agreement or disagreement on controversial issues, national and international consensus reports, abstracts and comments of important international articles, interesting case reports, writings related to clinical and practical applications, letters to the editor, and editorials are accepted.