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":"COVID-19重症患者的体重指数和死亡率：肥胖悖论的又一块砖。","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":"{\"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). 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BMI and mortality in critically ill patients with COVID-19: another brick in the wall of the obesity paradox
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.
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.
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