{"title":"肥胖是COVID-19预后不良的潜在危险因素吗?","authors":"Meltem Agca, Eylem Tuncay, Elif Yıldırım, Reyhan Yıldız, Tülin Sevim, Dilek Ernam, Nermin Ozer Yılmaz, Nazlı Huma Teke, Simge Yavuz, Zuhal Karakurt, Ipek Ozmen","doi":"10.3947/ic.2021.0026","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Materials and methods: </strong>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.</p><p><strong>Results: </strong>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% <i>vs.</i> 50%, <i>P</i> = 0.002), and a longer median (interquartile range [IQR]) duration of hospitalization (8 [5 - 12] <i>vs.</i> 6 [5 - 9]) days, <i>P</i> = 0.006). Obese participants had higher concentrations of serum C-reactive protein, procalcitonin, ferritin than non-obese patients (<i>P</i> <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, <i>P</i> = 0.012). Moreover, IMV requirement was associated with obesity (aOR: 8.73, 95% CI: 2.44 - 31.20, <i>P</i> = 0.001). Mortality occurred in 16%, 9%, and 1% of the obese group, overweight group, and normal-weight group, respectively (Chi-square trend analysis, <i>P</i> = 0.002).</p><p><strong>Conclusion: </strong>Obesity is a risk factor for adverse outcomes and caused increased mortality, hence requiring close follow-up.</p>","PeriodicalId":520645,"journal":{"name":"Infection & chemotherapy","volume":" ","pages":"319-331"},"PeriodicalIF":2.9000,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f3/4a/ic-53-319.PMC8258288.pdf","citationCount":"5","resultStr":"{\"title\":\"Is Obesity a Potential Risk factor for Poor Prognosis of COVID-19?\",\"authors\":\"Meltem Agca, Eylem Tuncay, Elif Yıldırım, Reyhan Yıldız, Tülin Sevim, Dilek Ernam, Nermin Ozer Yılmaz, Nazlı Huma Teke, Simge Yavuz, Zuhal Karakurt, Ipek Ozmen\",\"doi\":\"10.3947/ic.2021.0026\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Materials and methods: </strong>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.</p><p><strong>Results: </strong>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% <i>vs.</i> 50%, <i>P</i> = 0.002), and a longer median (interquartile range [IQR]) duration of hospitalization (8 [5 - 12] <i>vs.</i> 6 [5 - 9]) days, <i>P</i> = 0.006). Obese participants had higher concentrations of serum C-reactive protein, procalcitonin, ferritin than non-obese patients (<i>P</i> <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, <i>P</i> = 0.012). Moreover, IMV requirement was associated with obesity (aOR: 8.73, 95% CI: 2.44 - 31.20, <i>P</i> = 0.001). Mortality occurred in 16%, 9%, and 1% of the obese group, overweight group, and normal-weight group, respectively (Chi-square trend analysis, <i>P</i> = 0.002).</p><p><strong>Conclusion: </strong>Obesity is a risk factor for adverse outcomes and caused increased mortality, hence requiring close follow-up.</p>\",\"PeriodicalId\":520645,\"journal\":{\"name\":\"Infection & chemotherapy\",\"volume\":\" \",\"pages\":\"319-331\"},\"PeriodicalIF\":2.9000,\"publicationDate\":\"2021-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f3/4a/ic-53-319.PMC8258288.pdf\",\"citationCount\":\"5\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Infection & chemotherapy\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.3947/ic.2021.0026\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Infection & chemotherapy","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3947/ic.2021.0026","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Is Obesity a Potential Risk factor for Poor Prognosis of COVID-19?
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.
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