Association of obesity on the outcome of critically ill patients affected by COVID-19
Copyright © 2023 Elsevier España, S.L.U. and SEMICYUC. All rights reserved..
OBJECTIVE: To evaluate the impact of obesity on ICU mortality.
DESIGN: Observational, retrospective, multicentre study.
SETTING: Intensive Care Unit (ICU).
PATIENTS: Adults patients admitted with COVID-19 and respiratory failure.
INTERVENTIONS: None.
PRIMARY VARIABLES OF INTEREST: Collected data included demographic and clinical characteristics, comorbidities, laboratory tests and ICU outcomes. Body mass index (BMI) impact on ICU mortality was studied as (1) a continuous variable, (2) a categorical variable obesity/non-obesity, and (3) as categories defined a priori: underweight, normal, overweight, obesity and Class III obesity. The impact of obesity on mortality was assessed by multiple logistic regression and Smooth Restricted cubic (SRC) splines for Cox hazard regression.
RESULTS: 5,206 patients were included, 20 patients (0.4%) as underweight, 887(17.0%) as normal, 2390(46%) as overweight, 1672(32.1) as obese and 237(4.5%) as class III obesity. The obesity group patients (n = 1909) were younger (61 vs. 65 years, p < 0.001) and with lower severity scores APACHE II (13 [9-17] vs. 13[10-17, p < 0.01) than non-obese. Overall ICU mortality was 28.5% and not different for obese (28.9%) or non-obese (28.3%, p = 0.65). Only Class III obesity (OR = 2.19, 95%CI 1.44-3.34) was associated with ICU mortality in the multivariate and SRC analysis.
CONCLUSIONS: COVID-19 patients with a BMI > 40 are at high risk of poor outcomes in the ICU. An effective vaccination schedule and prolonged social distancing should be recommended.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:48 |
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| Enthalten in: |
Medicina intensiva - 48(2024), 3 vom: 02. März, Seite 142-154 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Rodríguez, Alejandro [VerfasserIn] |
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| Links: |
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| Themen: |
COVID-19 |
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| Anmerkungen: |
Date Completed 04.03.2024 Date Revised 03.04.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.medine.2023.08.003 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 100 | 1 | |a Rodríguez, Alejandro |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Association of obesity on the outcome of critically ill patients affected by COVID-19 |
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| 500 | |a Date Completed 04.03.2024 | ||
| 500 | |a Date Revised 03.04.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 Elsevier España, S.L.U. and SEMICYUC. All rights reserved. | ||
| 520 | |a OBJECTIVE: To evaluate the impact of obesity on ICU mortality | ||
| 520 | |a DESIGN: Observational, retrospective, multicentre study | ||
| 520 | |a SETTING: Intensive Care Unit (ICU) | ||
| 520 | |a PATIENTS: Adults patients admitted with COVID-19 and respiratory failure | ||
| 520 | |a INTERVENTIONS: None | ||
| 520 | |a PRIMARY VARIABLES OF INTEREST: Collected data included demographic and clinical characteristics, comorbidities, laboratory tests and ICU outcomes. Body mass index (BMI) impact on ICU mortality was studied as (1) a continuous variable, (2) a categorical variable obesity/non-obesity, and (3) as categories defined a priori: underweight, normal, overweight, obesity and Class III obesity. The impact of obesity on mortality was assessed by multiple logistic regression and Smooth Restricted cubic (SRC) splines for Cox hazard regression | ||
| 520 | |a RESULTS: 5,206 patients were included, 20 patients (0.4%) as underweight, 887(17.0%) as normal, 2390(46%) as overweight, 1672(32.1) as obese and 237(4.5%) as class III obesity. The obesity group patients (n = 1909) were younger (61 vs. 65 years, p < 0.001) and with lower severity scores APACHE II (13 [9-17] vs. 13[10-17, p < 0.01) than non-obese. Overall ICU mortality was 28.5% and not different for obese (28.9%) or non-obese (28.3%, p = 0.65). Only Class III obesity (OR = 2.19, 95%CI 1.44-3.34) was associated with ICU mortality in the multivariate and SRC analysis | ||
| 520 | |a CONCLUSIONS: COVID-19 patients with a BMI > 40 are at high risk of poor outcomes in the ICU. An effective vaccination schedule and prolonged social distancing should be recommended | ||
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a Obesidad | |
| 650 | 4 | |a Obesity | |
| 650 | 4 | |a Prognosis | |
| 650 | 4 | |a Pronóstico | |
| 700 | 1 | |a Martín-Loeches, Ignacio |e verfasserin |4 aut | |
| 700 | 1 | |a Moreno, Gerard |e verfasserin |4 aut | |
| 700 | 1 | |a Díaz, Emili |e verfasserin |4 aut | |
| 700 | 1 | |a Ferré, Cristina |e verfasserin |4 aut | |
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| 700 | 1 | |a Reyes, Luis F |e verfasserin |4 aut | |
| 700 | 1 | |a Albaya-Moreno, Antonio |e verfasserin |4 aut | |
| 700 | 1 | |a Berlanga, Alfonso Canabal |e verfasserin |4 aut | |
| 700 | 1 | |a Ortiz, María Del Valle |e verfasserin |4 aut | |
| 700 | 1 | |a Ballesteros, Juan Carlos |e verfasserin |4 aut | |
| 700 | 1 | |a Chinesta, Susana Sancho |e verfasserin |4 aut | |
| 700 | 1 | |a Laderas, Juan Carlos Pozo |e verfasserin |4 aut | |
| 700 | 1 | |a Gómez, Josep |e verfasserin |4 aut | |
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