Association of obesity on the outcome of critically ill patients affected by COVID-19.
Med Intensiva (Engl Ed)
; 48(3): 142-154, 2024 03.
Article
em En
| MEDLINE
| ID: mdl-37923608
ABSTRACT
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 (nâ¯=â¯1909) were younger (61 vs. 65 years, pâ¯<â¯0.001) and with lower severity scores APACHE II (13 [9-17] vs. 13[10-17, pâ¯<â¯0.01) than non-obese. Overall ICU mortality was 28.5% and not different for obese (28.9%) or non-obese (28.3%, pâ¯=â¯0.65). Only Class III obesity (ORâ¯=â¯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 BMIâ¯>â¯40 are at high risk of poor outcomes in the ICU. An effective vaccination schedule and prolonged social distancing should be recommended.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Sobrepeso
/
COVID-19
Limite:
Adult
/
Humans
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article