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Is Obesity a Potential Risk factor for Poor Prognosis of COVID-19?
Meltem Agca1, Eylem Tuncay2, Elif Yıldırım3
1Department of Pulmonology, University of Health Sciences, Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey. agcameltem@yahoo.com.
Insights
Obesity is a significant risk factor for severe outcomes in COVID-19 patients. Obese individuals face higher rates of intensive care unit admission, mechanical ventilation, and mortality.
Area of Science:
- Medical Research
- Infectious Diseases
- Public Health
Background:
- Coronavirus disease 2019 (COVID-19) poses a global health threat with significant mortality and morbidity.
- While initial studies identified hypertension, diabetes, and cardiovascular disease as risk factors, obesity's impact gained later recognition.
- This study investigates the association between obesity and adverse clinical outcomes in COVID-19 patients.
Purpose of the Study:
- To determine if obesity is a risk factor for unfavorable clinical outcomes in COVID-19 patients.
- To compare the clinical features and laboratory findings of normal-weight, overweight, and obese COVID-19 patients.
- To analyze the association between body mass index (BMI) and adverse outcomes such as ICU admission, mechanical ventilation, and mortality.
Main Methods:
- Retrospective analysis of COVID-19 patients with positive PCR tests between March-May 2020.
- Patients categorized into normal-weight (BMI 18.5-24.99 kg/m²), overweight (BMI 25-29.99 kg/m²), and obese (BMI ≥ 30 kg/m²) groups.
- Multivariate logistic regression used to assess the impact of obesity on unfavorable outcomes.
Main Results:
- Obese patients had a higher prevalence of comorbidities (73% vs. 50%) and longer hospitalization (8 vs. 6 days) compared to normal-weight patients.
- Obesity was significantly associated with increased intensive care unit (ICU) admission (aOR: 2.99) and invasive mechanical ventilation (IMV) (aOR: 8.73).
- Mortality rates were substantially higher in the obese group (16%) compared to overweight (9%) and normal-weight (1%) groups.
Conclusions:
- Obesity is identified as a significant risk factor for adverse clinical outcomes in COVID-19.
- Obese COVID-19 patients require closer monitoring due to increased risk of severe disease and mortality.
- Findings underscore the importance of considering obesity in COVID-19 risk stratification and management strategies.
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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