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Impact Of body Mass Index on Cardiopulmonary Outcomes of COVID-19 Hospitalizations Complicated by Severe Sepsis
Sivaram Neppala1, Himaja Dutt Chigurupati2, Nikhilender Nag Mopuru3
1University of Texas at San Antonio, San Antonio, TX, USA.
Insights
Higher classes of obesity (Class II and III) significantly increased the risk of major adverse cardiac and cerebrovascular events (MACCE) and in-hospital mortality in patients hospitalized with severe Coronavirus disease (COVID-19) and sepsis.
Area of Science:
- Critical Care Medicine
- Cardiology
- Infectious Diseases
Background:
- Body Mass Index (BMI) significantly influences Coronavirus disease (COVID-19) outcomes.
- Understanding major adverse cardiac and cerebrovascular events (MACCE) in severe sepsis patients with varying BMIs is crucial.
Purpose of the Study:
- To investigate the association between Body Mass Index (BMI) and outcomes in hospitalized patients with severe Coronavirus disease (COVID-19)-sepsis.
- To analyze the impact of obesity classes on mortality, respiratory failure, and MACCE.
Main Methods:
- Observational study analyzing data from 51,740 severe COVID-19-sepsis hospitalizations.
- Multivariable regression analyses adjusted for comorbidities and patient features.
- Primary outcomes included in-hospital mortality, respiratory failure, and MACCE; secondary outcome was healthcare resource utilization.
Main Results:
- Patients with Class II and Class III obesity exhibited significantly higher odds of MACCE compared to overweight individuals (p < 0.001).
- All-cause in-hospital mortality showed significantly higher odds in patients with Class III, Class II, and Class I obesity versus overweight patients (p < 0.001).
- Obesity classes showed a trend towards lower odds of respiratory failure, but did not reach statistical significance.
Conclusions:
- Class II and Class III obesity are associated with significantly increased odds of MACCE in severe COVID-19-sepsis admissions.
- Higher obesity classes (II and III) are linked to significantly higher in-hospital mortality in severe COVID-19-sepsis patients.
Background:
Body Mass Index (BMI) has a significant impact on Coronavirus disease (COVID-19) patient outcomes; however, major adverse cardiac and cerebrovascular outcomes in patients with severe sepsis have been poorly understood. Our study aims to explore and provide insight into its association.
Methods:
This is an observational study looking at the impact of BMI on COVID-19-severe sepsis hospitalizations. The primary outcomes are adjusted odds of all-cause in-hospital mortality, respiratory failure, and major adverse cardiac and cerebrovascular events (MACCE), which include acute myocardial infarction, cardiac arrest, and acute ischemic stroke. The secondary outcome was healthcare resource utilization. Coexisting comorbidities and patient features were adjusted with multivariable regression analyses.
Results:
Of 51,740 patients with severe COVID-19-sepsis admissions, 11.4% were overweight, 24.8% had Class I obesity (BMI 30-34.9), 19.8% had Class II obesity (BMI 35-39.9), and 43.9% had the categorization of Class III obesity (BMI >40) cohorts with age>18 years. The odds of MACCE in patients with class II obesity and class III obesity (OR 1.09 and 1.54; 95CI 0.93-1.29 and 1.33-1.79) were significantly higher than in overweight (p < 0.001). Class I, Class II, and Class III patients with obesity revealed lower odds of respiratory failure compared to overweight (OR 0.89, 0.82, and 0.82; 95CI 0.75-1.05, 0.69-0.97, and 0.70-0.97), but failed to achieve statistical significance (p = 0.079). On multivariable regression analysis, all-cause in-hospital mortality revealed significantly higher odds in patients with Class III obesity, Class II, and Class I (OR 1.56, 1.17, and 1.06; 95CI 1.34-1.81, 0.99-1.38, and 0.91-1.24) vs. overweight patients (p < 0.001).
Conclusions:
Patients with Class II and Class III obesity had significantly higher odds of MACCE and in-hospital mortality in COVID-19-severe sepsis admissions.
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