Association of obesity on the outcome of critically ill patients affected by COVID-19.

Autores de IIS La Fe

• Alejandro Rodríguez Ortega

  Autor

• Ignacio Martin Loheches

  Autor

• Rafael Zaragoza Crespo

  Autor

Participantes ajenos a IIS La Fe

• Moreno, Gerard
• Diaz, Emili
• Ferre, Cristina
• Salgado, Melina
• Marin-Corral, Judith
• Estella, Angel
• Sole-Violan, Jordi
• Trefler, Sandra
• Socias, Lorenzo
• Borges-Sa, Marcio
• Restrepo, Marcos I
• Guardiola, Juan J
• Reyes, Luis F
• Albaya-Moreno, Antonio
• Berlanga, Alfonso Canabal
• Ortiz, Maria Del Valle
• Ballesteros, Juan Carlos
• Chinesta, Susana Sancho
• Laderas, Juan Carlos Pozo
• Gomez, Josep
• Bodi, Maria
• on behalf COVID-19/SEMCYUC Working group

Grupos

• Infección Grave

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 (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.

Copyright © 2023 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.

Keywords

• COVID-19; Obesidad; Obesity; Prognosis; Pronóstico