Obesity prolongs the hospital stay in patients affected by COVID-19, and may impact on SARS-COV-2 shedding

Obes Res Clin Pract. May-Jun 2020;14(3):205-209. doi: 10.1016/j.orcp.2020.05.009. Epub 2020 Jun 4.

Abstract

Introduction: On the last three months the new SARS-COV-2 coronavirus has created a pandemic, rapidly spreading all around the world. The aim of the study is to investigate whether obesity impacts on COVID-19 morbidity.

Methods: One hundred consecutive patients with COVID-19 pneumonia admitted in our Medical Unit were evaluated. Anthropometric parameters and past medical history were registered. Nasopharyngeal swab samples and biochemical analysis were obtained at admission and during hospital stay.

Results: Patients with (OB, 29) and without obesity (N-OB, 71) were similar in age, gender and comorbidities, with the exception of hypertension that was more frequent in OB group. At admission, inflammatory markers were higher in OB than N-OB group. OB group showed a worse pulmonary clinical picture, with lower PaO2 (57 ± 15 vs. 68 ± 14 mmHg, p = 0.042), and SaO2 (88 ± 6 vs. 92 ± 5%, p = 0.049) at admission consequently requiring higher volumes of oxygen (Fi02: 38 ± 15 vs. 29 ± 19%, p = 0.047) and a longer period to achieve oxygen weaning (10 ± 6 vs. 15 ± 7 days, p = 0.03). OB group also had positive swabs for longer time (19 ± 8 vs. 13 ± 7, days, p = 0.002), and required longer hospital stay (21 ± 8 vs. 13 ± 8, days, p = 0.0008). Partial least square regression analysis showed that BMI, age and CRP at admission were related to longer length of hospital stay, and time for negative swab. On the contrary, in this cohort, obesity did not predict higher mortality.

Conclusions: Subjects with obesity affected by COVID-19 require longer hospitalization, more intensive and longer oxygen treatment, and they may have longer SARS-COV-2 shedding.

Keywords: COVID-19; CRP; Citokynes; Obesity; Viral shedding.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Betacoronavirus*
  • COVID-19
  • Cohort Studies
  • Coronavirus Infections / complications*
  • Coronavirus Infections / physiopathology*
  • Female
  • Humans
  • Italy
  • Length of Stay / statistics & numerical data*
  • Male
  • Obesity / complications*
  • Obesity / physiopathology*
  • Pandemics
  • Pneumonia, Viral / complications*
  • Pneumonia, Viral / physiopathology*
  • Retrospective Studies
  • SARS-CoV-2
  • Virus Shedding / physiology*