Obesity as a risk factor for unfavourable outcomes in critically ill patients affected by Covid 19

Nutr Metab Cardiovasc Dis. 2021 Mar 10;31(3):762-768. doi: 10.1016/j.numecd.2020.11.012. Epub 2020 Nov 20.

Abstract

Background and aims: Recent studies show that obesity is a risk factor for hospital admission and for critical care need in patients with coronavirus disease 2019 (COVID-19). The aim was to determine whether obesity is a risk factor for unfavourable health outcomes in patients affected by COVID-19 admitted to ICU.

Methods and results: 95 consecutive patients with COVID-19 (78 males and 18 females) were admitted to ICU and included in the study. Height, weight, BMI, Sequential Organ Failure Assessment (SOFA) and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores, CRP, CPK, ICU and hospital length of stay and comorbidities were evaluated. Participants with obesity had a lower 28 day survival rate from ICU admission than normal weight subjects. Cox proportional hazard model-derived estimates, adjusted for age, gender and comorbidity, confirmed the results of the survival analysis (HR:5.30,95%C.I.1.26-22.34). Obese subjects showed longer hospital and ICU stay as compared with normal weight counterpart.Subjects with obesity showed significantly higher CRP and CPK levels than normal weight subjects.

Conclusion: In individuals with obesity, careful management and prompt intervention in case of suspected SARS-CoV-2 infection is necessary to prevent the progression of the disease towards severe outcomes and the increase of hospital treatment costs.

Keywords: Body mass index; COVID-19; Intensive care unit; Obesity; SARS-CoV-2.

MeSH terms

  • APACHE
  • Adult
  • Aged
  • Aged, 80 and over
  • Body Mass Index
  • COVID-19 / epidemiology*
  • COVID-19 / mortality*
  • Critical Illness
  • Female
  • Hospitalization / statistics & numerical data
  • Humans
  • Intensive Care Units
  • Length of Stay / statistics & numerical data
  • Male
  • Middle Aged
  • Obesity / epidemiology*
  • Obesity / mortality
  • Proportional Hazards Models
  • Risk Factors
  • SARS-CoV-2
  • Severity of Illness Index