Obesity and the Risk of Intubation or Death in Patients With Coronavirus Disease 2019.

Autor:	Frank RC; Cardiology Division, Department of Medicine, Massachusetts General Hospital, Boston, MA., Mendez SR; Department of Medicine, Massachusetts General Hospital, Boston, MA., Stevenson EK; Division of Pulmonary, Critical Care, and Sleep Medicine, North Shore Medical Center, Salem, MA., Guseh JS; Cardiology Division, Department of Medicine, Massachusetts General Hospital, Boston, MA.; Cardiovascular Performance Program, Massachusetts General Hospital, Boston, MA., Chung M; Cardiology Division, Department of Medicine, Massachusetts General Hospital, Boston, MA.; Department of Medicine, Massachusetts General Hospital, Boston, MA.; Division of Pulmonary, Critical Care, and Sleep Medicine, North Shore Medical Center, Salem, MA.; Cardiovascular Performance Program, Massachusetts General Hospital, Boston, MA.; Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA.; Smith Center for Outcomes Research in Cardiology, Division of Cardiovascular Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA.; Heart Center Intensive Care Unit, Massachusetts General Hospital, Boston, MA., Silverman MG; Cardiology Division, Department of Medicine, Massachusetts General Hospital, Boston, MA.; Heart Center Intensive Care Unit, Massachusetts General Hospital, Boston, MA.
Jazyk:	angličtina
Zdroj:	Critical care medicine [Crit Care Med] 2020 Nov; Vol. 48 (11), pp. e1097-e1101.
DOI:	10.1097/CCM.0000000000004553
Abstrakt:	Objectives: To characterize the impact of obesity on disease severity in patients with coronavirus disease 2019. Design: This was a retrospective cohort study designed to evaluate the association between body mass index and risk of severe disease in patients with coronavirus disease 2019. Data were abstracted from the electronic health record. The primary endpoint was a composite of intubation or death. Setting: Two hospitals in Massachusetts (one quaternary referral center and one affiliated community hospital). Patients: Consecutive patients hospitalized with confirmed coronavirus disease 2019 admitted between March 13, 2020, and April 3, 2020. Interventions: None. Measurements and Main Results: A total of 305 patients were included in this study. We stratified patients by body mass index category: < 25 kg/m (54 patients, 18%), ≥ 25 kg/m to < 30 kg/m (124 patients, 41%), ≥ 30 kg/m to < 35 kg/m (58 patients, 19%), and ≥ 35 kg/m (69 patients, 23%). In total, 128 patients (42%) had a primary endpoint (119 patients [39%] were intubated and nine died [3%] without intubation). Sixty-five patients (51%) with body mass index greater than or equal to 30 kg/m were intubated or died. Adjusted Cox models demonstrated that body mass index greater than or equal to 30 kg/m was associated with a 2.3-fold increased risk of intubation or death (95% CI, 1.2-4.3) compared with individuals with body mass index less than 25 kg/m. Diabetes was also independently associated with risk of intubation or death (hazard ratio, 1.8; 95% CI, 1.2-2.7). Fifty-six out of 127 patients (44%) with body mass index greater than or equal to 30 kg/m had diabetes, and the combination of both diabetes and body mass index greater than or equal to 30 kg/m was associated with a 4.5-fold increased risk of intubation or death (95% CI, 2.0-10.2) compared with patients without diabetes and body mass index less than 25 kg/m. Conclusions: Among consecutive patients hospitalized with coronavirus disease 2019, obesity was an independent risk factor for intubation or death.
Databáze:	MEDLINE
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