Does there exist an obesity paradox in COVID-19? Insights of the international HOPE-COVID-19-registry.

Autor: Abumayyaleh M; University Medical Center Mannheim (UMM), University of Heidelberg, Mannheim, Germany. Electronic address: mohammad.abumayyaleh@medma.uni-heidelberg.de., Núñez Gil IJ; Hospital Clínico San Carlos, Universidad Complutense de Madrid, Instituto de Investigación, Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain. Electronic address: ibnsky@yahoo.es., El-Battrawy I; University Medical Center Mannheim (UMM), University of Heidelberg, Mannheim, Germany., Estrada V; Hospital Clínico San Carlos, Universidad Complutense de Madrid, Instituto de Investigación, Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain., Becerra-Muñoz VM; Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain., Aparisi A; Hospital Clínico Universitario de Valladolid, Valladolid, Spain., Fernández-Rozas I; Hospital Severo Ochoa, Leganés, Spain., Feltes G; Hospital Nuestra Señora de América, Madrid, Spain., Arroyo-Espliguero R; Hospital Universitario Guadalajara, Guadalajara, Spain., Trabattoni D; Centro Cardiologico Monzino, IRCCS, Milano, Italy., López-País J; Complejo Hospitalario Universitario de Santiago de Compostela Santiago de Compostela, Spain., Pepe M; Azienda ospedaliero-universitaria consorziale policlinico di Bari, Bari, Italy., Romero R; Hospital Universitario Getafe, Madrid, Spain., García DRV; Hospital General del norte de Guayaquil IESS Los Ceibos, Guayaquil, Ecuador., Biole C; Cardiology Unit, San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy., Astrua TC; Hospital Virgen del Mar, Madrid, Spain., Eid CM; Hospital Universitario La Paz, Instituto de Investigacion, Hospital Universitario La Paz (IdiPAZ), Madrid, Spain., Alfonso E; Instituto de Cardiologia, Havana, Cuba., Fernandez-Presa L; Hospital Clínico de Valencia, INCLIVA, Valencia, Spain., Espejo C; Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Spain., Buonsenso D; Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy., Raposeiras S; University Hospital Álvaro Cunqueiro, Vigo, Spain., Fernández C; Complejo Hospitalario Universitario de Santiago de Compostela Santiago de Compostela, Spain; Fundación Instituto para la Mejora de la Asistencia Sanitaria (IMAS), Madrid, Spain., Macaya C; Hospital Clínico San Carlos, Universidad Complutense de Madrid, Instituto de Investigación, Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain., Akin I; University Medical Center Mannheim (UMM), University of Heidelberg, Mannheim, Germany.
Jazyk: angličtina
Zdroj: Obesity research & clinical practice [Obes Res Clin Pract] 2021 May-Jun; Vol. 15 (3), pp. 275-280. Date of Electronic Publication: 2021 Mar 03.
DOI: 10.1016/j.orcp.2021.02.008
Abstrakt: Background: Obesity has been described as a protective factor in cardiovascular and other diseases being expressed as 'obesity paradox'. However, the impact of obesity on clinical outcomes including mortality in COVID-19 has been poorly systematically investigated until now. We aimed to compare clinical outcomes among COVID-19 patients divided into three groups according to the body mass index (BMI).
Methods: We retrospectively collected data up to May 31 st , 2020. 3635 patients were divided into three groups of BMI (<25 kg/m 2 ; n = 1110, 25-30 kg/m 2 ; n = 1464, and >30 kg/m 2 ; n = 1061). Demographic, in-hospital complications, and predictors for mortality, respiratory insufficiency, and sepsis were analyzed.
Results: The rate of respiratory insufficiency was more recorded in BMI 25-30 kg/m 2 as compared to BMI < 25 kg/m 2 (22.8% vs. 41.8%; p < 0.001), and in BMI > 30 kg/m 2 than BMI < 25 kg/m 2 , respectively (22.8% vs. 35.4%; p < 0.001). Sepsis was more observed in BMI 25-30 kg/m 2 and BMI > 30 kg/m 2 as compared to BMI < 25 kg/m 2 , respectively (25.1% vs. 42.5%; p = 0.02) and (25.1% vs. 32.5%; p = 0.006). The mortality rate was higher in BMI 25-30 kg/m 2 and BMI > 30 kg/m 2 as compared to BMI < 25 kg/m 2 , respectively (27.2% vs. 39.2%; p = 0.31) (27.2% vs. 33.5%; p = 0.004). In the Cox multivariate analysis for mortality, BMI < 25 kg/m 2 and BMI > 30 kg/m 2 did not impact the mortality rate (HR 1.15, 95% CI: 0.889-1.508; p = 0.27) (HR 1.15, 95% CI: 0.893-1.479; p = 0.27). In multivariate logistic regression analyses for respiratory insufficiency and sepsis, BMI < 25 kg/m 2 is determined as an independent predictor for reduction of respiratory insufficiency (OR 0.73, 95% CI: 0.538-1.004; p = 0.05).
Conclusions: HOPE COVID-19-Registry revealed no evidence of obesity paradox in patients with COVID-19. However, Obesity was associated with a higher rate of respiratory insufficiency and sepsis but was not determined as an independent predictor for a high mortality.
(Copyright © 2021 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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