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

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 co...

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Detalles Bibliográficos
Autores: Abumayyaleh, Mohammad, Nunez Gil, Ivan J, El-Battrawy, Ibrahim, Estrada, Vicente, Becerra-Munoz, Victor Manuel, Aparisi, Alvaro, Fernandez-Rozas, Inmaculada, Feltes, Gisela, Arroyo-Espliguero, Ramon, Trabattoni, Daniela, Lopez-Pais, Javier, Pepe, Martino, Romero, Rodolfo, Garcia, Diego Raul Villavicencio, Biole, Carloalberto, Astrua, Thamar Capel, Eid, Charbel Maroun, Alfonso, Emilio, Fernandez-Presa, Lucia, Espejo, Carolina, Buonsenso, Danilo, Raposeiras, Sergio, Fernandez, Cristina, Macaya, Carlos, Akin, Ibrahim, HOPE COVID-19 investigators
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2021
País:España
Institución:INCLIVA
Repositorio:r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
OAI Identifier:oai:incliva.fundanetsuite.com:p15654
Acceso en línea:https://incliva.portalinvestigacion.com/publicaciones/15654
Access Level:acceso abierto
Palabra clave:BMI
COVID-19
Obesity paradox
SARS-CoV-2
Descripción
Sumario: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.

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