BMI and pneumonia outcomes in critically ill covid‐19 patients: An international multicenter study

Objective Previous studies have unveiled a relationship between the severity of coronavirus disease 2019 (COVID‐19) pneumonia and obesity. The aims of this multicenter retrospective cohort study were to disentangle the association of BMI and associated metabolic risk factors (diabetes, hypertension,...

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Published in:Obesity 2021-09, Vol.29 (9), p.1477-1486
Main Authors: Chetboun, Mikael, Raverdy, Violeta, Labreuche, Julien, Simonnet, Arthur, Wallet, Florent, Caussy, Cyrielle, Antonelli, Massimo, Artigas, Antonio, Goma, Gemma, Meziani, Ferhat, Helms, Julie, Mylonakis, Eleftherios, Levy, Mitchell M., Kalligeros, Markos, Latronico, Nicola, Piva, Simone, Cerf, Charles, Neuville, Mathilde, Klouche, Kada, Larcher, Romaric, Tamion, Fabienne, Occhiali, Emilie, Snacken, Morgane, Preiser, Jean‐Charles, Kontar, Loay, Riviere, Antoine, Silva, Stein, Sarton, Benjamine, Krouchi, Raphael, Dubar, Victoria, Palaiodimos, Leonidas, Karamanis, Dimitrios, Perche, Juliette, L'Her, Erwan, Busetto, Luca, Dicker, Dror, Lev, Shaul, Duhamel, Alain, Jourdain, Mercè, Pattou, François
Format: Article
Language:English
Subjects:
Body Mass Index
Cancer
Cardiovascular disease
Chronic illnesses
Coronaviruses
COVID-19
COVID-19 / mortality
Critical Illness
Diabetes
Europe
Female
Human health and pathology
Humans
Hypertension
Intensive care
Israel
Life Sciences
Male
Metabolism
Middle Aged
Mortality
Obesity
Original
ORIGINAL ARTICLES
Pandemics
Patients
Pneumonia
Pneumonia / mortality
Retrospective Studies
Risk factors
Severe acute respiratory syndrome coronavirus 2
United States
Ventilators
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Summary:Objective Previous studies have unveiled a relationship between the severity of coronavirus disease 2019 (COVID‐19) pneumonia and obesity. The aims of this multicenter retrospective cohort study were to disentangle the association of BMI and associated metabolic risk factors (diabetes, hypertension, hyperlipidemia, and current smoking status) in critically ill patients with COVID‐19. Methods Patients admitted to intensive care units for COVID‐19 in 21 centers (in Europe, Israel, and the United States) were enrolled in this study between February 19, 2020, and May 19, 2020. Primary and secondary outcomes were the need for invasive mechanical ventilation (IMV) and 28‐day mortality, respectively. Results A total of 1,461 patients were enrolled; the median (interquartile range) age was 64 years (40.9‐72.0); 73.2% of patients were male; the median BMI was 28.1 kg/m2 (25.4‐32.3); a total of 1,080 patients (73.9%) required IMV; and the 28‐day mortality estimate was 36.1% (95% CI: 33.0‐39.5). An adjusted mixed logistic regression model showed a significant linear relationship between BMI and IMV: odds ratio = 1.27 (95% CI: 1.12‐1.45) per 5 kg/m2. An adjusted Cox proportional hazards regression model showed a significant association between BMI and mortality, which was increased only in obesity class III (≥40; hazard ratio = 1.68 [95% CI: 1.06‐2.64]). Conclusions In critically ill COVID‐19 patients, a linear association between BMI and the need for IMV, independent of other metabolic risk factors, and a nonlinear association between BMI and mortality risk were observed.
ISSN:1930-7381
1930-739X
DOI:10.1002/oby.23223