Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 100
Filter
1.
Obes Surg ; 32(5): 1689-1700, 2022 May.
Article in English | MEDLINE | ID: covidwho-1777795

ABSTRACT

Currently, pneumonia caused by the coronavirus disease 2019 (COVID-19) is a pandemic. To date, there is no specific antiviral treatment for the disease, and universal access to the vaccine is a serious challenge. Some observational studies have shown that COVID-19 is more common in countries with a high prevalence of obesity and that people with COVID-19 have a higher body mass index. In these studies, obesity increased the risk of disease, as well as its severity and mortality. This study aimed to review the mechanisms that link obesity to COVID-19.


Subject(s)
COVID-19 , Obesity, Morbid , Humans , Obesity/complications , Obesity/epidemiology , Obesity, Morbid/surgery , Pandemics , SARS-CoV-2
2.
Nutrients ; 14(7)2022 Apr 02.
Article in English | MEDLINE | ID: covidwho-1776308

ABSTRACT

OBJECTIVES: To evaluate the effect of the SARS-CoV-2 lockdown on dietary habits, body weight, left hepatic lobe volume, use of micronutrient supplements, micronutrient status, frequency of physical activity, and evolution of comorbidities in patients undergoing preoperative care for BS. MATERIALS AND METHODS: We prospectively evaluated the dietary habits (including use of micronutrient supplements and frequency of physical activity) of 36 patients who were candidates for BS from March to May 2020; 7-day food dietary records, body weight, left hepatic lobe volume by ultrasound, micronutrient status, and evolution of comorbidities were assessed. RESULTS: All patients completed the study. Of the participants, 44.4% (16/36), 47.2% (17/36), and 27.8% (10/36) followed the preoperative indications for vegetables, fruits, and legumes, respectively, whereas over 50% did not. Furthermore, 30.6% (11/36) and 55.6% (20/36) of participants followed the prescribed recommendations for carbohydrates/sweets products and alcohol, respectively. A total of 61.1% (22/36) of participants experienced new foods and new culinary preparations. In addition, at the time of the study, we found that only 11.1% (4/36) were engaged in prescribed physical activity and only 36.1% (13/36) were taking prescribed micronutrient supplements. Compared to the initial weight, we observed an increased body weight and body mass index (+4.9%, p = 0.115; +1.89%, p = 0.0692, respectively), and no improvement in left hepatic lobe volume, micronutrient status, or comorbidities was recorded for any patient in the anamnesis. CONCLUSIONS: Lockdown determined by the SARS-CoV-2 pandemic has negatively affected the preoperative program of BS candidates, resulting in a postponement to the resumption of bariatric surgical activity.


Subject(s)
Bariatric Surgery , COVID-19 , Obesity, Morbid , Trace Elements , Communicable Disease Control , Humans , Micronutrients , Obesity, Morbid/surgery , Preoperative Care , SARS-CoV-2
3.
World Neurosurg ; 157: e357-e363, 2022 01.
Article in English | MEDLINE | ID: covidwho-1757929

ABSTRACT

BACKGROUND: Prior studies demonstrated reduced risk for venous thromboembolism (VTE) in neurosurgical patients secondary to prophylaxis with both heparin and low-molecular-weight heparin. The ability to monitor low-molecular-weight heparin by obtaining anti-factor Xa (anti-Xa) serum levels provides an opportunity to evaluate safety and efficacy. The aim of this study was to describe characteristics of patients who have anti-Xa levels outside of the goal range (0.2-0.4/0.5 IU/mL) and investigate incidence of major bleeding and VTE. METHODS: A single-center, retrospective, observational study was conducted on neurosurgical patients receiving enoxaparin for VTE prophylaxis between August 2019 and December 2020. Significance testing was conducted via Fisher exact test and independent samples t test. RESULTS: The study included 85 patients. Patients were less likely to have an anti-Xa level in the goal range if they were male, had a higher weight, or were morbidly obese. Three neuroendovascular patients (3.5%) experienced a major bleed. Serum anti-Xa levels were significantly higher in patients who experienced major bleeds compared with patients who did not (0.45 ± 0.16 IU/mL vs. 0.28 ± 0.09 IU/mL, P = 0.003). Patients with a supraprophylactic anti-Xa level (>0.5 IU/mL) were more likely to experience a major bleed (P = 0.005). One VTE event occurred: the patient experienced a pulmonary embolism with anti-Xa level at goal. CONCLUSIONS: Anti-Xa-guided enoxaparin dosing for VTE prophylaxis in neurosurgical patients may help prevent major bleeding. These data suggest that a higher anti-Xa level may predispose patients to major bleeding. Further evaluation is needed to identify the goal anti-Xa level for VTE prophylaxis in this population.


Subject(s)
Enoxaparin/blood , Factor Xa Inhibitors/blood , Hemorrhage/blood , Neurosurgical Procedures/trends , Pre-Exposure Prophylaxis/trends , Adult , Aged , Anticoagulants/administration & dosage , Anticoagulants/adverse effects , Anticoagulants/blood , Drug Monitoring/methods , Enoxaparin/administration & dosage , Enoxaparin/adverse effects , Factor Xa Inhibitors/administration & dosage , Factor Xa Inhibitors/adverse effects , Female , Hemorrhage/prevention & control , Humans , Male , Middle Aged , Obesity, Morbid/blood , Obesity, Morbid/surgery , Pre-Exposure Prophylaxis/methods , Retrospective Studies , Sex Factors , Venous Thromboembolism/blood , Venous Thromboembolism/prevention & control
4.
Obesity (Silver Spring) ; 30(2): 338-346, 2022 02.
Article in English | MEDLINE | ID: covidwho-1750426

ABSTRACT

OBJECTIVE: A first-in-human responsive deep brain stimulation (rDBS) trial (NCT03868670) for obesity is under way, which is based on promising preclinical evidence. Given the upfront costs of rDBS, it is prudent to examine the success threshold for cost-effectiveness compared with laparoscopic Roux-en-Y gastric bypass (LRYGB). METHODS: Efficacy and safety data on LRYGB and safety data on rDBS were collected for established indications through a literature search. The success threshold was defined as minimum BMI reduction. Treatment costs were calculated via Medicare national reimbursement data. RESULTS: LRYGB had a mean BMI reduction of 13.75 kg/m2 . Based on adverse events, LRYGB was a less-preferred health state (overall adverse event utility of 0.96 [0.02]) than rDBS (0.98 [0.01]), but LRYGB ($14,366 [$6,410]) had a significantly lower treatment cost than rDBS ($29,951 [$4,490]; p < 0.0001). Therefore, for rDBS to be cost-effective compared with LRYGB, the multiple models yielded a success threshold range of 13.7 to 15.2 kg/m2 . CONCLUSIONS: This study established a preliminary efficacy success threshold for rDBS to be cost-effective for severe obesity, and results from randomized controlled trials are needed. This analysis allows for interpretation of the economic impact of advancing rDBS for obesity in light of ongoing trial results and suggests an attainable threshold is needed for cost-effectiveness.


Subject(s)
Deep Brain Stimulation , Gastric Bypass , Obesity, Morbid , Aged , Cost-Benefit Analysis , Gastrectomy/methods , Gastric Bypass/methods , Health Care Costs , Humans , Medicare , Obesity/etiology , Obesity, Morbid/surgery , Treatment Outcome , United States
5.
Obes Surg ; 32(4): 1064-1071, 2022 04.
Article in English | MEDLINE | ID: covidwho-1712329

ABSTRACT

PURPOSE: to outline the clinical and laboratorial profile of patients with obesity undergoing bariatric surgery who presented positive reverse transcription-polymerase chain reaction (RT-PCR) for severe acute respiratory syndrome coronavirus-2 (Sars-CoV-2) in the preoperative period without symptoms presentation. METHODS: Case series of 17 patients undergoing bariatric surgery who presented positive RT-PCR for Sars-CoV-2 in the preoperative period, with no reported symptoms. Data collected included demographic characteristics, length of hospital stay, waiting time for surgery, inflammatory markers, serum levels of micronutrients and dengue virus (DENV) serology. RESULTS: In total, 219 patients underwent bariatric surgery in our institution during the study period. The incidence of asymptomatic cases was 7.7%. The sample comprised 88.2% of women, with mean age of 39.3 years and mean preoperative body mass index (BMI) of 37.7 kg/m2. Thirty five percent of the sample had previous diagnosis of diabetes and 29.4% had hypertension. The mean time elapsed between positive RT-PCR and the operation was 17 ± 7.5 days and the mean length of postoperative hospital stay was 1.9 ± 0.43 day. Mean lymphocytes count was 2,409.7/mm3 and the mean platelet-to-lymphocyte ratio was 126.3. Mean C-reactive protein value was 5.8 mg/dL, while ferritin marked 107.4 µg/L. DENV IgG was identified in all patients who tested for it. Mean levels of vitamin D and zinc were 25.6 ng/mL and 79.9 µg/dL, respectively. There were no postoperative complications reported. CONCLUSION: None of the included patients presented any of the laboratory markers related to disease severity. Moreover, it is important to notice that all patients who tested for DENV, had the specific IgG detected in their serum.


Subject(s)
Bariatric Surgery , COVID-19 , Obesity, Morbid , Adult , Brazil/epidemiology , COVID-19/epidemiology , Female , Humans , Obesity/complications , Obesity/surgery , Obesity, Morbid/surgery , Retrospective Studies , SARS-CoV-2
9.
Obes Surg ; 32(5): 1451-1458, 2022 May.
Article in English | MEDLINE | ID: covidwho-1681711

ABSTRACT

PURPOSE: To compare sleeve gastrectomy (SG) to SG associated with Rossetti fundoplication (SG + RF) in terms of de novo gastro-esophageal reflux disease (GERD) after surgery, weight loss, and postoperative complications. MATERIALS AND METHODS: Patients affected by morbid obesity, without symptoms of GERD, who were never in therapy with proton pump inhibitors (PPIs), were randomized into two groups. One group underwent SG and the other SG + RF. The study was stopped on February 2020 due to the COVID pandemic. RESULTS: A total of 278 patients of the programmed number of 404 patients were enrolled (68.8%). De novo esophagitis was considered in those patients who had both pre- and postoperative gastroscopy (97/278, 34.9%). Two hundred fifty-one patients (90.3%) had completed clinical follow-up at 12 months. SG + RF resulted in an adequate weight loss, similar to classic SG at 12-month follow-up (%TWL = 35. 4 ± 7.2%) with a significantly better outcome in terms of GERD development. One year after surgery, PPIs were necessary in 4.3% SG + RF patients compared to 17.1% SG patients (p = 0.001). Esophagitis was present in 2.0% of SG + RF patients versus 23.4% SG patients (p = 0.002). The main complication after SG + RF was wrap perforation (4.3%), which improved with the surgeon's learning curve. CONCLUSION: SG + RF seemed to be an effective alternative to classic SG in preventing de novo GERD. More studies are needed to establish that an adequate learning curve decreases the higher percentage of short-term complications in the SG + RF group.


Subject(s)
COVID-19 , Esophagitis , Gastroesophageal Reflux , Laparoscopy , Obesity, Morbid , Esophagitis/etiology , Fundoplication/adverse effects , Gastrectomy/adverse effects , Gastrectomy/methods , Gastroesophageal Reflux/diagnosis , Humans , Laparoscopy/adverse effects , Obesity, Morbid/surgery , Postoperative Complications/etiology , Proton Pump Inhibitors/therapeutic use , Retrospective Studies , Treatment Outcome , Weight Loss
10.
Obes Surg ; 32(4): 1397-1398, 2022 04.
Article in English | MEDLINE | ID: covidwho-1681710

ABSTRACT

In March 2020, the coronavirus disease 2019 (COVID-19) outbreak was declared as a pandemic by the World Health Organization. The COVID-19 breached the Taiwanese government's defense, and the Central Epidemic Command Center (CECC) announced a Nationwide Level 3 Alert on May 19, 2021. In summary, the residency training has been affected as follows: less exposure to elective surgeries and decreased training time. In the COVID-19 pandemic era, both my life and career as a surgical resident have been deeply affected. Worries, anxiety, and fear about insufficient training, unfulfilled career development, and unknown future have been prevalent daily. However, surgeons have always managed to confront and overcome difficulties and challenges with courage and fearlessness. Hence, it is also important that we face the COVID-19 pandemic situation and adapt wisely.


Subject(s)
COVID-19 , Internship and Residency , Obesity, Morbid , Humans , Obesity, Morbid/surgery , Pandemics , SARS-CoV-2
11.
Obes Surg ; 32(4): 1178-1183, 2022 04.
Article in English | MEDLINE | ID: covidwho-1653733

ABSTRACT

PURPOSE: The aim of this study was to determine the real influence of bariatric surgery on the clinical evolution of patients infected with SARS-Cov-2 in the postoperative period. METHODS: We conducted a retrospective analysis including two groups of patients: those who presented COVID-19 before bariatric surgery and those who presented it within 3 months of postoperative. Primary outcome was related to the severity of COVID-19, measured by the following variables: presence of symptoms, need for hospitalization, ICU admission, and invasive ventilation. Laboratory markers for inflammatory response, glycemic status, and micronutrients were analyzed as secondary outcomes. RESULTS: From the 222 individuals operated on within the study period, only 66 (29.7%) presented COVID-19, 42 (18.9%) in the preoperative period and 24 (10.8%) after the procedure. Mean age was 36.3 ± 9.5 years and mean preoperative BMI was 39.9 ± 4.2 kg/m2. There were no statistically significant differences between the groups regarding symptoms presentation (92.9% × 87.5%, p = 0.66), need for hospitalization (11.9% × 16.7%, p = 0.713), ICU admission (4.8% × 4.2%, p = 1.000), and invasive ventilation (2.4% × 0.0%, p = 1.000). Regarding the quantitative variables, absolute lymphocyte count was significantly lower in the group who presented COVID-19 after surgery (1822.9 ± 482.2 × 2158.6 ± 552.9, p = 0.035). CONCLUSION: Patients who had COVID-19 before and after sleeve gastrectomy did not differ with statistical significance for the presence of symptoms, need for hospitalization, ICU admission, and invasive ventilation.


Subject(s)
Bariatric Surgery , COVID-19 , Obesity, Morbid , Adult , Humans , Middle Aged , Obesity, Morbid/surgery , Postoperative Period , Retrospective Studies , SARS-CoV-2
12.
Obes Surg ; 32(4): 1072-1076, 2022 04.
Article in English | MEDLINE | ID: covidwho-1640994

ABSTRACT

PURPOSE: Many bariatric centers were restricted from providing routine care for outpatients. Telehealth visits allowed the continued care for outpatients and thus the preoperative screening for bariatric candidates. The objective of this study was to evaluate the effect of tele-screening on the multidisciplinary obesity team's decision (MDD) for bariatric surgery: disapproval, direct approval, or a recommendation for a prehabilitation program. MATERIALS AND METHODS: Hospital data were collected from patients who underwent face-to-face or tele-screening for bariatric surgery between April and December 2020. The tele-screening cohort was then compared with a propensity-matched cohort of patients with face-to-face consultations. A chi-square and multinomial logistic regression analyses were performed. RESULTS: After propensity matching, 396 patients remained for analysis. The majority received preoperative prehabilitation advice in both the tele-screening and face-to-face group (51% versus 50%). Although not significant, there were more direct approvals and fewer denials in the face-to-face group (p = 0.691). The multinomial logistic regression analysis showed no significant impact of tele-screening on the MDD result. CONCLUSION: Tele-screening in bariatric centers is feasible; the multidisciplinary team's decision was not significantly different between tele-screening and face-to-face screening which encourages the use of tele-screening in the future. An insignificant amount of fewer direct approvals and more denials were observed in the tele-screening group, which should be taken into account in future and larger case studies.


Subject(s)
Bariatric Surgery , COVID-19 , Obesity, Morbid , Telemedicine , COVID-19/epidemiology , Humans , Obesity, Morbid/surgery , Pandemics
16.
Obes Surg ; 32(3): 852-860, 2022 03.
Article in English | MEDLINE | ID: covidwho-1611494

ABSTRACT

BACKGROUND: Obesity has played a central role in heightened coronavirus disease 2019 (COVID-19) risk and vaccine response. COVID-19 vaccine intention among those with a history of severe obesity, specifically those who have undergone bariatric surgery, has not been described. This study aims to examine early COVID-19 vaccine intention among mothers with a history of severe obesity who underwent bariatric surgery. METHODS: Sixty-four mothers (Mage = 39.3 years) who underwent bariatric surgery (Mtime since surgery = 19.6 months) completed surveys online (November 2020-February 2021). Information obtained included their COVID-19 vaccine intention (vaccine ready, undecided, vaccine opposed). Analyses examined group differences in demographics, body mass index (BMI = kg/m2), knowledge of obesity-related COVID-19 risk, flu vaccination history, general beliefs about vaccine safety/effectiveness, and factors increasing confidence/motivation to obtain a COVID-19 vaccine. RESULTS: Thirty-six (56.3%) mothers had severe obesity (≥ Class II [BMI = ≥ 35 kg/m2]). The majority were vaccine hesitant (undecided [n = 28; 43.8%]; vaccine opposed [n = 15; 23.4%]). Compared to the vaccine-ready group, vaccine-hesitant groups were younger (p < .05). For the vaccine opposed, recent flu vaccination rates (p = .012) and general belief that vaccines are safe (p = .028) were lower than expected. Among hesitant participants, no reported side effects and the health of self and others were endorsed as top factors increasing vaccine confidence and motivation respectively. CONCLUSIONS: While preliminary, the prominence of early vaccine hesitancy in this sample of mothers who have undergone bariatric surgery, with most persisting with severe obesity, indicates a subgroup at high risk. Factors to address through targeted messaging and intervention were identified.


Subject(s)
Bariatric Surgery , COVID-19 , Obesity, Morbid , Adult , COVID-19 Vaccines , Female , Humans , Mothers , Obesity, Morbid/surgery , SARS-CoV-2
18.
JAMA Surg ; 157(3): 221-230, 2022 03 01.
Article in English | MEDLINE | ID: covidwho-1591201

ABSTRACT

Importance: Obesity is an established risk factor for severe COVID-19 infection. However, it is not known whether losing weight is associated with reduced adverse outcomes of COVID-19 infection. Objective: To investigate the association between a successful weight loss intervention and improved risk and severity of COVID-19 infection in patients with obesity. Design, Setting, and Participants: This cohort study involved adult patients with a body mass index of 35 or higher (calculated as weight in kilograms divided by height in meters squared) who underwent weight loss surgery between January 1, 2004, and December 31, 2017, at the Cleveland Clinic Health System (CCHS). Patients in the surgical group were matched 1:3 to patients who did not have surgical intervention for their obesity (control group). The source of data was the CCHS electronic health record. Follow-up was conducted through March 1, 2021. Exposures: Weight loss surgery including Roux-en-Y gastric bypass and sleeve gastrectomy. Main Outcomes and Measures: Distinct outcomes were examined before and after COVID-19 outbreak on March 1, 2020. Weight loss and all-cause mortality were assessed between the enrollment date and March 1, 2020. Four COVID-19-related outcomes were analyzed in patients with COVID-19 diagnosis between March 1, 2020, and March 1, 2021: positive SARS-CoV-2 test result, hospitalization, need for supplemental oxygen, and severe COVID-19 infection (a composite of intensive care unit admission, need for mechanical ventilation, or death). Results: A total of 20 212 patients (median [IQR] age, 46 [35-57] years; 77.6% female individuals [15 690]) with a median (IQR) body mass index of 45 (41-51) were enrolled. The overall median (IQR) follow-up duration was 6.1 (3.8-9.0) years. Before the COVID-19 outbreak, patients in the surgical group compared with control patients lost more weight (mean difference at 10 years from baseline: 18.6 [95% CI, 18.4-18.7] percentage points; P < .001) and had a 53% lower 10-year cumulative incidence of all-cause non-COVID-19 mortality (4.7% [95% CI, 3.7%-5.7%] vs 9.4% [95% CI, 8.7%-10.1%]; P < .001). Of the 20 212 enrolled patients, 11 809 were available on March 1, 2020, for an assessment of COVID-19-related outcomes. The rates of positive SARS-CoV-2 test results were comparable in the surgical and control groups (9.1% [95% CI, 7.9%-10.3%] vs 8.7% [95% CI, 8.0%-9.3%]; P = .71). However, undergoing weight loss surgery was associated with a lower risk of hospitalization (adjusted hazard ratio [HR], 0.51; 95% CI, 0.35-0.76; P < .001), need for supplemental oxygen (adjusted HR, 0.37; 95% CI, 0.23-0.61; P < .001), and severe COVID-19 infection (adjusted HR, 0.40; 95% CI, 0.18-0.86; P = .02). Conclusions and Relevance: This cohort study found that, among patients with obesity, substantial weight loss achieved with surgery was associated with improved outcomes of COVID-19 infection. The findings suggest that obesity can be a modifiable risk factor for the severity of COVID-19 infection.


Subject(s)
Bariatric Surgery , COVID-19 , Obesity, Morbid , Adult , COVID-19 Testing , Cohort Studies , Female , Humans , Male , Middle Aged , Obesity, Morbid/complications , Obesity, Morbid/epidemiology , Obesity, Morbid/surgery , SARS-CoV-2 , Weight Loss
19.
Int J Obes (Lond) ; 46(4): 750-757, 2022 04.
Article in English | MEDLINE | ID: covidwho-1575632

ABSTRACT

BACKGROUND: There is a paucity of data comparing 30-day morbidity and mortality of sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), and one anastomosis gastric bypass (OAGB). This study aimed to compare the 30-day safety of SG, RYGB, and OAGB in propensity score-matched cohorts. MATERIALS AND METHODS: This analysis utilised data collected from the GENEVA study which was a multicentre observational cohort study of bariatric and metabolic surgery (BMS) in 185 centres across 42 countries between 01/05/2022 and 31/10/2020 during the Coronavirus Disease-2019 (COVID-19) pandemic. 30-day complications were categorised according to the Clavien-Dindo classification. Patients receiving SG, RYGB, or OAGB were propensity-matched according to baseline characteristics and 30-day complications were compared between groups. RESULTS: In total, 6770 patients (SG 3983; OAGB 702; RYGB 2085) were included in this analysis. Prior to matching, RYGB was associated with highest 30-day complication rate (SG 5.8%; OAGB 7.5%; RYGB 8.0% (p = 0.006)). On multivariate regression modelling, Insulin-dependent type 2 diabetes mellitus and hypercholesterolaemia were associated with increased 30-day complications. Being a non-smoker was associated with reduced complication rates. When compared to SG as a reference category, RYGB, but not OAGB, was associated with an increased rate of 30-day complications. A total of 702 pairs of SG and OAGB were propensity score-matched. The complication rate in the SG group was 7.3% (n = 51) as compared to 7.5% (n = 53) in the OAGB group (p = 0.68). Similarly, 2085 pairs of SG and RYGB were propensity score-matched. The complication rate in the SG group was 6.1% (n = 127) as compared to 7.9% (n = 166) in the RYGB group (p = 0.09). And, 702 pairs of OAGB and RYGB were matched. The complication rate in both groups was the same at 7.5 % (n = 53; p = 0.07). CONCLUSIONS: This global study found no significant difference in the 30-day morbidity and mortality of SG, RYGB, and OAGB in propensity score-matched cohorts.


Subject(s)
COVID-19 , Diabetes Mellitus, Type 2 , Gastric Bypass , Obesity, Morbid , COVID-19/epidemiology , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/epidemiology , Diabetes Mellitus, Type 2/surgery , Gastrectomy/adverse effects , Humans , Morbidity , Obesity, Morbid/complications , Obesity, Morbid/epidemiology , Obesity, Morbid/surgery , Propensity Score , Retrospective Studies , Treatment Outcome
20.
Obes Surg ; 32(2): 391-397, 2022 02.
Article in English | MEDLINE | ID: covidwho-1530389

ABSTRACT

BACKGROUND: Obesity is a widely accepted risk factor for the development of severe COVID-19. We sought to determine the survival benefit of early initiation of aggressive anticoagulation in obese critically ill COVID-19 patients. METHODS: We retrospectively reviewed 237 intubated patients at a single academic accredited bariatric center and stratified them based on their BMI into 2 groups, obese (BMI > 30) and non-obese (BMI ≤ 30). We used chi-square tests to compare categorical variables such as age and sex, and two-sample t-tests or Mann Whitney U-tests for continuous variables, including important laboratory values. Cox proportional-hazards regression models were utilized to determine whether obesity was an independent predictor of survival and multivariable analysis was performed to compare risk factors that were deemed significant in the univariable analysis. Survival with respect to BMI and its association with level of anticoagulation in the obese cohort was evaluated using Kaplan-Meier models. RESULTS: The overall mortality in the obese and non-obese groups was similar at 47% and 44%, respectively (p = 0.65). Further analysis based on the level of AC showed that obese patients placed on early aggressive AC protocol had improved survival compared to obese patients who did not receive protocol based aggressive AC (ON-aggressive AC protocol 26% versus OFF-aggressive AC protocol 61%, p = 0.0004). CONCLUSIONS: The implementation of early aggressive anticoagulation may balance the negative effects of obesity on the overall mortality in critically ill COVID-19 patients.


Subject(s)
COVID-19 , Obesity, Morbid , Anticoagulants/therapeutic use , Body Mass Index , Critical Illness , Humans , Obesity/complications , Obesity, Morbid/surgery , Retrospective Studies , SARS-CoV-2
SELECTION OF CITATIONS
SEARCH DETAIL