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Impact of obesity on intensive care outcomes in patients with COVID-19 in Sweden-A cohort study.
Sjögren, Lovisa; Stenberg, Erik; Thuccani, Meena; Martikainen, Jari; Rylander, Christian; Wallenius, Ville; Olbers, Torsten; Kindblom, Jenny M.
  • Sjögren L; Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
  • Stenberg E; Department of Pediatrics, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
  • Thuccani M; Department of Pediatrics, Hallands Hospital Halmstad, Halmstad, Sweden.
  • Martikainen J; Department of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
  • Rylander C; Department of Anaesthesiology and Intensive Care Medicine, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
  • Wallenius V; Bioinformatics Core Facility, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
  • Olbers T; Department of Anaesthesiology and Intensive Care Medicine, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
  • Kindblom JM; Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
PLoS One ; 16(10): e0257891, 2021.
Article in English | MEDLINE | ID: covidwho-1468161
ABSTRACT

BACKGROUND:

Previous studies have shown that a high body mass index (BMI) is a risk factor for severe COVID-19. The aim of the present study was to assess whether a high BMI affects the risk of death or prolonged length of stay (LOS) in patients with COVID-19 during intensive care in Sweden. METHODS AND

FINDINGS:

In this observational, register-based study, we included patients with COVID-19 from the Swedish Intensive Care Registry admitted to intensive care units (ICUs) in Sweden. Outcomes assessed were death during intensive care and ICU LOS ≥14 days. We used logistic regression models to evaluate the association (odds ratio [OR] and 95% confidence interval [CI]) between BMI and the outcomes. Valid weight and height information could be retrieved in 1,649 patients (1,227 (74.4%) males) with COVID-19. We found a significant association between BMI and the risk of the composite outcome death or LOS ≥14 days in survivors (OR per standard deviation [SD] increase 1.30, 95%CI 1.16-1.44, adjusted for sex, age and comorbidities), and this association remained after further adjustment for severity of illness (simplified acute physiology score; SAPS3) at ICU admission (OR 1.30 per SD, 95%CI 1.17-1.45). Individuals with a BMI ≥ 35 kg/m2 had a doubled risk of the composite outcome. A high BMI was also associated with death during intensive care and a prolonged LOS in survivors assessed as separate outcomes. The main limitations were the restriction to the first wave of the pandemic, and the lack of information on socioeconomic status as well as smoking.

CONCLUSIONS:

In this large cohort of Swedish ICU patients with COVID-19, a high BMI was associated with increasing risk of death and prolonged length of stay in the ICU. Based on our findings, we suggest that individuals with obesity should be more closely monitored when hospitalized for COVID-19.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Main subject: COVID-19 / Obesity Subject: COVID-19 / Obesity Type of study: Etiology study / Incidence study / Observational study / Prognostic study / Risk factors Language: English Journal: PLoS One Clinical aspect: Diagnosis / Etiology Year: 2021

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Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Main subject: COVID-19 / Obesity Subject: COVID-19 / Obesity Type of study: Etiology study / Incidence study / Observational study / Prognostic study / Risk factors Language: English Journal: PLoS One Clinical aspect: Diagnosis / Etiology Year: 2021
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