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Aggressive Anticoagulation May Decrease Mortality in Obese Critically Ill COVID-19 Patients.
Drakos, Panagiotis; Volteas, Panagiotis; Naeem, Zaina; Asencio, Anthony A; Cleri, Nathaniel A; Alkadaa, Leor N; Oganov, Anthony; Gammel, Theresa; Saadon, Jordan R; Bannazadeh, Mohsen; Tassiopoulos, Apostolos K; Mikell, Charles B; Rubano, Jerry; Pryor, Aurora; Spaniolas, Konstantinos; Mofakham, Sima.
  • Drakos P; Department of Surgery, Renaissance School of Medicine, Stony Brook, NY, USA.
  • Volteas P; Department of Surgery, Renaissance School of Medicine, Stony Brook, NY, USA.
  • Naeem Z; Department of Surgery, Renaissance School of Medicine, Stony Brook, NY, USA.
  • Asencio AA; Department of Neurosurgery, Renaissance School of Medicine, Stony Brook, NY, USA.
  • Cleri NA; Department of Neurosurgery, Renaissance School of Medicine, Stony Brook, NY, USA.
  • Alkadaa LN; Department of Neurosurgery, Renaissance School of Medicine, Stony Brook, NY, USA.
  • Oganov A; Department of Neurosurgery, Renaissance School of Medicine, Stony Brook, NY, USA.
  • Gammel T; Department of Neurosurgery, Renaissance School of Medicine, Stony Brook, NY, USA.
  • Saadon JR; Department of Neurosurgery, Renaissance School of Medicine, Stony Brook, NY, USA.
  • Bannazadeh M; Department of Surgery, Renaissance School of Medicine, Stony Brook, NY, USA.
  • Tassiopoulos AK; Division of Vascular Surgery, Department of Surgery, Renaissance School of Medicine, Stony Brook, NY, USA.
  • Mikell CB; Department of Surgery, Renaissance School of Medicine, Stony Brook, NY, USA.
  • Rubano J; Division of Vascular Surgery, Department of Surgery, Renaissance School of Medicine, Stony Brook, NY, USA.
  • Pryor A; Department of Neurosurgery, Renaissance School of Medicine, Stony Brook, NY, USA.
  • Spaniolas K; Department of Surgery, Renaissance School of Medicine, Stony Brook, NY, USA.
  • Mofakham S; Department of Surgery, Renaissance School of Medicine, Stony Brook, NY, USA.
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.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Obesity, Morbid / COVID-19 Type of study: Observational study / Prognostic study / Randomized controlled trials / Risk factors Topics: Long Covid Limits: Humans Language: English Journal: Obes Surg Journal subject: Metabolism Year: 2022 Document Type: Article Affiliation country: S11695-021-05799-8

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Obesity, Morbid / COVID-19 Type of study: Observational study / Prognostic study / Randomized controlled trials / Risk factors Topics: Long Covid Limits: Humans Language: English Journal: Obes Surg Journal subject: Metabolism Year: 2022 Document Type: Article Affiliation country: S11695-021-05799-8