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Obesity and Its Impact on Adverse In-Hospital Outcomes in Hospitalized Patients With COVID-19.
Keller, Karsten; Sagoschen, Ingo; Schmitt, Volker H; Sivanathan, Visvakanth; Espinola-Klein, Christine; Lavie, Carl J; Münzel, Thomas; Hobohm, Lukas.
  • Keller K; Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.
  • Sagoschen I; Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.
  • Schmitt VH; Medical Clinic VII, Department of Sports Medicine, University Hospital Heidelberg, Heidelberg, Germany.
  • Sivanathan V; Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.
  • Espinola-Klein C; Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.
  • Lavie CJ; German Center for Cardiovascular Research (DZHK)Partner Site Rhine Main, Mainz, Germany.
  • Münzel T; Department of Gastroenterology, University Medical Center Mainz (Johannes Gutenberg-University Mainz), Mainz, Germany.
  • Hobohm L; Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.
Front Endocrinol (Lausanne) ; 13: 876028, 2022.
Article in English | MEDLINE | ID: covidwho-1855337
ABSTRACT

Background:

An increasing level of evidence suggests that obesity not only is a major risk factor for cardiovascular diseases (CVDs) but also has adverse outcomes during COVID-19 infection.

Methods:

We used the German nationwide inpatient sample to analyze all hospitalized patients with confirmed COVID-19 diagnosis in Germany from January to December 2020 and stratified them for diagnosed obesity. Obesity was defined as body mass index ≥30 kg/m2 according to the WHO. The impact of obesity on in-hospital case fatality and adverse in-hospital events comprising major adverse cardiovascular and cerebrovascular events (MACCE), acute respiratory distress syndrome (ARDS), venous thromboembolism (VTE), and others was analyzed.

Results:

We analyzed data of 176,137 hospitalizations of patients with confirmed COVID-19 infection; among them, 9,383 (5.3%) had an additional obesity diagnosis. Although COVID-19 patients without obesity were older (72.0 [interquartile range (IQR) 56.0/82.0] vs. 66.0 [54.0/76.0] years, p < 0.001), the CVD profile was less favorable in obese COVID-19 patients (Charlson comorbidity index 4.44 ± 3.01 vs. 4.08 ± 2.92, p < 0.001). Obesity was independently associated with increased in-hospital case fatality (OR 1.203 [95% CI 1.131-1.279], p < 0.001) and MACCE (OR 1.168 [95% CI 1.101-1.239], p < 0.001), ARDS (OR 2.605 [95% CI 2.449-2.772], p < 0.001), and VTE (OR 1.780 [95% CI 1.605-1.973], p < 0.001) and also associated with increased necessity of treatment on intensive care unit (OR 2.201 [95% CI 2.097-2.310], p < 0.001), mechanical ventilation (OR 2.277 [95% CI 2.140-2.422], p < 0.001), and extracorporeal membrane oxygenation (OR 3.485 [95% CI 3.023-4.017], p < 0.001).

Conclusions:

Obesity independently affected case fatality, MACCE, ARDS development, VTE, and other adverse in-hospital events in patients with COVID-19 infection. Obesity should be taken into account regarding COVID-19 prevention strategies, risk stratification, and adequate healthcare planning. Maintaining a healthy weight is important not only to prevent cardiometabolic diseases but also for better individual outcomes during COVID-19 infection.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Respiratory Distress Syndrome / Venous Thromboembolism / COVID-19 Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Humans Language: English Journal: Front Endocrinol (Lausanne) Year: 2022 Document Type: Article Affiliation country: Fendo.2022.876028

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Respiratory Distress Syndrome / Venous Thromboembolism / COVID-19 Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Humans Language: English Journal: Front Endocrinol (Lausanne) Year: 2022 Document Type: Article Affiliation country: Fendo.2022.876028