Body mass index and outcome in patients with COVID-19: A dose-response meta-analysis.

BACKGROUND: There is mounting evidence related to the association between obesity and severity of COVID-19. However, the direct relationship of the increase in the severe COVID-19 risk factors, with an increase in body mass index (BMI), has not yet been evaluated. AIM: This meta-analysis aims to evaluate the dose-response relationship between body mass index (BMI) and poor outcome in patients with COVID-19. METHODS: A systematic literature search was conducted using PubMed, Europe PMC, ProQuest, and the Cochrane Central Database. The primary outcome was composite poor outcome composed of mortality and severity. The secondary outcomes were mortality and severity. RESULTS: A total of 34,390 patients from 12 studies were included in this meta-analysis. The meta-analysis demonstrated that obesity was associated with composite poor outcome (OR 1.73 [1.40, 2.14], P<0.001; I2: 55.6%), mortality (OR 1.55 [1.16, 2.06], P=0.003; I2: 74.4%), and severity (OR 1.90 [1.45, 2.48], P<0.001; I2: 5.2%) in patients with COVID-19. A pooled analysis of highest BMI versus reference BMI indicate that a higher BMI in the patients was associated with composite poor outcome (aOR 3.02 [1.82, 5.00], P<0.001; I2: 59.8%), mortality (aOR 2.85 [1.17, 6.92], P=0.002; I2: 79.7%), and severity (aOR 3.08 [1.78, 5.33], P<0.001; I2: 11.7%). The dose-response meta-analysis showed an increased risk of composite poor outcome by aOR of 1.052 [1.028, 1.077], P<0.001 for every 5kg/m2 increase in BMI (Pnon-linearity<0.001). The curve became steeper with increasing BMI. CONCLUSION: Dose-response meta-analysis demonstrated that increased BMI was associated with increased poor outcome in patients with COVID-19.

Recent advances in diagnosis and management of hypertrophic cardiomyopathy.

Hypertrophic cardiomyopathy (HCM) is characterised by a thickened but non-dilated left ventricle in the absence of another cardiac or systemic condition capable of producing the magnitude of hypertrophy evident. It is the most common familial genetic disease of the heart (1/500 to 1/1000), as well as the most common cause of sudden cardiac death in young people and athletes. Survival rates of patients with HCM have improved from the 1960s onwards. Natural history in patients with HCM might vary from developing severe heart failure or atrial fibrillation, some die suddenly, often at a young age and in the absence of previous symptoms. Because of its heterogeneous clinical course and expression, HCM frequently presents uncertainty and represents a management dilemma to cardiovascular specialists and other practitioners.