Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, China.
Department of Spine Surgery and Musculoskeletal Tumor, Zhongnan Hospital of Wuhan University, Wuhan, China.
Obesity (Silver Spring). 2020 Oct;28(10):1815-1825. doi: 10.1002/oby.22943. Epub 2020 Sep 2.
This study aims to explore the indicators for severity of coronavirus disease 2019 (COVID-19) in young patients between the ages of 18 and 40 years.
This retrospective cohort study included 65 consecutively admitted patients with COVID-19 who were between 18 and 40 years old in Zhongnan Hospital of Wuhan University in Wuhan, China. Among them, 53 were moderate cases, and 12 were severe or critical cases. Epidemiological, clinical, and laboratory characteristics and treatment data were collected. A multivariate logistic regression analysis was implemented to explore risk factors.
The patients with severe/critical cases had obviously higher BMI (average 29.23 vs. 22.79 kg/m ) and lower liver computed tomography value (average 50.00 vs. 65.00 mU) than the group of moderate cases. The patients with severe/critical cases had higher fasting glucose, alanine aminotransferase, aspartate aminotransferase, and creatinine compared with patients with moderate cases (all P < 0.01). More severe/critical cases (58.33% vs. 1.92%) had positive urine protein levels. The severe/critical cases also experienced a significant process of serum albumin decline. Logistic regression analysis showed that male sex, high BMI (especially obesity), elevated fasting blood glucose, and urinary protein positivity were all risk factors for young patients with severe COVID-19.
Obesity is an important predictor of COVID-19 severity in young patients. The main mechanism is related to damage of the liver and kidney.
本研究旨在探讨 18 至 40 岁年轻 COVID-19 患者严重程度的指标。
本回顾性队列研究纳入了 65 例连续收治于中国武汉武汉大学中南医院的 18 至 40 岁 COVID-19 患者，其中 53 例为中度病例，12 例为重症或危重症病例。收集了流行病学、临床和实验室特征以及治疗数据。采用多变量逻辑回归分析探讨危险因素。
重症/危重症组患者的 BMI（平均 29.23 vs. 22.79 kg/m ）明显更高，而肝脏 CT 值（平均 50.00 vs. 65.00 mU）更低。重症/危重症组患者的空腹血糖、丙氨酸转氨酶、天冬氨酸转氨酶和肌酐均高于中度组（均 P<0.01）。更多的重症/危重症患者（58.33% vs. 1.92%）出现尿蛋白阳性。重症/危重症组患者血清白蛋白也明显下降。Logistic 回归分析显示，男性、高 BMI（尤其是肥胖）、空腹血糖升高和尿蛋白阳性都是年轻重症 COVID-19 患者的危险因素。
肥胖是年轻 COVID-19 患者严重程度的一个重要预测因素。其主要机制与肝肾功能损伤有关。
