Department of Medicine, Geriatrics Division, University of Verona, Verona, Italy.
Department of Surgery, Dentistry, Paediatrics and Gynaecology, Section of Anesthesiology, University of Verona, Verona, Italy.
Nutr Metab Cardiovasc Dis. 2021 Mar 10;31(3):762-768. doi: 10.1016/j.numecd.2020.11.012. Epub 2020 Nov 20.
Recent studies show that obesity is a risk factor for hospital admission and for critical care need in patients with coronavirus disease 2019 (COVID-19). The aim was to determine whether obesity is a risk factor for unfavourable health outcomes in patients affected by COVID-19 admitted to ICU.
95 consecutive patients with COVID-19 (78 males and 18 females) were admitted to ICU and included in the study. Height, weight, BMI, Sequential Organ Failure Assessment (SOFA) and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores, CRP, CPK, ICU and hospital length of stay and comorbidities were evaluated. Participants with obesity had a lower 28 day survival rate from ICU admission than normal weight subjects. Cox proportional hazard model-derived estimates, adjusted for age, gender and comorbidity, confirmed the results of the survival analysis (HR:5.30,95%C.I.1.26-22.34). Obese subjects showed longer hospital and ICU stay as compared with normal weight counterpart.Subjects with obesity showed significantly higher CRP and CPK levels than normal weight subjects.
In individuals with obesity, careful management and prompt intervention in case of suspected SARS-CoV-2 infection is necessary to prevent the progression of the disease towards severe outcomes and the increase of hospital treatment costs.
最近的研究表明，肥胖是 2019 冠状病毒病（COVID-19）患者住院和需要重症监护的危险因素。本研究旨在确定肥胖是否是 COVID-19 患者入住 ICU 后不良健康结局的危险因素。
95 例连续的 COVID-19 患者（78 名男性和 18 名女性）被收入 ICU 并纳入研究。评估了身高、体重、BMI、序贯器官衰竭评估（SOFA）和急性生理学和慢性健康评估 II 评分（APACHE II）、CRP、CPK、ICU 和住院时间以及合并症。与体重正常的患者相比，肥胖患者从 ICU 入院到 28 天的生存率较低。Cox 比例风险模型估计值，调整了年龄、性别和合并症，证实了生存分析的结果（HR：5.30，95%CI1.26-22.34）。肥胖患者的住院和 ICU 时间均长于体重正常患者。与体重正常的患者相比，肥胖患者的 CRP 和 CPK 水平明显更高。
对于肥胖个体，在疑似 SARS-CoV-2 感染的情况下，需要进行仔细的管理和及时的干预，以防止疾病向严重结局发展，并增加医院治疗费用。
