Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, USA.
Department of Pathology, Division of Bioinformatics at Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, USA.
Clin Obes. 2022 Jun;12(3):e12514. doi: 10.1111/cob.12514. Epub 2022 Feb 22.
The association between body mass index (BMI) and poor COVID-19 outcomes in patients has been demonstrated across numerous studies. However, obesity-related comorbidities have also been shown to be associated with poor outcomes. The purpose of this study was to determine whether BMI or obesity-associated comorbidities contribute to elevated COVID-19 severity in non-elderly, hospitalized patients with elevated BMI (≥25 kg/m ). This was a single-center, retrospective cohort study of 526 hospitalized, non-elderly adult (aged 18-64) COVID-19 patients with BMI ≥25 kg/m in suburban New York from March 6 to May 11, 2020. The Edmonton Obesity Staging System (EOSS) was used to quantify the severity of obesity-related comorbidities. EOSS was compared with BMI in multivariable regression analyses to predict COVID-19 outcomes. We found that higher EOSS scores were associated with poor outcomes after demographic adjustment, unlike BMI. Specifically, patients with increased EOSS scores had increased odds of acute kidney injury (adjusted odds ratio [aOR] = 6.40; 95% CI 3.71-11.05), intensive care unit admission (aOR = 10.71; 95% CI 3.23-35.51), mechanical ventilation (aOR = 3.10; 95% CI 2.01-4.78) and mortality (aOR = 5.05; 95% CI 1.83-13.90). Obesity-related comorbidity burden as determined by EOSS was a better predictor of poor COVID-19 outcomes relative to BMI, suggesting that comorbidity burden may be driving risk in those hospitalized with elevated BMI.
大量研究表明，体重指数（BMI）与 COVID-19 患者不良结局之间存在关联。然而，肥胖相关的合并症也与不良结局有关。本研究旨在确定 BMI 或肥胖相关合并症是否导致 BMI 升高（≥25kg/m ）的非老年住院 COVID-19 患者 COVID-19 严重程度升高。这是一项在纽约郊区的单中心、回顾性队列研究，纳入了 2020 年 3 月 6 日至 5 月 11 日期间的 526 名 BMI≥25kg/m 的住院非老年成年（18-64 岁）COVID-19 患者。采用埃德蒙顿肥胖分期系统（EOSS）来量化肥胖相关合并症的严重程度。EOSS 与 BMI 在多变量回归分析中进行比较，以预测 COVID-19 结局。我们发现，EOSS 评分升高与人口统计学调整后的不良结局相关，与 BMI 不同。具体而言，EOSS 评分升高的患者发生急性肾损伤的几率增加（调整后的优势比[aOR] = 6.40；95%可信区间[CI] 3.71-11.05）、入住重症监护病房（aOR = 10.71；95% CI 3.23-35.51）、机械通气（aOR = 3.10；95% CI 2.01-4.78）和死亡（aOR = 5.05；95% CI 1.83-13.90）的几率增加。与 BMI 相比，EOSS 确定的肥胖相关合并症负担是 COVID-19 不良结局的更好预测因素，这表明合并症负担可能是导致 BMI 升高的住院患者风险增加的原因。
