Mir Irfan A, Soni Renu, Srivastav Shrey K, Bhavya Inimerla, Dar Waseem Q, Farooq Malik D, Chawla Vrinda, Nadeem Mir
Internal Medicine, School of Medical Sciences & Research, Greater Noida, IND.
Department of Pulmonology, Mayo Institute of Medical Sciences, Lucknow, IND.
Cureus. 2022 Jan 19;14(1):e21403. doi: 10.7759/cureus.21403. eCollection 2022 Jan.
In December 2019, the emergence of the new coronavirus disease 2019 (COVID-19) began in Wuhan, China. Thereafter, the disease has been spreading rapidly across the world, with about 300 million registered cases worldwide, and the numbers are also exponentially increasing in India, with about 34 million registered cases by the end of 2021. Among the comorbidities, obesity may increase the risk of hospitalization due to COVID-19 infection as it is related to immune system dysfunction. Since the epidemiological picture of COVID-19 is changing very rapidly. Therefore, it is very important to discuss the pattern of clinical manifestation and association with comorbidities. Hence, we have conducted this observational study in one of the tertiary care centers in North India. Methods and Materials: We conducted a hospital-based prospective observational study in dedicated COVID-19 wards and ICU of a tertiary care center in North India with a sample size of 400 positive patients (males: 260, females: 140). We divided the patients in this study into three different age groups (less than 40 years, 40-60 years, and more than 60 years). The patients with age ≤ 18 years and BMI 18.5 kg/m2 were excluded from the study. Results: Out of these 400 patients, 55 (13.8%) developed severe COVID-19. There was a fewer number of patients who developed severe COVID-19 in the normal and over-weight group. Moreover, obese patients progressed to more severe cases (34.5%). This also shows that after adjusting for age, compared to the normal-weight group, those who were overweight had a 1.48-fold chance of developing severe COVID-19 (OR 1.48, P 0.0455), while those who were obese had a 1.73-fold chance of developing the disease (ORs 1.73, P 5 0.0652). Regarding gender distribution, the association appeared to be stronger in men than in women. After similar adjustment, the ORs for overweight and obese patients compared to normal-weight patients were 1.39 (p 0.5870) and 3.55 (p 0.0113) in females and 1.36 (0.5115) and 6.19 (0.0001) in males, respectively. Conclusion: Our study shows that obese patients with a BMI of greater than or equal to 27.5 are at higher risk of developing COVID-19 severity, especially in the male population. Moreover, severity may be related to other comorbid conditions. However, in our study, patients with chronic obstructive pulmonary disease (COPD) and GI/liver diseases were less obese, and severity was relatively low. So, the conclusion is that obese male patients with comorbidities are more likely to develop severe COVID-19 infection.
2019年12月，新型冠状病毒病2019（COVID-19）在中国武汉出现。此后，该疾病在全球迅速传播，全球登记病例约3亿例，印度的病例数也呈指数级增长，到2021年底登记病例约3400万例。在合并症中，肥胖可能会增加因COVID-19感染而住院的风险，因为它与免疫系统功能障碍有关。由于COVID-19的流行病学情况变化非常迅速。因此，讨论其临床表现模式以及与合并症的关联非常重要。因此，我们在印度北部的一家三级医疗中心进行了这项观察性研究。方法和材料：我们在印度北部一家三级医疗中心的专用COVID-19病房和重症监护室进行了一项基于医院的前瞻性观察性研究，样本量为400例阳性患者（男性：260例，女性：140例）。我们将本研究中的患者分为三个不同年龄组（小于40岁、40-60岁和大于60岁）。年龄≤18岁且体重指数（BMI）<18.5kg/m²的患者被排除在研究之外。结果：在这400例患者中，55例（13.8%）发展为重症COVID-19。正常体重和超重组中发展为重症COVID-19的患者较少。此外，肥胖患者进展为更严重病例的比例（34.5%）。这也表明，在调整年龄后，与正常体重组相比，超重者发生重症COVID-19的几率为1.48倍（比值比[OR]1.48，P=0.0455），而肥胖者发生该病的几率为1.73倍（ORs 1.73，P=0.0652）。关于性别分布，男性的关联似乎比女性更强。经过类似调整后，女性超重和肥胖患者与正常体重患者相比的ORs分别为1.39（p=0.5870）和3.55（p=0.0113），男性分别为1.36（0.5115）和6.19（0.0001）。结论：我们的研究表明，BMI大于或等于27.5的肥胖患者发生COVID-19重症的风险更高，尤其是在男性人群中。此外，重症可能与其他合并症有关。然而，在我们的研究中，慢性阻塞性肺疾病（COPD）和胃肠道/肝脏疾病患者的肥胖程度较低，重症程度也相对较低。所以，结论是合并症的肥胖男性患者更易发生重症COVID-19感染。
