Department of Epidemiology, Institute of Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
Department of Physical Education and Sports, Naval Academy - Brazilian Navy, Rio de Janeiro, RJ, Brazil.
Sci Rep. 2022 Aug 12;12(1):13737. doi: 10.1038/s41598-022-17197-w.
The present study aimed to evaluate the association between obesity and COVID-19 mortality and length of stay in ICU patients, and how these associations were modified by age groups. We performed a retrospective multicenter cohort study with data obtained from a hospital-based registry. The sample consisted of 8183 ICU hospitalized patients who tested positive for SARS-CoV-2. Cox proportional models were used to evaluate the association between BMI categories and COVID-19 mortality and generalized linear models for the length of stay in the ICU. After adjusting for confounders, those in the younger group with severe obesity had an increased risk of COVID-19 mortality compared to those with normal/overweight (HR 1.27; 95% CI 1.01-1.61). An increased risk of death was also observed for patients with underweight (HR 3.74; 95% CI 1.39-10.07). For patients aged ≥ 60 year, mild/moderate obesity was associated with reduced mortality risk (HR 0.87; 95% CI 0.78-0.97). For the age group < 60 year, the length of stay in ICU for those patients with severe obesity was 35% higher compared to the normal/overweight category (e 1.35; 95% CI 1.21-1.51). Conversely, for the survivors in the underweight category, the length of stay in ICU was 51% lower compared to the normal/overweight group (e 0.49; 95% CI 0.31-0.78). In the age group ≥ 60 year, mild/moderate obesity was associated with an increased length of stay in the ICU (e 1.10; 95% CI 1.01-1.21), adjusting for confounders. These findings could be helpful for health professionals to identify subgroups at higher risk for worse outcomes.
本研究旨在评估肥胖与 COVID-19 死亡率和 ICU 住院患者住院时间的关系,以及这些关系如何因年龄组而改变。我们进行了一项回顾性多中心队列研究,数据来自基于医院的登记处。样本包括 8183 名 ICU 住院的 SARS-CoV-2 检测呈阳性的患者。使用 Cox 比例模型评估 BMI 类别与 COVID-19 死亡率之间的关系,使用广义线性模型评估 ICU 住院时间的关系。在调整混杂因素后,与正常/超重相比,年轻组中严重肥胖的 COVID-19 死亡率风险增加(HR 1.27;95%CI 1.01-1.61)。体重过轻的患者死亡风险也增加(HR 3.74;95%CI 1.39-10.07)。对于年龄≥60 岁的患者,轻度/中度肥胖与降低死亡率风险相关(HR 0.87;95%CI 0.78-0.97)。对于年龄<60 岁的患者,与正常/超重患者相比,严重肥胖患者的 ICU 住院时间延长了 35%(e 1.35;95%CI 1.21-1.51)。相反,对于体重过轻患者的幸存者,与正常/超重组相比,ICU 住院时间缩短了 51%(e 0.49;95%CI 0.31-0.78)。在年龄≥60 岁的患者中,轻度/中度肥胖与 ICU 住院时间延长相关(e 1.10;95%CI 1.01-1.21),在调整混杂因素后。这些发现可能有助于卫生专业人员识别风险较高的亚组,以获得更差的结局。
Lancet Diabetes Endocrinol. 2024-7
Nutr Metab Cardiovasc Dis. 2021-10-28
Clin Obes. 2020-12
Arq Bras Cardiol. 2024-2
Diabetes Metab Syndr Obes. 2024-4-30
Lancet Reg Health Am. 2022-3
J Clin Endocrinol Metab. 2021-11-19
Int J Obes (Lond). 2021-9
Int J Popul Data Sci. 2021-3-3