肥胖与新冠病毒疾病住院时长之间的关联：来自美国心脏协会全国新冠病毒疾病登记处的意外见解
Association between Obesity and Length of COVID-19 Hospitalization: Unexpected Insights from the American Heart Association National COVID-19 Registry.
作者信息
Collins William J, Chang Andrew Y, Weng Yingjie, Dahlen Alex, O'Brien Connor G, Hom Jason, Ahuja Neera, Rodriguez Fatima, Rohatgi Nidhi
机构信息
Division of Hospital Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.
Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, USA.
出版信息
J Obes Metab Syndr. 2022 Sep 30;31(3):277-281. doi: 10.7570/jomes22042. Epub 2022 Sep 5.
BACKGROUND
The mechanism for possible association between obesity and poor clinical outcomes from Coronavirus Disease 2019 (COVID-19) remains unclear.
METHODS
We analyzed 22,915 adult COVID-19 patients hospitalized from March 2020 to April 2021 to non-intensive care using the American Heart Association National COVID Registry. A multivariable Poisson model adjusted for age, sex, medical history, admission respiratory status, hospitalization characteristics, and laboratory findings was used to calculate length of stay (LOS) as a function of body mass index (BMI). We similarly analyzed 5,327 patients admitted to intensive care for comparison.
RESULTS
Relative to normal BMI subjects, overweight, class I obese, and class II obese patients had approximately half-day reductions in LOS (-0.469 days, <0.01; -0.480 days, <0.01; -0.578 days, <0.01, respectively).
CONCLUSION
The model identified a dose-dependent, inverse relationship between BMI category and LOS for COVID-19, which was not seen when the model was applied to critically ill patients.
背景
肥胖与2019冠状病毒病（COVID-19）临床预后不良之间可能存在关联的机制尚不清楚。
方法
我们使用美国心脏协会国家COVID登记处的数据，分析了2020年3月至2021年4月期间因COVID-19住院但未入住重症监护病房的22915名成年患者。采用多变量泊松模型，对年龄、性别、病史、入院时呼吸状况、住院特征和实验室检查结果进行调整，以计算住院时间（LOS）作为体重指数（BMI）的函数。我们同样分析了5327名入住重症监护病房的患者作为对照。
结果
与正常BMI受试者相比，超重、I类肥胖和II类肥胖患者的住院时间分别缩短了约半天（分别为-0.469天，<0.01；-0.480天，<0.01；-0.578天，<0.01）。
结论
该模型确定了COVID-19患者BMI类别与住院时间之间存在剂量依赖性的反比关系，而将该模型应用于危重症患者时未观察到这种关系。
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