Kim Nina, Aly Abdalla, Craver Chris, Garvey W Timothy
Novo Nordisk Inc., Plainsboro, NJ, USA.
Craver Research Services, Huntersville, North Carolina.
J Med Econ. 2023 Jan-Dec;26(1):376-385. doi: 10.1080/13696998.2023.2183679.
SARS-CoV-2 (COVID-19) continues to be a major public health issue. Obesity is a major risk factor for disease severity and mortality associated with COVID-19.
This study sought to estimate the healthcare resource use and cost outcomes in patients hospitalized with COVID-19 in the United States (US) according to body mass index (BMI) class.
Retrospective cross-sectional study analyzing data from the Premier Healthcare COVID-19 database for hospital length-of-stay (LOS), intensive care unit (ICU) admission, ICU LOS, invasive mechanical ventilator use, invasive mechanical ventilator use duration, in-hospital mortality, and total hospital costs from hospital charge data.
After adjustment for patient age, gender, and race, patients with COVID-19 and overweight or obesity had longer durations for mean hospital LOS (normal BMI = 7.4 days, class 3 obesity = 9.4 days, < .0001) and ICU LOS (normal BMI = 6.1 days, class 3 obesity = 9.5 days, < .0001) than patients with normal weight. Patients with normal BMI had fewer days on invasive mechanical ventilation compared to patients with overweight and obesity classes 1-3 (6.7 days vs. 7.8, 10.1, 11.5, and 12.4, respectively, < .0001). The predicted probability of in-hospital mortality was nearly twice that of patients with class 3 obesity compared to patients with normal BMI (15.0 vs 8.1%, < .0001). Mean (standard deviation) total hospital costs for a patient with class 3 obesity is estimated at $26,545 ($24,433-$28,839), 1.5 times greater than the mean for a patient with a normal BMI at $17,588 ($16,298-$18,981).
Increasing levels of BMI class, from overweight to obesity class 3, are significantly associated with higher levels of healthcare resource utilization and costs in adult patients hospitalized with COVID-19 in the US. Effective treatment of overweight and obesity are needed to reduce the burden of illness associated with COVID-19.
严重急性呼吸综合征冠状病毒2（SARS-CoV-2，即新冠病毒病）仍是一个重大的公共卫生问题。肥胖是与新冠病毒病相关的疾病严重程度和死亡率的主要危险因素。
本研究旨在根据体重指数（BMI）类别估算美国新冠病毒病住院患者的医疗资源使用情况和成本结果。
一项回顾性横断面研究，分析来自Premier Healthcare新冠病毒病数据库的数据，包括住院时长（LOS）、重症监护病房（ICU）入住情况、ICU住院时长、有创机械通气使用情况、有创机械通气使用时长、院内死亡率以及根据医院收费数据得出的总住院费用。
在对患者年龄、性别和种族进行调整后，新冠病毒病超重或肥胖患者的平均住院时长（正常BMI = 7.4天，3级肥胖 = 9.4天，P < 0.0001）和ICU住院时长（正常BMI = 6.1天，3级肥胖 = 9.5天，P < 0.0001）均长于体重正常的患者。与超重和1 - 3级肥胖患者相比，正常BMI患者接受有创机械通气的天数更少（分别为6.7天 vs. 7.8天、10.1天、11.5天和12.4天，P < 0.0001）。与正常BMI患者相比，3级肥胖患者的院内死亡预测概率几乎高出一倍（15.0% vs. 8.1%，P < 0.0001）。3级肥胖患者的平均（标准差）总住院费用估计为26,545美元（24,433 - 28,839美元），是正常BMI患者平均费用17,588美元（16,298 - 18,981美元）的1.5倍。
在美国，新冠病毒病住院成年患者中，BMI类别从超重到3级肥胖的升高与更高水平的医疗资源利用和成本显著相关。需要有效治疗超重和肥胖以减轻与新冠病毒病相关的疾病负担。
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