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年龄和肥胖对丹麦新冠肺炎住院患者预后的影响:一项全国性队列研究。

The impact of age and obesity on outcomes among patients hospitalized with COVID-19 in Denmark: A nationwide cohort study.

作者信息

Andersen Anton Lund, Gribsholt Sigrid Bjerge, Pedersen Lars, Thomsen Reimar Wernich, Benfield Thomas Lars, Søgaard Ole, Nielsen Stig Lønberg, Omland Lars Haukali, Lindegaard Birgitte, Richelsen Bjørn, Bodilsen Jacob, Bruun Jens Meldgaard

机构信息

Steno Diabetes Centre Aarhus Aarhus University Hospital Aarhus N Denmark.

Danish National Centre for Obesity Aarhus N Denmark.

出版信息

Obes Sci Pract. 2023 Jan 17;9(4):355-363. doi: 10.1002/osp4.659. eCollection 2023 Aug.

Abstract

PURPOSE

Obesity may alter the severity of infection with Coronavirus disease 2019 (COVID-19). Age may impact the association between body weight and severity of COVID-19 in patients with obesity. The aim of the study was to examine the association between obesity and severity of infection in a Danish cohort hospitalized with COVID-19 in the initial wave of the pandemic.

PATIENTS AND METHODS

Based on data from the nationwide, clinical database: COVID-DK, risks of intensive care unit (ICU) admission, invasive mechanical ventilation (IMV), and mortality were compared among patients with and without obesity. Interaction with age was examined and we used Inverse Probability of Treatment Weighting regression for confounder adjustment.

RESULTS

Among 524 patients, 142 (27%) were admitted to the ICU, 112 (21%) required IMV, and 109 (21%) died. Compared to COVID-19 patients without obesity, patients with obesity displayed a non-significant increased risk of ICU admission (Relative Risk [RR] 1.19, 95% Confidence Interval [CI] 0.88; 1.60), IMV (RR 1.23, CI 0.86; 1.75) and mortality (RR 1.21, CI 0.84; 1.75). COVID-19 patients with obesity, <60 years had highly increased risk of ICU admission (RR 1.92, CI 1.14; 3.24) and IMV (RR 1.95, CI 1.09; 3.49).

CONCLUSIONS

In hospitalized COVID-19 patients, obesity conferred an approximately 20% increased risk for ICU admission, IMV, and death, although these relationships did not reach statistical significance. COVID-19 patients with obesity and <60 years had an almost doubled risk of ICU admission and IMV.

摘要

目的

肥胖可能会改变2019冠状病毒病(COVID-19)感染的严重程度。年龄可能会影响肥胖患者体重与COVID-19严重程度之间的关联。本研究的目的是在丹麦第一波新冠疫情期间因COVID-19住院的队列中,研究肥胖与感染严重程度之间的关联。

患者与方法

基于全国性临床数据库COVID-DK的数据,比较了肥胖患者与非肥胖患者入住重症监护病房(ICU)、有创机械通气(IMV)和死亡的风险。研究了年龄的交互作用,并使用逆概率治疗加权回归进行混杂因素调整。

结果

在524例患者中,142例(27%)入住ICU,112例(21%)需要IMV,109例(21%)死亡。与非肥胖的COVID-19患者相比,肥胖患者入住ICU(相对风险[RR]1.19,95%置信区间[CI]0.88;1.60)、IMV(RR 1.23,CI 0.86;1.75)和死亡(RR 1.21,CI 0.84;1.75)的风险虽有增加但无统计学意义。年龄<60岁的肥胖COVID-19患者入住ICU(RR 1.92,CI 1.14;3.24)和IMV(RR 1.95,CI 1.09;3.49)的风险大幅增加。

结论

在住院的COVID-19患者中,肥胖使入住ICU、IMV和死亡的风险增加约20%,尽管这些关系未达到统计学意义。年龄<60岁的肥胖COVID-19患者入住ICU和IMV的风险几乎翻倍。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ec2/10399535/b25f57892907/OSP4-9-355-g003.jpg

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