Infection Control Committee, Shimonoseki City Hospital, Shimonoseki, Japan.
Department of Anesthesiology, Shimonoseki City Hospital, Shimonoseki, Japan.
Int J Med Sci. 2023 Sep 11;20(11):1508-1512. doi: 10.7150/ijms.86933. eCollection 2023.
To investigate the effect of obesity on mortality and invasive respiratory care (IRC) in patients with COVID-19. We studied 1,105 patients for 34 months and collected data. The primary outcome was all-cause death at 29 days. The secondary outcome was IRC indicated by a pulse oximetry rate below 93% at a mask oxygenation rate of 5 L/min or more. Age- and sex-adjusted multivariate regression analysis for 29-day deaths showed the significance of body mass index (BMI) > 19.6 kg/m (odds ratio 0.117, 95% confidence interval 0.052-0.265, <0.001). The graphs with BMI in the abscissa showed, within a BMI between 11 and 25 kg/m, a decreasing pattern for mortality and IRC rate, and no increase in overweight. In Japanese COVID-19 patients, the risk of mortality and the IRC rate decreased in underweight patients and remained low in overweight patients, suggesting the importance of the obesity paradox.
探讨肥胖对 COVID-19 患者死亡率和侵入性呼吸支持（IRC）的影响。我们对 1105 例患者进行了 34 个月的研究，并收集了数据。主要结局是 29 天的全因死亡。次要结局是指在面罩给氧率为 5 L/min 或更高时，脉搏血氧饱和度率低于 93%的 IRC。对 29 天死亡率进行年龄和性别调整的多变量回归分析显示，体重指数（BMI）>19.6 kg/m（比值比 0.117，95%置信区间 0.052-0.265，<0.001）具有统计学意义。BMI 为横坐标的图表显示，在 BMI 为 11 至 25 kg/m 之间，死亡率和 IRC 率呈下降趋势，而超重患者没有增加。在日本 COVID-19 患者中，体重不足患者的死亡率和 IRC 率降低，超重患者的死亡率和 IRC 率保持较低水平，这表明肥胖悖论的重要性。
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