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肥胖与 COVID-19 危重症患者的治疗持续时间、ICU 住院时间和死亡风险之间的关联。

The association between obesity with treatment duration, ICU length of stay and the risk of death in critically ill patients with COVID-19.

机构信息

Student Research Committee, Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Endocrinol Diabetes Metab. 2023 Nov;6(6):e458. doi: 10.1002/edm2.458. Epub 2023 Oct 29.

Abstract

BACKGROUND

Despite the confirmed association between higher BMI with increased risk of the acute respiratory distress syndrome (ARDS), the association between obesity with mortality in critically ill patients with coronavirus disease 2019 (COVID-19) is not clear. The present study aimed to investigate the association between obesity with treatment duration, ICU length of stay, and the risk of death in critically ill patients with COVID-19.

METHODS

This case-control study was performed on 223 patients with COVID-19 including 148 surviving patients as the control group and 75 eventually dead patients as the case group in Rasht, Iran. Data on demographic factors, comorbidities, anthropometric measurements, the length of hospitalization and the mortality were obtained from patients' medical records.

RESULTS

The mortality rate was significantly associated with weight (OR = 1.04, 95% CI: 1.002-1.083, p = .04), but not with BMI after adjustments for age, gender, length of stay in ICU, chronic diseases and smoking. The results did not change after further adjustments for biochemical and pathological factors.

CONCLUSIONS

Weight was positively associated with mortality after controlling for confounding variables. Further studies should consider the patient's body composition such as fat mass to establish the relationship between obesity and COVID-19 outcomes.

摘要

背景

尽管较高的 BMI 与急性呼吸窘迫综合征(ARDS)风险增加有关,但肥胖与 2019 年冠状病毒病(COVID-19)危重症患者死亡率之间的关系尚不清楚。本研究旨在调查肥胖与 COVID-19 危重症患者治疗持续时间、ICU 住院时间和死亡风险之间的关系。

方法

本病例对照研究在伊朗拉什特对 223 名 COVID-19 患者进行了研究,包括 148 名幸存患者作为对照组和 75 名最终死亡患者作为病例组。从患者病历中获取人口统计学因素、合并症、人体测量学测量值、住院时间和死亡率的数据。

结果

死亡率与体重显著相关(OR=1.04,95%CI:1.002-1.083,p=0.04),但在校正年龄、性别、ICU 住院时间、慢性疾病和吸烟后与 BMI 无关。在进一步调整生化和病理因素后,结果没有改变。

结论

在控制混杂变量后,体重与死亡率呈正相关。进一步的研究应考虑患者的身体成分,如脂肪量,以确定肥胖与 COVID-19 结局之间的关系。

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Obesity and Critical Illness in COVID-19: Respiratory Pathophysiology.肥胖与 COVID-19 重症:呼吸病理生理学。
Obesity (Silver Spring). 2021 May;29(5):870-878. doi: 10.1002/oby.23142. Epub 2021 Mar 31.

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The World Health Organization COVID-19 surveillance database.世界卫生组织 COVID-19 监测数据库。
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