Telang Madhavi Mahesh, Waghaye Samrat, Muthusamy Elangho, Choudhary Sunil, Alrais Zeyad Faoor, Kasim Fathima, Khatib Khalid Ismail
Rashid Hospital and Emergency Trauma Centre, Intensive Care Unit, Dubai, United Arab Emirates.
Department of Medicine, SKN Medical College, Pune, Maharashtra, India.
Int J Crit Illn Inj Sci. 2024 Jul-Sep;14(3):153-159. doi: 10.4103/ijciis.ijciis_27_24. Epub 2024 Sep 20.
Chronic conditions such as obesity are associated with adverse outcomes in coronavirus disease 2019 (COVID-19) acute respiratory distress syndrome (ARDS) patients. The aim of our study was to evaluate the relationship between BMI and outcomes in critically ill patients with COVID-19 ARDS.
A retrospective study including all patients with COVID-19 and ARDS on mechanical ventilation admitted to the intensive care unit (ICU) over 2 years. Patients with obesity (BMI ≥30 kg/m) were compared with those without obesity (BMI >18.5 up to 29.9 kg/m). Outcomes compared were primary (mortality, duration of mechanical ventilation, and length of ICU stay) and secondary complications during the ICU course (inotrope requirement, acute kidney injury [AKI] requiring renal replacement therapy [RRT], and bloodstream and urinary tract infections).
One hundred and eight patients were included in the study. The mean age of patients was 52 years, and 94 (87%) patients were males. As compared to COVID-19 ARDS patients without obesity, COVID-19 patients with obesity were more prone to develop complications like AKI, necessitating continuous RRT ( = 0.005). There was no significant difference in other complications between the two groups (all > 0.05). There was no increased mortality in these obese patients ( = 0.056). In these patients with obesity, those who also had ischemic heart disease had an increased likelihood of mortality ( = 0.036).
Our study concludes that patients with COVID-19 ARDS who are obese are not at higher risk of mortality and more likely to develop renal complications. When these patients develop cardiac complications or bloodstream infections, they have a significantly higher risk of mortality.
肥胖等慢性疾病与2019冠状病毒病（COVID-19）急性呼吸窘迫综合征（ARDS）患者的不良预后相关。我们研究的目的是评估COVID-19 ARDS重症患者的体重指数（BMI）与预后之间的关系。
一项回顾性研究，纳入了2年内入住重症监护病房（ICU）并接受机械通气的所有COVID-19合并ARDS患者。将肥胖患者（BMI≥30 kg/m²）与非肥胖患者（BMI>18.5至29.9 kg/m²）进行比较。比较的结局指标包括主要指标（死亡率、机械通气时间和ICU住院时间）以及ICU病程中的次要并发症（血管活性药物使用需求、需要肾脏替代治疗[RRT]的急性肾损伤[AKI]以及血流感染和尿路感染）。
108例患者纳入研究。患者的平均年龄为52岁，94例（87%）为男性。与非肥胖的COVID-19 ARDS患者相比，肥胖的COVID-19患者更易发生AKI等并发症，需要持续RRT（P = 0.005）。两组间其他并发症无显著差异（均P>0.05）。这些肥胖患者的死亡率没有增加（P = 0.056）。在这些肥胖患者中，患有缺血性心脏病的患者死亡可能性增加（P = 0.036）。
我们的研究得出结论，肥胖的COVID-19 ARDS患者死亡风险并不更高，但更易发生肾脏并发症。当这些患者发生心脏并发症或血流感染时死亡风险显著更高。
