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肥胖及其他关键风险因素对危重症监护环境下COVID-19患者不良结局的影响。

Impact of obesity and other key risk factors on adverse outcomes in COVID-19 patients in critical care settings.

作者信息

Iftikhar Mehwish, Rizvi Amna, Zartash Saba, Nawaz Arsalan

机构信息

Mehwish Iftikhar, FCPS Endocrinology, FCPS Medicine, Assistant Professor of Endocrinology, Department of Endocrinology and Metabolism. SIMS, Services Hospital Lahore, Pakistan.

Amna Rizvi, FCPS Endocrinology FCPS Medicine, SCE Endocrinology UK, Associate Professor Endocrinology, Department of Endocrinology and Metabolism. SIMS, Services Hospital Lahore, Pakistan.

出版信息

Pak J Med Sci. 2025 May;41(5):1337-1343. doi: 10.12669/pjms.41.5.9302.

Abstract

BACKGROUND & OBJECTIVE: Although the global emergency caused by COVID-19 was officially declared over in 2023, the pandemic by no means has completely disappeared. Study explored the interconnection between obesity and critical outcomes in intensive care. Focusing on the infiltration of viruses and increased risk with obesity and other factors, this study provides insights for tailored interventions. This study is devised to establish the effect of obesity and other associated factors with outcomes of patients having COVID 19 infection in the critical care setting.

METHODS

This observational study was performed in the COVID-19 ICU of Services Hospital Lahore from December 10, 2020 to February 10, 2021. One hundred fifty consecutive COVID-PCR positive, conscious patients with Age (18-80 years) and BMI (18 to ≥ 40) were included. Patients with inability to provide informed consent and pregnancy were excluded. BMI was categorized into non-obese (18-29.9) and obese (≥ 30), with outcomes assessed during ICU stay. Analysis involved descriptive statistics and logistic regression to predict outcomes.

RESULTS

Study showed an average age of 59.73 years, BMI 30.14 kg/m², and 80.66% baseline O2 levels. BMI's had significant impact on COVID-19 outcomes, emphasizing its association with severity, comorbidities, ARDS, and mortality (p<0.05). Logistic regression indicates BMI, SpO2, and HCO3 significantly predict outcomes, with increased BMI elevating mortality risk, while decreased SpO2 and HCO3 increase mortality likelihood (p<0.05).

CONCLUSION

These findings highlight considering obesity as a critical factor in COVID-19 prognosis. This research has contributed valuable insights needed to grapple with the complexities of the pandemic.

摘要

背景与目的

尽管2023年新冠病毒感染引发的全球紧急情况已正式宣告结束,但这场大流行远未彻底消失。本研究探讨了肥胖与重症监护中关键结局之间的内在联系。聚焦于病毒浸润以及肥胖和其他因素导致的风险增加,本研究为针对性干预提供了见解。本研究旨在确定肥胖及其他相关因素对重症监护环境下感染新冠病毒患者结局的影响。

方法

本观察性研究于2020年12月10日至2021年2月10日在拉合尔服务医院的新冠重症监护病房进行。纳入了150例连续的新冠核酸检测阳性、意识清醒、年龄在18 - 80岁且体重指数(BMI)在18至≥40之间的患者。无法提供知情同意书的患者及孕妇被排除。BMI分为非肥胖(18 - 29.9)和肥胖(≥30),在重症监护病房住院期间评估结局。分析包括描述性统计和逻辑回归以预测结局。

结果

研究显示平均年龄为59.73岁,BMI为30.14kg/m²,基线氧水平为80.66%。BMI对新冠病毒感染结局有显著影响,强调了其与病情严重程度、合并症、急性呼吸窘迫综合征(ARDS)及死亡率的关联(p<0.05)。逻辑回归表明BMI、血氧饱和度(SpO2)和碳酸氢根(HCO3)显著预测结局,BMI升高会增加死亡风险,而SpO2和HCO3降低会增加死亡可能性(p<0.05)。

结论

这些发现凸显了将肥胖视为新冠病毒感染预后的关键因素。本研究为应对这场大流行的复杂性提供了宝贵的见解。

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Prevalence of obesity among adult inpatients with COVID-19 in France.法国新冠肺炎成年住院患者中的肥胖患病率。
Lancet Diabetes Endocrinol. 2020 Jul;8(7):562-564. doi: 10.1016/S2213-8587(20)30160-1. Epub 2020 May 18.

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