Obesity is a strong risk factor for short-term mortality and adverse outcomes in Mexican patients with COVID-19: a national observational study.
Obesity is a strong risk factor for short-term mortality and adverse outcomes in Mexican patients with COVID-19: a national observational study.
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DOI：
10.1017/s0950268821001023
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发表时间：
2021-04-29
影响因子：
4.2
通讯作者：
Vidal-Mayo JJ
中科院分区：
文献类型：
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作者：
Vera-Zertuche JM;Mancilla-Galindo J;Tlalpa-Prisco M;Aguilar-Alonso P;Aguirre-García MM;Segura-Badilla O;Lazcano-Hernández M;Rocha-González HI;Navarro-Cruz AR;Kammar-García A;Vidal-Mayo JJ
通过对肥胖作为 2019 年冠状病毒病 (COVID-19) 患者不良结局危险因素的荟萃分析，获得了相互矛盾的结果，这可能是由于纳入了主要患有严重 COVID-19 的多病态患者。在这里，我们的目的是研究肥胖单独或与其他合并症结合作为短期全因死亡率和其他不良后果的危险因素，这些患者在墨西哥门诊病房和医院接受了疑似 COVID-19 评估。我们对国家 COVID-19 流行病学监测研究中来自墨西哥所有 32 个州的 71 103 名患者进行了回顾性观察分析。通过 Cox 回归应用两个统计模型来创建生存模型和逻辑回归模型，以确定由肥胖和其他合并症（糖尿病 (DM)、慢性阻塞性肺病、哮喘、免疫抑制、高血压、心血管疾病和慢性肾病）引起的死亡、住院、有创机械通气、肺炎和入住重症监护病房的风险。针对其他风险因素调整模型。 2020年2月24日至4月26日，对71 103名疑似COVID-19患者进行了评估； 15 529 人 (21.8%) SARS-CoV-2 检测呈阳性； 46 960 (66.1%) 为阴性，8614 (12.1%) 待结果。单纯肥胖会增加阳性患者的调整后死亡风险（风险比 (HR) = 2.7，95% 置信区间 (CI) 2.04–2.98），但不会增加阴性患者和待结果患者。肥胖与其他合并症相结合进一步增加死亡风险（DM：HR = 2.79，95% CI 2.04–3.80；免疫抑制：HR = 5.06，95% CI 2.26–11.41；高血压：HR = 2.30，95% CI 1.77–3.01）和其他不良结果。总之，肥胖是墨西哥 COVID-19 患者短期死亡和危重疾病的一个重要危险因素；当肥胖同时存在其他合并症时，风险就会增加。
Conflicting results have been obtained through meta-analyses for the role of obesity as a risk factor for adverse outcomes in patients with coronavirus disease-2019 (COVID-19), possibly due to the inclusion of predominantly multimorbid patients with severe COVID-19. Here, we aimed to study obesity alone or in combination with other comorbidities as a risk factor for short-term all-cause mortality and other adverse outcomes in Mexican patients evaluated for suspected COVID-19 in ambulatory units and hospitals in Mexico. We performed a retrospective observational analysis in a national cohort of 71 103 patients from all 32 states of Mexico from the National COVID-19 Epidemiological Surveillance Study. Two statistical models were applied through Cox regression to create survival models and logistic regression models to determine risk of death, hospitalisation, invasive mechanical ventilation, pneumonia and admission to an intensive care unit, conferred by obesity and other comorbidities (diabetes mellitus (DM), chronic obstructive pulmonary disease, asthma, immunosuppression, hypertension, cardiovascular disease and chronic kidney disease). Models were adjusted for other risk factors. From 24 February to 26 April 2020, 71 103 patients were evaluated for suspected COVID-19; 15 529 (21.8%) had a positive test for SARS-CoV-2; 46 960 (66.1%), negative and 8614 (12.1%), pending results. Obesity alone increased adjusted mortality risk in positive patients (hazard ratio (HR) = 2.7, 95% confidence interval (CI) 2.04–2.98), but not in negative and pending-result patients. Obesity combined with other comorbidities further increased risk of death (DM: HR = 2.79, 95% CI 2.04–3.80; immunosuppression: HR = 5.06, 95% CI 2.26–11.41; hypertension: HR = 2.30, 95% CI 1.77–3.01) and other adverse outcomes. In conclusion, obesity is a strong risk factor for short-term mortality and critical illness in Mexican patients with COVID-19; risk increases when obesity is present with other comorbidities.
影响因子：
3.9
作者：
Crisafulli E;Cillóniz C;Liapikou A;Ferrari M;Busti F;Girelli D;Torres A
通讯作者：
Torres A