Disseminated cryptococcal infection in rheumatoid arthritis treated with methotrexate and infliximab.
Disseminated cryptococcal infection in rheumatoid arthritis treated with methotrexate and infliximab.
复制标题
用甲氨蝶呤和英夫利昔单抗治疗类风湿性关节炎的播散性隐球菌感染。
作者：
D. True;M. Penmetcha;S. Peckham
目的：本研究旨在评估肥胖与2019年冠状病毒病（COVID-19）患者综合不良结局之间的相关性。
方法：我们从PubMed和Embase数据库中进行了系统的文献检索。我们纳入了所有关于COVID-19成人患者和肥胖的原始研究文章，这些研究文章基于体重指数（BMI）分类和复合不良结局，包括死亡率、发病率、入住重症监护室（ICU）、机械通气、急性呼吸窘迫综合征（ARDS）和严重COVID-19。
结果如下：9项研究被纳入荟萃分析，其中6项研究将BMI作为连续结局，3项研究将BMI作为二分结局（肥胖和非肥胖）。大多数研究在中国（55.5%）进行，其余研究来自法国、德国和美国（US）。复合不良结局的COVID-19患者BMI较高，平均差异为0.55 kg/m2（95% CI 0.07-1.03，P=0.02）。BMI ≥30（肥胖）与复合不良结局相关，比值比为1.89（95%CI 1.06-3.34，P=0.03）。包括三个调节因素：年龄、高血压和2型糖尿病（DM）的多变量荟萃回归分析显示，肥胖与复合不良结局之间的相关性受年龄的影响，回归系数=-0.06，P=0.02。由于几种结局的研究数量有限，未进行亚组分析。
结论：肥胖是COVID-19复合不良结局的危险因素。另一方面，复合预后不良的COVID-19患者BMI较高。BMI是一项重要的常规程序，应在COVID-19患者的管理中进行评估，并应特别关注肥胖患者。
关键词：COVID-19，肥胖，体重指数
Aim: This study aimed to evaluate the association between obesity and composite poor outcome in coronavirus disease 2019 (COVID-19) patients.
Methods: We conducted a systematic literature search from PubMed and Embase database. We included all original research articles in COVID-19 adult patients and obesity based on classification of Body Mass Index (BMI) and composite poor outcome which consist of mortality, morbidity, admission of Intensive Care Unit (ICU), mechanical ventilation, Acute Respiratory Distress Syndrome (ARDS), and severe COVID-19.
Results: Nine studies were included in meta-analysis with 6 studies presented BMI as continuous outcome and 3 studies presented BMI as dichotomous outcome (obese and non-obese). Most studies were conducted in China (55.5%) with remaining studies from French, Germany, and United States (US). COVID-19 patients with composite poor outcome had higher BMI with mean difference 0.55 kg/m2 (95% CI 0.07-1.03, P=0.02). BMI ≥30 (obese) was associated with composite poor outcome with odds ratio 1.89 (95% CI 1.06-3.34, P=0.03). Multivariate meta-regression analysis by including three moderators: age, hypertension, and Diabetes Mellitus type 2 (DM type 2) showed the association between obesity and composite poor outcome was affected by age with regression coefficient =-0.06 and P=0.02. Subgroup analysis was not performed due to the limited number of studies for several outcomes.
Conclusion: Obesity is a risk factor of composite poor outcome of COVID-19. On the other hand, COVID-19 patients with composite poor outcome have higher BMI. BMI is an important routine procedure that should be assessed in the management of COVID-19 patients and special attention should be given to patients with obesity.
Keywords: Covid-19, Obesity, Body Mass Index