Association of body mass index with severity and mortality of COVID-19 pneumonia: a two-center, retrospective cohort study from Wuhan, China.
Association of body mass index with severity and mortality of COVID-19 pneumonia: a two-center, retrospective cohort study from Wuhan, China.
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体重指数与 COVID-19 肺炎严重程度和死亡率的关联：来自中国武汉的两中心回顾性队列研究
DOI：
10.18632/aging.202813
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发表时间：
2021-03-24
期刊：
影响因子：
--
通讯作者：
Lin L
中科院分区：
文献类型：
--
作者：
Wu X;Li C;Chen S;Zhang X;Wang F;Shi T;Li Q;Lin L
在这项研究中，我们旨在研究体重指数（BMI）与2019冠状病毒病（COVID-19）肺炎的多种严重结局之间的关系。共纳入了来自中国武汉的1091名因COVID-19肺炎住院的患者。总的来说，2.8%（n = 31）接受有创机械通气（IMV），10.8%（n = 118）入住重症监护室（ICU），6.4%（n = 70）发生急性呼吸窘迫综合征（ARDS），4.4%（n = 48）死亡。多变量校正的风险比（HR）与肥胖相关的IMV治疗、ICU入院和ARDS的95%可信区间[CI]分别为2.86（1.16-7.05）、2.62（1.52-4.49）和3.15（1.69-5.88）;体重不足与死亡显著相关（HR 3.85，95%CI 1.26-11.76）。限制性三次样条分析显示BMI与ICU入院和死亡呈U型关系，但与IMV治疗和ARDS呈线性关系。总之，肥胖增加了IMV治疗、ICU入院和ARDS的风险，而体重过轻与COVID-19肺炎的死亡率较高相关。BMI与ICU入院和死亡呈U型相关，BMI与IMV治疗和ARDS呈线性关系，这些发现表明，在治疗体重不足和肥胖的COVID-19患者时应格外谨慎。
In this study, we aimed to investigate the relationship between body mass index (BMI) and multiple severe outcomes of the coronavirus disease 2019 (COVID-19) pneumonia. A total of 1091 patients hospitalized with COVID-19 pneumonia were included from Wuhan, China. Overall, 2.8% (n = 31) received invasive mechanical ventilation (IMV), 10.8% (n = 118) were admitted to the intensive care unit (ICU), 6.4% (n = 70) developed acute respiratory distress syndrome (ARDS), and 4.4% (n = 48) died. Multivariable-adjusted hazard ratios (HRs) (95% confidence intervals [CIs]) of IMV therapy, ICU admission and ARDS associated with obesity were 2.86 (1.16-7.05), 2.62 (1.52-4.49) and 3.15 (1.69-5.88), respectively; underweight was significantly associated with death (HR 3.85, 95%CI 1.26-11.76). Restricted cubic spline analyses suggested U-shaped associations of BMI with ICU admission and death, but linear relationships of BMI with IMV therapy and ARDS. In conclusion, obesity had an increased risk of IMV therapy, ICU admission and ARDS, while underweight was associated with higher mortality in COVID-19 pneumonia. U-shaped associations of BMI with ICU admission and death, and linear relationships of BMI with IMV therapy and ARDS, were found. These findings indicate that extra caution should be taken when treating COVID-19 patients with underweight and obesity.