COVID-19 patients with obesity at risk for worse outcomes despite younger age and fewer inflammatory derangements.
COVID-19 patients with obesity at risk for worse outcomes despite younger age and fewer inflammatory derangements.
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DOI：
10.1016/j.soard.2021.06.006
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发表时间：
2021-10
期刊：
影响因子：
--
通讯作者：
Soans RS
中科院分区：
文献类型：
--
作者：
Le Guen CL;King NA;Zhao H;Renza-Stingone EP;Gerhard GS;Soans RS
冠状病毒病2019(新冠肺炎)是一种病毒性肺部感染，由于广泛存在的调节失调的炎症反应，可进展为细胞因子风暴综合征。许多有可能出现严重新冠肺炎症状的患者已被确认为既有肺部疾病，又有损害适当免疫反应的疾病，如肥胖。本研究的目的是描述肥胖症患者新冠肺炎的表现、临床病程和炎症生物标志物环境。宾夕法尼亚州费城大学医院。在这项回顾性队列研究中，60 0例新冠肺炎阳性患者按世界卫生组织肥胖级别进行分层，调查他们的主要症状、疾病生物标志物、人口统计学和结局(插管率、重症监护病房入院时间、住院时间和死亡率)。年龄与肥胖级别呈负相关；III级肥胖患者比正常体重患者年轻12.9岁(P<；.0001)。初始铁蛋白实验室值与肥胖级别的增加呈负相关(P=.0192)。肥胖组与非肥胖组比较，淋巴细胞图谱正常或接近正常(P=0.0017)。肥胖患者的ICU住院率(P=.0215)和住院时间(P=.0004)增加，但在插管率(P=.3705)和死亡率(P=.2486)方面没有差异。肥胖患者更有可能在更年轻的时候到医院就诊，新冠肺炎相关生物标记物干扰水平降低，洛杉矶和重症监护病房入院率增加，尽管死亡风险没有增加。
Coronavirus disease 2019 (COVID-19) is a viral pulmonary infection that can progress to cytokine storm syndrome because of widespread dysregulated inflammatory response. Many patients at risk for severe COVID-19 manifestation have been identified as those with preexisting conditions of pulmonary origin, as well as conditions that impair appropriate immune response, such as obesity. The aim of this study is to describe the manifestation, clinical course, and inflammatory biomarker milieu of COVID-19 in patients with obesity. University Hospital Philadelphia, Pennsylvania. In this retrospective cohort study, 600 patients who were positive for COVID-19 were stratified by World Health Organization (WHO) obesity class and their presenting symptoms, disease biomarkers, demographics, and outcomes (intubation rate, intensive care unit [ICU] admission, length of stay [LOS], and mortality) were investigated. Age was inversely related to obesity class; patients of obesity class III presented 12.9 years younger than patients of normal weight (P < .0001). Initial ferritin lab values were negatively correlated with increasing obesity class (P = .0192). Normal or near-normal lymphocyte profile was noted in patients with obesity compared with patients without obesity (P = .0017). Patients with obesity had an increased rate of ICU admission (P = .0215) and increased length of stay (P = .0004), but no differences in intubation rate (P = .3705) or mortality (P = .2486). Patients with obesity were more likely to present to the hospital at a younger age, with reduced levels of COVID-19 related biomarker disturbances, and increased LOS and ICU admission rates, although were not at increased risk for mortality.
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