The role of obesity in inflammatory markers in COVID-19 patients.
The role of obesity in inflammatory markers in COVID-19 patients.
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DOI：
10.1016/j.orcp.2020.12.004
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发表时间：
2021-01
影响因子：
4.3
通讯作者：
Ho JE
中科院分区：
文献类型：
--
作者：
McNeill JN;Lau ES;Paniagua SM;Liu EE;Wang JK;Bassett IV;Selvaggi CA;Lubitz SA;Foulkes AS;Ho JE
肥胖已成为全球严重COVID-19的重要风险因素。鉴于COVID-19感染和肥胖都与全身炎症增加有关，我们评估了在马萨诸塞州总医院因COVID-19住院的肥胖和非肥胖个体的炎症标志物。我们假设肥胖患者会有更旺盛的炎症反应，这可以通过较高的初始和峰值炎症标志物沿着较差的临床结果来证明。在781例患者中，349例肥胖（45%）。肥胖组CRP、ESR及D-二聚体峰值均显著高于非肥胖组（P <0.01），而D-二聚体峰值显著高于非肥胖组（P <0.01）。IL-6和铁蛋白相似。此外，肥胖者需要使用血管加压药的几率更高（OR 1.54，95%CI 1.00-2.38，P = 0.05），发生低氧性呼吸衰竭（OR 1.58，95%CI 1.04 - 2.40，P = 0.03）和就诊后28天内死亡（OR 2.20，95%CI 1.31 - 3.70，P = 0.003）。最后，即使在校正BMI后，较高的CRP和D-二聚体基线水平与较差的临床结局相关。我们的研究结果表明，肥胖个体的疾病严重程度更高，其特征是炎症更旺盛。
Obesity has emerged as a significant risk factor for severe COVID-19 worldwide. Given both COVID-19 infection and obesity have been associated with increased systemic inflammation, we evaluated inflammatory markers in obese and non-obese individuals hospitalized for COVID-19 at Massachusetts General Hospital. We hypothesized that obese patients would have a more exuberant inflammatory response as evidenced by higher initial and peak inflammatory markers along with worse clinical outcomes. Of the 781 patients, 349 were obese (45%). Obese individuals had higher initial and peak levels of CRP and ESR as well as higher peak d-dimer (P < 0.01 for all) in comparison to non-obese individuals, while. IL-6 and ferritin were similar. In addition, obese individuals had a higher odds of requiring vasopressor use (OR 1.54, 95% CI 1.00–2.38, P = 0.05), developing hypoxemic respiratory failure (OR 1.58, 95% CI 1.04–2.40, P = 0.03) and death (OR 2.20, 95% CI 1.31–3.70, P = 0.003) within 28 days of presentation to care. Finally, higher baseline levels of CRP and D-dimer were associated with worse clinical outcomes even after adjustment for BMI. Our findings suggest greater disease severity in obese individuals is characterized by more exuberant inflammation.
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