Nonrespiratory Complications and Obesity in Patients Dying with COVID-19 in Italy
Nonrespiratory Complications and Obesity in Patients Dying with COVID-19 in Italy
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DOI：
10.1002/oby.23007
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发表时间：
2020-10-18
期刊：
影响因子：
6.9
通讯作者：
Brusaferro, Silvio
中科院分区：
文献类型：
--
作者：
Onder, Graziano;Palmieri, Luigi;Brusaferro, Silvio
目的探讨肥胖对新冠肺炎死亡患者非呼吸系统并发症的影响。方法回顾意大利3,694例新冠肺炎死亡患者的病历，以提取有关人口统计学、既有并存疾病和导致死亡的院内并发症的信息。采用多因素Logistic回归分析肥胖与非呼吸道并发症的关系。这些分析根据年龄、性别和先前存在的合并症的数量进行了调整。结果3694例新冠肺炎死亡患者中有411例(11.1%)存在肥胖。肥胖与发生急性肾功能衰竭(调整后的优势比[OR]，1.33；95%可信区间：1.04-1.71)和休克(调整后的优势比：1.54；95%可信区间：1.19-1.99)的概率增加显著相关。肥胖与急性肾功能衰竭和休克的相关性在60岁以上患者中(调整后OR：2.00；95%CI：1.09~3.67和OR，2.37；95%CI：1.29~4.36)强于60岁以上患者(调整后OR：1.20；95%CI：0.90~1.60和OR：1.22；95%CI：0.91~1.65)。结论：在意大利死于新冠肺炎的患者中，肥胖与非呼吸系统并发症，特别是休克和急性肾功能衰竭的概率增加有关。这些关联在年轻人中似乎比在老年人中更强。对于肥胖的新冠肺炎患者，应该制定相应的策略来预防这些并发症。
Objective This study aimed to assess the impact of obesity on nonrespiratory complications in patients dying with coronavirus disease (COVID-19). Methods Medical charts of 3,694 of patients dying with COVID-19 in Italy were reviewed to extract information on demographics, preexisting comorbidities, and in-hospital complications leading to death. Multivariate logistic regressions were performed to assess the association of obesity with nonrespiratory complications. These analyses were adjusted for age, gender, and number of preexisting comorbidities. Results Obesity was present in 411/3,694 (11.1%) patients dying with COVID-19. Obesity was significantly associated with increased probability of experiencing acute renal failure (adjusted odds ratio [OR], 1.33; 95% CI: 1.04-1.71) and shock (adjusted OR, 1.54; 95% CI: 1.19-1.99). The associations of obesity with acute renal failure and shock were stronger in patients aged < 60 years (adjusted OR, 2.00; 95% CI: 1.09-3.67 and OR, 2.37; 95% CI 1.29-4.36) than in those aged 60 years or older (adjusted OR, 1.20; 95% CI: 0.90-1.60 and OR, 1.22; 95% CI: 0.91-1.65). Conclusions In patients dying with COVID-19 in Italy, obesity is associated with an increased probability of nonrespiratory complications, particularly shock and acute renal failure. These associations seem stronger in younger than in older adults. Strategies should be put in place in patients with COVID-19 with obesity to prevent these complications.