The obesity paradox: Analysis from the SMAtteo COvid-19 REgistry (SMACORE) cohort
The obesity paradox: Analysis from the SMAtteo COvid-19 REgistry (SMACORE) cohort
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DOI：
10.1016/j.numecd.2020.07.047
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发表时间：
2020-10-30
影响因子：
3.9
通讯作者：
Mondelli, Mario U.
中科院分区：
文献类型：
--
作者：
Biscarini, Simona;Colaneri, Marta;Mondelli, Mario U.
背景和目标：肥胖被认为是导致COVID-19更严重病程的可能风险因素;然而，缺乏确凿的证据，很少有研究调查BMI作为进入重症监护室（ICU）和死亡率的风险因素的作用。我们回顾性分析了意大利疫情前40天招募的COVID-19队列。我们研究了肥胖与COVID-19患者的30天死亡率、入住ICU、死亡率和住院时间之间的关系。方法与结果：回顾性分析了2020年2月21日至3月31日期间入院的331名COVID- 19患者的人口统计学、临床和结局数据。采用考克斯比例风险回归模型评估肥胖对死亡率的预测作用，采用logistic回归分析肥胖对ICU入院率和ICU死亡率的影响，采用线性回归分析肥胖对住院时间的影响。331例患者中有74例BMI >= 30 kg/m2。肥胖患者中，21例（28.4%）需要入住ICU，25例（33.8%）死亡。在控制了性别、年龄、合并症和临床数据后，肥胖与死亡率、ICU死亡率和住院时间无显著相关性。在控制了性别、年龄、间质性肺疾病、心脏病和血清C反应蛋白后，肥胖对ICU入院的影响仍然显著。结论：肥胖的COVID- 19患者比非肥胖患者更有可能入住ICU。然而，两组之间的死亡率没有显著差异。(C)2020年意大利糖尿病学会，意大利动脉粥样硬化研究学会，意大利人类营养学会和临床医学和外科学系，费德里科二世大学。Elsevier B. V.出版，保留所有权利。
Background and aims: Obesity has been suggested as a possible risk factor for a more severe course of COVID-19; however, conclusive evidence is lacking and few studies have investigated the role of BMI as a risk factor for admission to intensive care unit (ICU) and mortality.We retrospectively analyzed a COVID-19 cohort recruited during the first 40 days of the epidemic in Italy. We examined the association between obesity and 30-day mortality, admission to ICU, mortality and length of hospital stay in patients with COVID-19. Methods and results: Demographic, clinical and outcome data were retrospectively analyzed in 331 patients with COVID- 19 admitted to hospital between 21 February and 31 March 2020. The predictive effect of obesity on mortality was assessed using a Cox proportional-hazard regression model, its effect on ICU admission and mortality in the ICU using logistic regressions, and its effect on length of hospital stay using a linear regression.Seventy-four of 331 patients had a BMI >= 30 kg/m(2). Among obese patients, 21 (28.4%) required admission in ICU and 25 died (33.8%). After controlling for sex, age, comorbidities and clinical data, obesity was not significantly associated with mortality, mortality in ICU and length of hospital stay. The effect of obesity on ICU admission remained significant after controlling for sex, age, interstitial lung disease, heart disease and serum C-reactive protein. Conclusions: Obese patients with COVID- 19 were more likely to be admitted to ICU than non-obese patients. However, there were no significant differences in mortality between the two groups. (C) 2020 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.