Does there exist an obesity paradox in COVID-19?: insights of the international HOPE-COVID-19-registry

Background - Obesity has been described as a protective factor in cardiovascular and other diseases being expressed as ‘obesity paradox’. However, the impact of obesity on clinical outcomes including mortality in COVID-19 has been poorly systematically investigated until now. We aimed to compare cli...

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Main Authors: Abumayyaleh, Mohammad S. A. (Author) , Núñez Gil, Iván J. (Author) , El-Battrawy, Ibrahim (Author) , Estrada, Vicente (Author) , Becerra-Muñoz, Víctor Manuel (Author) , Aparisi, Alvaro (Author) , Fernández-Rozas, Inmaculada (Author) , Feltes, Gisela (Author) , Arroyo-Espliguero, Ramón (Author) , Trabattoni, Daniela (Author) , López-País, Javier (Author) , Pepe, Martino (Author) , Romero, Rodolfo (Author) , García, Diego Raúl Villavicencio (Author) , Biole, Carloalberto (Author) , Astrua, Thamar Capel (Author) , Eid, Charbel Maroun (Author) , Alfonso, Emilio (Author) , Fernandez-Presa, Lucia (Author) , Espejo, Carolina (Author) , Buonsenso, Danilo (Author) , Raposeiras, Sergio (Author) , Fernández, Cristina (Author) , Macaya, Carlos (Author) , Akın, Ibrahim (Author)
Format: Article (Journal)
Language:English
Published: May-June 2021
In: Obesity research & clinical practice
Year: 2021, Volume: 15, Issue: 3, Pages: 275-280
ISSN:1878-0318
DOI:10.1016/j.orcp.2021.02.008
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.orcp.2021.02.008
Verlag, lizenzpflichtig, Volltext: https://www.sciencedirect.com/science/article/pii/S1871403X2100034X
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Author Notes:Mohammad Abumayyaleh, Iván J. Núñez Gil, Ibrahim El-Battrawy, Vicente Estrada, Víctor Manuel Becerra-Muñoz, Alvaro Aparisi, Inmaculada Fernández-Rozas, Gisela Feltes, Ramón Arroyo-Espliguero, Daniela Trabattoni, Javier López-País, Martino Pepe, Rodolfo Romero, Diego Raúl Villavicencio García, Carloalberto Biole, Thamar Capel Astrua, Charbel Maroun Eid, Emilio Alfonso, Lucia Fernandez-Presa, Carolina Espejo, Danilo Buonsenso, Sergio Raposeiras, Cristina Fernández, Carlos Macaya, Ibrahim Akin
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Summary:Background - Obesity has been described as a protective factor in cardiovascular and other diseases being expressed as ‘obesity paradox’. However, the impact of obesity on clinical outcomes including mortality in COVID-19 has been poorly systematically investigated until now. We aimed to compare clinical outcomes among COVID-19 patients divided into three groups according to the body mass index (BMI). - Methods - We retrospectively collected data up to May 31st, 2020. 3635 patients were divided into three groups of BMI (<25 kg/m2; n = 1110, 25−30 kg/m2; n = 1464, and >30 kg/m2; n = 1061). Demographic, in-hospital complications, and predictors for mortality, respiratory insufficiency, and sepsis were analyzed. - Results - The rate of respiratory insufficiency was more recorded in BMI 25−30 kg/m2 as compared to BMI < 25 kg/m2 (22.8% vs. 41.8%; p < 0.001), and in BMI > 30 kg/m2 than BMI < 25 kg/m2, respectively (22.8% vs. 35.4%; p < 0.001). Sepsis was more observed in BMI 25−30 kg/m2 and BMI > 30 kg/m2 as compared to BMI < 25 kg/m2, respectively (25.1% vs. 42.5%; p = 0.02) and (25.1% vs. 32.5%; p = 0.006). The mortality rate was higher in BMI 25−30 kg/m2 and BMI > 30 kg/m2 as compared to BMI < 25 kg/m2, respectively (27.2% vs. 39.2%; p = 0.31) (27.2% vs. 33.5%; p = 0.004). In the Cox multivariate analysis for mortality, BMI < 25 kg/m2 and BMI > 30 kg/m2 did not impact the mortality rate (HR 1.15, 95% CI: 0.889−1.508; p = 0.27) (HR 1.15, 95% CI: 0.893−1.479; p = 0.27). In multivariate logistic regression analyses for respiratory insufficiency and sepsis, BMI < 25 kg/m2 is determined as an independent predictor for reduction of respiratory insufficiency (OR 0.73, 95% CI: 0.538−1.004; p = 0.05). - Conclusions - HOPE COVID-19-Registry revealed no evidence of obesity paradox in patients with COVID-19. However, Obesity was associated with a higher rate of respiratory insufficiency and sepsis but was not determined as an independent predictor for a high mortality.
Item Description:Gesehen am 23.11.2022
Physical Description:Online Resource
ISSN:1878-0318
DOI:10.1016/j.orcp.2021.02.008