High Prevalence of Obesity in Severe Acute Respiratory Syndrome Coronavirus‐2 (SARS‐CoV‐2) Requiring Invasive Mechanical Ventilation

Abstract

words)Objective: The Covid-19 pandemic is rapidly spreading worldwide, notably in Europe and North America, where obesity is highly prevalent. The relation between obesity and severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has not been fully documented.Methods: In this retrospective cohort study we analyzed the relationship between clinical characteristics, including body mass index (BMI), and the requirement for invasive mechanical ventilation (IMV) in 124 consecutive patients admitted in intensive care for SARS-CoV-2, in a single French center.Results : Obesity (BMI >30 kg/m2) and severe obesity (BMI >35 kg/m2) were present in 47.6% and 28.2% of cases, respectively. Overall, 85 patients (68.6%) required IMV. The proportion of patients who required IMV increased with BMI categories (p<0.01, Chi square test for trend), and it was greatest in patients with BMI >35 kg/m 2 (85.7%). In multivariate logistic regression, the need for IMV was significantly associated with male sex (p<0.05) and BMI (p<0.05), independent of age, diabetes, and hypertension. The odds ratio for IMV in patients with BMI >35 kg/m 2 vs patients with BMI <25 kg/m 2 was 7. 36 (1.63-33.14; p=0.02) Conclusion: The present study showed a high frequency of obesity among patients admitted in intensive care for SARS-CoV-2. Disease severity increased with BMI. Obesity is a risk factor for SARS-CoV-2 severity requiring increased attention to preventive measures in susceptible individuals. Accepted Article

Hypertension, Thrombosis, Kidney Failure, and Diabetes: Is COVID-19 an Endothelial Disease? A Comprehensive Evaluation of Clinical and Basic Evidence

“…Indeed, the diagnosis of diabetes in a cohort of patients with COVID-19 infection evidenced a sub-group of patients with a 2.26-fold higher risk of experiencing adverse disease outcome analyses [150]. Additionally, patients with obesity and/or glucose intolerance seem to be particularly vulnerable to COVID-19 [10,148,153,154]. Unfortunately, no data are hitherto available on anti-diabetic medications and glucose homeostasis in COVID-19 patients.…”

Obesity Is a Risk Factor for Severe COVID-19 Infection

“…1 Increasing numbers of reports have linked obesity to more severe COVID-19 illness and death. [1][2][3] In a French study, the risk for invasive mechanical ventilation in patients with COVID-19 infection admitted to Intensive Treatment Unit was more than seven-fold higher for those with Body Mass Index (BMI) >35 compared with BMI <25 Kg/m 2 . 2 Among individuals with COVID-19 aged less than 60 years in New York City, those with a BMI between 30-34 Kg/m 2 and >35 Kg/m 2 were 1.8 times and 3.6 times more likely to be admitted to critical care, respectively, than individuals with a BMI <30 Kg/m 2 .…”

European Association for the Study of Obesity Position Statement on the Global COVID-19 Pandemic

“…Emerging data demonstrate that people with obesity may also experience more severe COVID-19 symptoms and may be more likely to need complex intensive care treatment. A retrospective cohort study conducted in France found that patients with severe obesity (body mass index [BMI] > 40 kg/m 2 ) who contracted COVID-19 were more likely to need invasive mechanical ventilation, independent of age, hypertension, and diabetes [11]. From Chinese data, we have learned that persons with underlying type 2 diabetes, cardiovascular conditions, and hypertension appear to face a greater risk of complications from a COVID-19 diagnosis [12,13].…”