Impact of obesity and diabetes mellitus in critically ill patients with SARS-CoV-2

Abstract

Purpose Evaluate the associations of obesity and diabetes with the risk of mortality in critically ill patients infected with SARS-CoV-2. Materials and methods This cohort study included 115 adult patients admitted to the ICU with SARS-CoV-2 pneumonia. Anthropometric variables and biochemical (C-reactive protein, ferritin, leukocyte, neutrophils, and fibrinogen) were measured. Multivariate logistic regression analyses were used to investigate the associations. Results Mean age was 50.6 ± 11.2 years, 68.7% were male. Median BMI was 30.9 kg/m 2 . All patients had invasive mechanical ventilation. Patients with diabetes had increased risk of mortality with OR of 2.86 (CI 95% 1.1-7.4, p = 0.026); among those patients who, in addition to diabetes had obesity, the risk was de 3.17 (CI 95% 1.9-10.2, p = 0.038). Patients with obesity had 1.25 times greater risk of developing a severe SARS-CoV-2 infection (95% CI 1.09-1.46, p = 0.025). Negative correlation was observed between BMI and the PaO2/FiO2 ratio (r = -0.023, p < 0.05). Obese patients required more days of mechanical ventilation and longer hospital stay compared to non-obese patients. Conclusions Diabetes and obesity are risk factors for increasing severity of SARS-CoV-2 infection, and they are both associated with an increase in mortality.

Prevalence of overweight and obesity and their effect on COVID‐19 severity and hospitalization among younger than 50 years versus older than 50 years population: A systematic review and meta‐analysis

“…A detailed description of the studies included in the two groups is provided in Data S1 12–194 . The literature search yielded a total of 826 citations.…”

Obesity as a Risk Factor for Complications and Mortality in Individuals with SARS-CoV-2: A Systematic Review

“…Of the 35 studies selected for the methodological assessment using the Downs and Black scale [ 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 ], 1 study scored 6/17 [ 35 ], 3 scored 7/10 [ 36 , 37 , 38 ], 11 scored 8/17 [ 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 ], 12 scored 9/17 [ 50 , 51 ,…”

“…Of the 35 studies selected for the methodological assessment using the Downs and Black scale , 1 study scored 6/17 [35], 3 scored 7/10 [36][37][38], 11 scored 8/17 [39][40][41][42][43][44][45][46][47][48][49], 12 scored 9/17 [50][51][52][53][54][55][56][57][58][59][60][61], 7 scored 10/17 [27][28][29][30][32][33][34], and 1 study scored 11/17 [31]. Only eight studies obtained 60% or more of the total scale score (17 points) [27][28][29][30][31][32][33][34]; therefore, they were selected to be analyzed in this systematic review (see Supplementary Table S1).…”

Obesity Paradox in Lung Diseases: What Explains It?

“…It has been reported that obesity significantly increases ORs for mortality in COVID-19 patients with hypertension or diabetes mellitus (DM) [192], and the OR reaches the peak in patients with hypertension, DM, and obesity [192,193]. Several independent research works show that obesity confers increased risk of adverse outcomes, including ICU admission, invasive mechanical ventilation, and in-hospital death, to COVID-19 patients with DM [194][195][196]. Holman et al [197] found that obesity only increases risk of COVID-19-related death in patients with DM type I, which is opposite to the report of Cariou et al [198].…”