The obesity paradox in community-acquired bacterial pneumonia

Corrales–Medina, Vicente F.; Valayam, Josemon; Serpa, José A.; Rueda, Adriana M.; Musher, Daniel M.

doi:10.1016/j.ijid.2010.09.011

Cited by 104 publications

(77 citation statements)

References 14 publications

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“…Our results extend the findings of a recent study by CORRALES-MEDINA et al [10] of 266 hospitalised patients with community-acquired bacterial pneumonia. Our study, which includes a larger sample size and is prospective in design, concurs with the findings from this smaller study.…”

Section: Discussionsupporting

confidence: 92%

“…Our study, which includes a larger sample size and is prospective in design, concurs with the findings from this smaller study. CORRALES-MEDINA et al [10] showed that increasing BMI values were associated with reduced 30-day mortality (OR 0.88, 95% CI 0.81-0.96; p,0.01) on multivariate analysis. Furthermore, in two large cohort studies of pneumonia mortality, higher BMI was again associated with reduced mortality.…”

Section: Discussionmentioning

confidence: 98%

“…However, conflicting results have emerged, with adverse outcomes reported in studies of CAP due to 2009 H1N1 influenza [9], but paradoxically, improved outcome in studies of acute bacterial pneumonia unrelated to an influenza pandemic [10][11][12]. In addition, studies on critically ill patients [13][14][15] have reported reduced mortality amongst obese patients in the intensive care unit (ICU).…”

Section: Introductionmentioning

confidence: 99%

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Obesity is associated with improved survival in community-acquired pneumonia

Singanayagam¹,

Singanayagam

Chalmers

2012

Eur Respir J

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Obesity has been identified as a risk factor for adverse outcomes of 2009 H1N1 influenza. However, the impact of obesity on outcomes of infection remains controversial. There are limited data investigating the effect of obesity on outcomes of community-acquired pneumonia (CAP).This prospective observational study included patients presenting with CAP who had body mass index (BMI) measured on admission. Outcome measures included 30-day mortality and need for mechanical ventilation or inotropic support (MV/IS).1079 patients were included, with 21% classified as obese (BMI o30 kg?m -2 ). Obesity was independently associated with reduced 30-day mortality from CAP on multivariate analysis (HR 0.53, 95% CI 0.29-0.98). This was not explained by differences in severity of disease on admission or requirement for MV/IS between obese and nonobese groups. Obese patients had higher median C-reactive protein levels and a higher frequency of sepsis using the systemic inflammatory response syndrome criteria (72.4% versus 64.1%; p50.03), than nonobese patients, suggesting greater systemic inflammation.Obesity was associated with reduced 30-day mortality in patients hospitalised with CAP.@ERSpublications Obesity appears to result in improved survival for patients hospitalised with community-acquired pneumonia

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

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Obesity is associated with improved survival in community-acquired pneumonia

Singanayagam¹,

Singanayagam

Chalmers

2012

Eur Respir J

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“…18 Third, a recent study from a single center indicated a decreased risk of pneumonia death in patients with higher BMI infected with Streptococcus pneumoniae or Haemophilus influenzae. 19 Our findings are in agreement with these three studies indicating that obesity is a protective factor for mortality in patients with pneumonia who are not infected with 2009 H1N1 influenza A virus. It is unclear why obese patients may be protected from poor outcomes when pneumonia is due to a bacterial pathogen.…”

Section: Discussionsupporting

confidence: 93%

Impact of obesity on mortality in hospitalized patients with pneumonia due to 2009 H1N1 Influenza A virus versus other etiologies.

Espinosa-Ginic¹,

Hurt²,

Furmanek³

et al. 2017

JRI

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“…Animal models of bacterial infection using the leptin-deficient obese mouse have also shown higher susceptibility to pneumonia [179,180]. Finally, an "obesity paradox" in CAP has also been reported extensively, in which obesity is associated with a higher incidence of bacterial pneumonia, but increased body mass index was associated with increased survival in patients hospitalized with CAP [181].…”

Section: Metabolic Effects Of Air Pollution and Their Relationship Wimentioning

confidence: 94%

Understanding the Intersection of Environmental Pollution, Pneumonia, and Inflammation: Does Gender Play a Role?

Silveyra¹,

Fuentes²,

Rivera³

2017

Contemporary Topics of Pneumonia

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Accumulating evidence indicates that exposure to air pollution is associated with increased mortality from respiratory disease. Exposure to ambient pollutants, such as ozone, particulate matter, sulfur dioxide, nitrogen dioxide, and other agents has been associated with decrease in lung function and immunity, and with increased rates of hospitalization for lung disease, including pneumonia. Furthermore, sex differences in frequency and severity of pulmonary disease and infection have been reported, suggesting a role of sex hormones in mediating these differences. Pneumonia, which is commonly caused by bacterial infection and subsequent lung inflammation leading to hospitalization and death, occurs at different rates in men and women. In this context, male and female hormones can have direct effects on the immunity system by binding to receptors in immune cells, and these responses can be modulated by environmental exposures. This chapter summarizes clinical, animal, and epidemiological studies linking exposure to air pollution and pneumonia in both males and females. Understanding sex-specific mechanisms in pneumonia pathogenesis and environmental responses can help in the development of more effective therapeutics and treatment options to reduce negative health outcomes in men and women.

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The obesity paradox in community-acquired bacterial pneumonia

Abstract: Our data suggest that obesity may exert a protective effect against 30-day mortality from community-acquired bacterial pneumonia.

Cited by 104 publications

References 14 publications

Obesity is associated with improved survival in community-acquired pneumonia

Obesity is associated with improved survival in community-acquired pneumonia

Impact of obesity on mortality in hospitalized patients with pneumonia due to 2009 H1N1 Influenza A virus versus other etiologies.

Understanding the Intersection of Environmental Pollution, Pneumonia, and Inflammation: Does Gender Play a Role?

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