Background A significant spread of Coronavirus Disease 19 (COVID-19) has been observed in Western countries. The aim of the study was to analyze whether obesity (BMI ≥ 30 kg/m2) was a risk factor for respiratory failure and death. Methods Retrospective multicentric cohort study of 296 COVID-19 patients admitted to the hospital between February 28 and March 28, 2020. Demographic characteristics, laboratory findings and clinical scores were compared in obese and non-obese patients. Multivariable analysis was carried out to identify the risk factors for respiratory failure and mortality. Findings Of 296 patients, 70 (23·6%) had a BMI ≥ 30 kg/m2. Obese patients were significantly older (68±13·5 vs. 63±16·8, p=0·0052) and reported a higher rate of hypertension (77.9% vs. 40.2%, p<0.0001), chronic obstructive pulmonary disease (COPD) (24·3% vs. 9·7%, p=0·0017), type 2 diabetes (18·6% vs. 9·3%, p=0·033) and moderate/severe renal disease (12·9% vs. 2·7%, p=0·0007). Obese patients were more likely to require continuous positive airway pressure (20% vs. 7·8%, p=0·0052), non-invasive ventilation (20% vs. 7·5%, p=0·0061) and intensive care admission (40% vs. 15·9%, p<0·0001). At multivariable analysis, age and obesity were the only significant risk factors for the onset of respiratory failure (odds ratio [OR] 1·04, p<0·0001; OR 3·16, p=0·001) and mortality (OR 1·10, p<0.0001; OR 3·11, p=0·008). Interpretation Obesity is the strongest risk factor for respiratory failure and death among COVID-19 patients. Taking into account the high prevalence of obesity in the Western countries, prompt evaluation and aggressive treatment are advisable in obese patients.
Obesity Is One of the Strongest Risk Factor for Respiratory Failure and Death in COVID-19 Patients: A Retrospective Multicentric Cohort Study
Matteo Rottoli
;Paolo Bernante;Silvia Garelli;Maddalena Giannella;Sara Tedeschi;Elena Rosselli Del Turco;Elena Nardi;Uberto Pagotto;Gilberto Poggioli;Vito Marco Ranieri;Pierluigi Viale;Michele Bartoletti
2020
Abstract
Background A significant spread of Coronavirus Disease 19 (COVID-19) has been observed in Western countries. The aim of the study was to analyze whether obesity (BMI ≥ 30 kg/m2) was a risk factor for respiratory failure and death. Methods Retrospective multicentric cohort study of 296 COVID-19 patients admitted to the hospital between February 28 and March 28, 2020. Demographic characteristics, laboratory findings and clinical scores were compared in obese and non-obese patients. Multivariable analysis was carried out to identify the risk factors for respiratory failure and mortality. Findings Of 296 patients, 70 (23·6%) had a BMI ≥ 30 kg/m2. Obese patients were significantly older (68±13·5 vs. 63±16·8, p=0·0052) and reported a higher rate of hypertension (77.9% vs. 40.2%, p<0.0001), chronic obstructive pulmonary disease (COPD) (24·3% vs. 9·7%, p=0·0017), type 2 diabetes (18·6% vs. 9·3%, p=0·033) and moderate/severe renal disease (12·9% vs. 2·7%, p=0·0007). Obese patients were more likely to require continuous positive airway pressure (20% vs. 7·8%, p=0·0052), non-invasive ventilation (20% vs. 7·5%, p=0·0061) and intensive care admission (40% vs. 15·9%, p<0·0001). At multivariable analysis, age and obesity were the only significant risk factors for the onset of respiratory failure (odds ratio [OR] 1·04, p<0·0001; OR 3·16, p=0·001) and mortality (OR 1·10, p<0.0001; OR 3·11, p=0·008). Interpretation Obesity is the strongest risk factor for respiratory failure and death among COVID-19 patients. Taking into account the high prevalence of obesity in the Western countries, prompt evaluation and aggressive treatment are advisable in obese patients.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
