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Martinato LHM, Schmidt D, Piva TC, Deponti GN, Graboski MC, Plentz RDM, Sbruzzi G. Influence of obesity on mortality, mechanical ventilation time and mobility of critical patients with COVID-19. CRITICAL CARE SCIENCE 2024; 36:e20240253en. [PMID: 38985049 PMCID: PMC11208042 DOI: 10.62675/2965-2774.20240253-en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 03/14/2024] [Indexed: 07/11/2024]
Abstract
OBJECTIVE To identify the influence of obesity on mortality, time to weaning from mechanical ventilation and mobility at intensive care unit discharge in patients with COVID-19. METHODS This retrospective cohort study was carried out between March and August 2020. All adult patients admitted to the intensive care unit in need of ventilatory support and confirmed to have COVID-19 were included. The outcomes included mortality, time on mechanical ventilation, and mobility at intensive care unit discharge. RESULTS Four hundred and twenty-nine patients were included, 36.6% of whom were overweight and 43.8% of whom were obese. Compared with normal body mass index patients, overweight and obese patients had lower mortality (p = 0.002) and longer intensive care unit survival (log-rank p < 0.001). Compared with patients with a normal body mass index, overweight patients had a 36% lower risk of death (p = 0.04), while patients with obesity presented a 23% lower risk (p < 0.001). There was no association between obesity and time on mechanical ventilation. The level of mobility at intensive care unit discharge did not differ between groups and showed a moderate inverse correlation with length of stay in the intensive care unit (r = -0.461; p < 0.001). CONCLUSION Overweight and obese patients had lower mortality and higher intensive care unit survival rates. The duration of mechanical ventilation and mobility level at intensive care unit discharge did not differ between the groups.
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Affiliation(s)
- Luísa Helena Machado Martinato
- Hospital de Clínicas de Porto AlegreUniversidade Federal do Rio Grande do SulPorto AlegreRSBrazilPhysical Therapy Service, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul - Porto Alegre (RS), Brazil.
| | - Débora Schmidt
- Hospital de Clínicas de Porto AlegreUniversidade Federal do Rio Grande do SulPorto AlegreRSBrazilPhysical Therapy Service, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul - Porto Alegre (RS), Brazil.
| | - Taila Cristina Piva
- Hospital de Clínicas de Porto AlegreUniversidade Federal do Rio Grande do SulPorto AlegreRSBrazilPhysical Therapy Service, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul - Porto Alegre (RS), Brazil.
| | - Gracieli Nadalon Deponti
- Hospital de Clínicas de Porto AlegreUniversidade Federal do Rio Grande do SulPorto AlegreRSBrazilPhysical Therapy Service, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul - Porto Alegre (RS), Brazil.
| | - Maricene Colissi Graboski
- Hospital de Clínicas de Porto AlegreUniversidade Federal do Rio Grande do SulPorto AlegreRSBrazilPhysical Therapy Service, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul - Porto Alegre (RS), Brazil.
| | - Rodrigo Della Méa Plentz
- Postgraduate Program in Rehabilitation ScienceUniversidade Federal de Ciências da Saúde de Porto AlegrePorto AlegreRSBrazilPostgraduate Program in Rehabilitation Science, Universidade Federal de Ciências da Saúde de Porto Alegre - Porto Alegre (RS), Brazil.
| | - Graciele Sbruzzi
- Hospital de Clínicas de Porto AlegreUniversidade Federal do Rio Grande do SulPorto AlegreRSBrazilPhysical Therapy Service, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul - Porto Alegre (RS), Brazil.
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Carra FA, de Melo ME, Stumpf MAM, Cercato C, Fernandes AE, Mancini MC. The impact of obesity in hospitalized patients with COVID-19: a retrospective cohort study. Diabetol Metab Syndr 2024; 16:20. [PMID: 38238775 PMCID: PMC10797807 DOI: 10.1186/s13098-023-01246-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 12/22/2023] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND Obesity is believed to be a risk factor for COVID-19 and unfavorable outcomes, although data on this remains to be better elucidated. OBJECTIVE To evaluate the impact of obesity on the endpoints of patients hospitalized due to SARS-CoV-2. METHODS This retrospective cohort study evaluated patients hospitalized at a tertiary hospital (Hospital das Clínicas da Faculdade de Medicina da USP) from March to December 2020. Only patients positive for COVID-19 (real-time PCR or serology) were included. Data were collected from medical records and included clinical and demographic information, weight and height, SAPS-3 score, comorbidities, and patient-centered outcomes (mortality, and need for mechanical ventilation, renal replacement therapy, or vasoactive drugs). Patients were divided into categories according to their BMI (underweight, eutrophic, overweight and obesity) for comparison porpoise. RESULTS A total of 2547 patients were included. The mean age was 60.3 years, 56.2% were men, 65.2% were white and the mean BMI was 28.1 kg/m2. SAPS-3 score was a risk factor for all patient-centered outcomes (HR 1.032 for mortality, OR 1.03 for dialysis, OR 1.07 for vasoactive drug use, and OR 1.08 for intubation, p < 0.05). Male sex increased the risk of death (HR 1.175, p = 0.027) and dialysis (OR 1.64, p < 0.001), and underweight was protective for vasoactive drug use (OR 0.45, p = 0.027) and intubation (OR 0.31, p < 0.003). CONCLUSION Obesity itself was not an independent factor for worse patient-centered outcomes. Critical clinical state (indirectly evaluated by SAPS-3) appears to be the most important variable related to hard outcomes in patients infected with COVID-19.
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Affiliation(s)
- Fábio Alfano Carra
- Unidade de Obesidade, Divisão de Endocrinologia e Metabologia, Hospital das Clínicas da Faculdade de Medicina da Universidade São Paulo, R. Dr. Ovídio Pires de Campos, 225 - Cerqueira César, São Paulo, SP, 05403-010, Brasil.
| | - Maria Edna de Melo
- Unidade de Obesidade, Divisão de Endocrinologia e Metabologia, Hospital das Clínicas da Faculdade de Medicina da Universidade São Paulo, R. Dr. Ovídio Pires de Campos, 225 - Cerqueira César, São Paulo, SP, 05403-010, Brasil
- Laboratório de Carboidratos e Radioimuniensaio (LIM-18), Faculdade de Medicina da Universidade São Paulo, São Paulo, Brasil
| | - Matheo A M Stumpf
- Unidade de Obesidade, Divisão de Endocrinologia e Metabologia, Hospital das Clínicas da Faculdade de Medicina da Universidade São Paulo, R. Dr. Ovídio Pires de Campos, 225 - Cerqueira César, São Paulo, SP, 05403-010, Brasil
| | - Cintia Cercato
- Unidade de Obesidade, Divisão de Endocrinologia e Metabologia, Hospital das Clínicas da Faculdade de Medicina da Universidade São Paulo, R. Dr. Ovídio Pires de Campos, 225 - Cerqueira César, São Paulo, SP, 05403-010, Brasil
| | - Ariana E Fernandes
- Unidade de Obesidade, Divisão de Endocrinologia e Metabologia, Hospital das Clínicas da Faculdade de Medicina da Universidade São Paulo, R. Dr. Ovídio Pires de Campos, 225 - Cerqueira César, São Paulo, SP, 05403-010, Brasil
| | - Marcio C Mancini
- Unidade de Obesidade, Divisão de Endocrinologia e Metabologia, Hospital das Clínicas da Faculdade de Medicina da Universidade São Paulo, R. Dr. Ovídio Pires de Campos, 225 - Cerqueira César, São Paulo, SP, 05403-010, Brasil
- Laboratório de Carboidratos e Radioimuniensaio (LIM-18), Faculdade de Medicina da Universidade São Paulo, São Paulo, Brasil
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