Influence of obesity on mortality, mechanical ventilation time and mobility of critical patients with COVID-19.

Critical care science Pub Date : 2024-07-08 eCollection Date: 2024-01-01 DOI:10.62675/2965-2774.20240253-en
Luísa Helena Machado Martinato, Débora Schmidt, Taila Cristina Piva, Gracieli Nadalon Deponti, Maricene Colissi Graboski, Rodrigo Della Méa Plentz, Graciele Sbruzzi
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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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肥胖对 COVID-19 危重病人死亡率、机械通气时间和活动能力的影响。
目的确定肥胖对 COVID-19 患者死亡率、机械通气断气时间和重症监护室出院时活动能力的影响:这项回顾性队列研究于 2020 年 3 月至 8 月间进行。研究纳入了所有入住重症监护病房、需要呼吸支持并被证实患有 COVID-19 的成年患者。研究结果包括死亡率、机械通气时间和重症监护室出院时的活动能力:结果:共纳入 429 名患者,其中 36.6% 超重,43.8% 肥胖。与体重指数正常的患者相比,超重和肥胖患者的死亡率较低(p = 0.002),重症监护室存活时间较长(对数秩p < 0.001)。与体重指数正常的患者相比,超重患者的死亡风险降低了36%(p = 0.04),而肥胖患者的死亡风险降低了23%(p < 0.001)。肥胖与机械通气时间没有关系。各组患者在重症监护室出院时的活动能力水平没有差异,但与重症监护室的住院时间呈中度反相关(r = -0.461; p < 0.001):结论:超重和肥胖患者的死亡率较低,重症监护室存活率较高。结论:超重和肥胖患者的死亡率较低,重症监护室存活率较高,两组患者在重症监护室的机械通气时间和出院时的活动能力水平没有差异。
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