体重指数对 COVID-19 严重败血症住院患者心肺功能结果的影响

Obesity Pillars Pub Date : 2024-02-14 DOI:10.1016/j.obpill.2024.100101

Sivaram Neppala , Himaja Dutt Chigurupati , Nikhilender Nag Mopuru , Naga Ruthvika Alle , Alpha James , Ami Bhalodia , Sajida Shaik , Revanth Reddy Bandaru , Athmananda Nanjundappa , Praveena Sunkara , Jyotsna Gummadi , Rupak Desai

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摘要

背景体重指数（BMI）对冠状病毒病（COVID-19）患者的预后有重大影响；然而，人们对严重脓毒症患者心脑血管的主要不良预后却知之甚少。方法这是一项观察性研究，探讨 BMI 对 COVID-19 严重脓毒症住院治疗的影响。主要结果是调整后的全因院内死亡率、呼吸衰竭和主要不良心脑血管事件（MACCE）几率，其中包括急性心肌梗死、心脏骤停和急性缺血性中风。次要结果是医疗资源利用率。结果在 51,740 名入院的严重 COVID-19 败血症患者中，11.4% 超重，24.8% I 级肥胖（BMI 30-34.9），19.8% II 级肥胖（BMI 35-39.9），43.9% III 级肥胖（BMI 40），年龄为 18 岁。II级肥胖和III级肥胖患者发生澳门巴黎人娱乐官网的几率（OR 1.09和1.54；95CI 0.93-1.29和1.33-1.79）明显高于超重患者（p <0.001）。一级、二级和三级肥胖患者发生呼吸衰竭的几率低于超重患者（OR 0.89、0.82 和 0.82；95CI 0.75-1.05、0.69-0.97 和 0.70-0.97），但未达到统计学意义（p = 0.079）。多变量回归分析显示，Ⅲ级肥胖、Ⅱ级肥胖和Ⅰ级肥胖患者的全因院内死亡率明显更高（OR 1.56、1.17 和 1.06；95CI 1.34-1.81、0.99-1.结论在 COVID-19 严重败血症入院患者中，II 级和 III 级肥胖患者发生 MACCE 和院内死亡的几率明显更高。

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Impact Of body Mass Index on Cardiopulmonary Outcomes of COVID-19 Hospitalizations Complicated by Severe Sepsis

Background

Body Mass Index (BMI) has a significant impact on Coronavirus disease (COVID-19) patient outcomes; however, major adverse cardiac and cerebrovascular outcomes in patients with severe sepsis have been poorly understood. Our study aims to explore and provide insight into its association.

Methods

This is an observational study looking at the impact of BMI on COVID-19-severe sepsis hospitalizations. The primary outcomes are adjusted odds of all-cause in-hospital mortality, respiratory failure, and major adverse cardiac and cerebrovascular events (MACCE), which include acute myocardial infarction, cardiac arrest, and acute ischemic stroke. The secondary outcome was healthcare resource utilization. Coexisting comorbidities and patient features were adjusted with multivariable regression analyses.

Results

Of 51,740 patients with severe COVID-19-sepsis admissions, 11.4% were overweight, 24.8% had Class I obesity (BMI 30–34.9), 19.8% had Class II obesity (BMI 35–39.9), and 43.9% had the categorization of Class III obesity (BMI >40) cohorts with age>18 years. The odds of MACCE in patients with class II obesity and class III obesity (OR 1.09 and 1.54; 95CI 0.93–1.29 and 1.33–1.79) were significantly higher than in overweight (p < 0.001). Class I, Class II, and Class III patients with obesity revealed lower odds of respiratory failure compared to overweight (OR 0.89, 0.82, and 0.82; 95CI 0.75–1.05, 0.69–0.97, and 0.70–0.97), but failed to achieve statistical significance (p = 0.079). On multivariable regression analysis, all-cause in-hospital mortality revealed significantly higher odds in patients with Class III obesity, Class II, and Class I (OR 1.56, 1.17, and 1.06; 95CI 1.34–1.81, 0.99–1.38, and 0.91–1.24) vs. overweight patients (p < 0.001).

Conclusions

Patients with Class II and Class III obesity had significantly higher odds of MACCE and in-hospital mortality in COVID-19-severe sepsis admissions.

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Obesity Pillars

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