Association of obesity on the outcome of critically ill patients affected by COVID-19

Rodríguez, Alejandro; Martín-Loeches, Ignacio; Moreno, Gerard; Díaz, Emili; Ferré, Cristina; Salgado, Melina; Marín-Corral, Judith; Estella, Angel; Solé-Violán, Jordi; Trefler, Sandra; Zaragoza, Rafael; Socias, Lorenzo; Borges-Sa, Marcio; Restrepo, Marcos I; Guardiola, Juan J; Reyes, Luis F; Albaya-Moreno, Antonio; Berlanga, Alfonso Canabal; Ortiz, María del Valle; Ballesteros, Juan Carlos; Chinesta, Susana Sancho; Laderas, Juan Carlos Pozo; Gómez, Josep; Bodí, María

doi:10.1016/j.medine.2023.08.003

ISSN: 2173-5727

Medicina Intensiva is the journal of the Spanish Society of Intensive and Critical Care Medicine and Coronary Units (SEMICIUC), and has become the reference publication in Spanish in its field. Medicina Intensiva mainly publishes Original Articles, Reviews, Clinical Notes, Images in Intensive Medicine, and Information relevant to the specialty. All works go through a rigorous selection process.

Indexed in:

Index Medicus / MEDLINE / EMBASE / Excerpta Medica / SCOPUS / MEDES / Science Citation Index Expanded, Journal of Citation Reports

Subscribe:

Impact factor

The Impact Factor measures the average number of citations received in a particular year by papers published in the journal during the two preceding years.

© Clarivate Analytics, Journal Citation Reports 2022

Impact factor 2022

Citescore

CiteScore measures average citations received per document published.

Citescore 2022

2.6

SJR

SRJ is a prestige metric based on the idea that not all citations are the same. SJR uses a similar algorithm as the Google page rank; it provides a quantitative and qualitative measure of the journal's impact.

SJR 2022

0.364

SNIP

SNIP measures contextual citation impact by wighting citations based on the total number of citations in a subject field.

SNIP 2022

0.687

View more metrics

Open Access option

Journal Information

Previous article | Next article

Vol. 48. Issue 3.

Pages 142-154 (March 2024)

Export reference

Download PDF

More article options

Statistics

Visits

754

Vol. 48. Issue 3.

Pages 142-154 (March 2024)

Original article

DOI: 10.1016/j.medine.2023.08.003

Association of obesity on the outcome of critically ill patients affected by COVID-19

Asociación de la obesidad en la evolución de los pacientes críticos afectados por COVID-19

Visits

754

Download PDF

Alejandro Rodrígueza,b,1,

Corresponding author

ahr1161@yahoo.es

Corresponding author.

, Ignacio Martín-Loechesc,1, Gerard Morenoa, Emili Díazd, Cristina Ferréa, Melina Salgadoa, Judith Marín-Corrale, Angel Estellaf, Jordi Solé-Violáng, Sandra Treflera, Rafael Zaragozah, Lorenzo Sociasi, Marcio Borges-Sai, Marcos I Restrepoj, Juan J Guardiolak, Luis F Reyesl, Antonio Albaya-Morenom, Alfonso Canabal Berlangan, María del Valle Ortizo, Juan Carlos Ballesterosp..., Susana Sancho Chinestaq, Juan Carlos Pozo Laderasr, Josep Gómezs, María Bodía,b, on behalf COVID-19/SEMCYUC Working group 2Ver más

a Critical Care Department, Hospital Universitari de Tarragona Joan XXIII, Tarragona, Spain

b Universidad Rovira & Virgili/Institut d’Investigació Sanitaria Pere Virigili/CIBERES, Tarragona, Spain

c Department of Intensive Care Medicine, Multidisciplinary Intensive Care Research Organization (MICRO), St. James’s Hospital, Dublin, Ireland

d Critical Care Department, Hospital Parc Tauli, Sabadell, Spain

e Critical Care Department, Hospital del Mar, Barcelona, Spain

f Critical Care Department, Hospital Universitario de Jerez, Jerez de la Frontera, Spain

g Critical Care Department, Hospital Universitario Dr. Negrin/Universidad Fernando Pessoa, Las Palmas de Gran Canaria, Spain

h Critical Care Department, Hospital Dr. Peset, Valencia, Spain

i Critical Care Department, Hospital Son Llatzer, Palma de Mallorca, Spain

j Medical Intensive Care Unit South Texas Veterans Health Care System Audie L. Murphy Division/University of Texas Health San Antonio, San Antonio, TX, USA

k Robley Rex VA Medical Center/University of Louisville, Louisville, USA

l Unisabana Center for Translational Science, Universidad de La Sabana, Clinica Universidadde La Sabana, Chía, Colombia/Pandemic Sciences Institute, University of Oxford, Oxford, UK

m Critical Care Department, Hospital Universitario de Guadalajara, Guadalajara, Spain

n Critical Care Department, Hospital de La Princesa, Madrid, Spain

o Critical Care Department, Hospital Universitario de Burgos, Burgos, Spain

p Critical Care Department, Hospital Clínico de Salamanca, Salamanca, Spain

q Critical Care Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain

r Critical Care Department, Hospital Universitario Reina Sofía, Córdoba, Spain

s Technical Secretary, Hospital Universitario de Tarragona Joan XXIII/URV, Tarragona, Spain

This item has received

754 Visits

Article information

Abstract

Full Text

Bibliography

Download PDF

Statistics

Figures (3)

Show moreShow less

Tables (3)

Table 1. Characteristics of 5186 critically ill patients included in the study according to presence of obesity (BMI ≥ 30) or not.

Table 2. Characteristics of 5186 critically ill patients included according to BMI categories.

Table 3. Characteristics of 5186 critically ill patients included in the study according to ICU outcome.

Show moreShow less

Additional material (1)

Abstract

Objective

To evaluate the impact of obesity on ICU mortality.

Design

Observational, retrospective, multicentre study.

Setting

Intensive Care Unit (ICU).

Patients

Adults patients admitted with COVID-19 and respiratory failure.

Interventions

None.

Primary variables of interest

Collected data included demographic and clinical characteristics, comorbidities, laboratory tests and ICU outcomes. Body mass index (BMI) impact on ICU mortality was studied as (1) a continuous variable, (2) a categorical variable obesity/non-obesity, and (3) as categories defined a priori: underweight, normal, overweight, obesity and Class III obesity. The impact of obesity on mortality was assessed by multiple logistic regression and Smooth Restricted cubic (SRC) splines for Cox hazard regression.

Results

5,206 patients were included, 20 patients (0.4%) as underweight, 887(17.0%) as normal, 2390(46%) as overweight, 1672(32.1) as obese and 237(4.5%) as class III obesity. The obesity group patients (n = 1909) were younger (61 vs. 65 years, p < 0.001) and with lower severity scores APACHE II (13 [9–17] vs. 13[10−17, p < 0.01) than non-obese. Overall ICU mortality was 28.5% and not different for obese (28.9%) or non-obese (28.3%, p = 0.65). Only Class III obesity (OR = 2.19, 95%CI 1.44–3.34) was associated with ICU mortality in the multivariate and SRC analysis.

Conclusions

COVID-19 patients with a BMI > 40 are at high risk of poor outcomes in the ICU. An effective vaccination schedule and prolonged social distancing should be recommended.

Keywords:

Obesity

COVID-19

Prognosis

Resumen

Objetivo

Evaluar el impacto de la obesidad en la mortalidad de la UCI.

Diseño

Estudio observacional, retrospectivo y multicéntrico.

Ámbito

Unidad de Cuidados Intensivos (UCI).

Pacientes

Pacientes adultos con COVID-19 e insuficiencia respiratoria.

Intervenciones

Ninguna.

Variables de interés principales

Características demográficas y clínicas, comorbilidades, pruebas de laboratorio y evolución en la UCI. El impacto del índice de masa corporal (IMC) sobre la mortalidad se estudió como (1) una variable continua, (2) una variable categórica obesidad/no obesidad, y (3) como categorías definidas a priori: bajo peso, normal, sobrepeso, obesidad y obesidad clase III. El impacto de la obesidad se evaluó mediante regresión logística múltiple y splines cúbicos suaves restringidos (SRC) para la regresión de riesgos de Cox.

Resultados

Se incluyeron 5.206 pacientes, 20 (0,4%) con bajo peso, 887 (17,0%) con peso normal, 2.390 (46%) con sobrepeso, 1.672 (32,1%) con obesidad y 237 (4,5%) con obesidad clase III. Los pacientes obesos (n = 1909) eran más jóvenes (61 vs. 65 años, p < 0,001) y con un nivel más bajo de APACHE II (13 [9–17] frente a 13[10−17, p < 0,01) que los no obesos. La mortalidad global en la UCI fue del 28,5% y no fue diferente entre obesos (28,9%) y no obesos (28,3%,p = 0,65). Sólo la obesidad clase III (OR = 2,19; IC del 95%: 1,44−3,34) se asoció con la mortalidad en la UCI en el análisis multivariante y SRC.

Conclusiones

Los pacientes con COVID-19 con un IMC > 40 tienen un alto riesgo de mala evolución en la UCI. Debe recomendarse un calendario de vacunación eficaz y un distanciamiento social prolongado.

Palabras clave:

Obesidad

COVID-19

Pronóstico

Article

These are the options to access the full texts of the publication Medicina Intensiva (English Edition)

Member of the society

Subscriber

Contact

Member

If you are a member of the Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias::
Go to the members area of the website of the SEMICYUC (www.semicyuc.org )and click the link to the magazine.

Subscriber

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”

Subscribe to

Medicina Intensiva (English Edition)

More information

Purchase

Purchase article

Purchasing article the PDF version will be downloaded

Price 19.34 €

Purchase now

Contact

Phone for subscriptions and reporting of errors

From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.

Calls from Spain

932 415 960

Calls from outside Spain

+34 932 415 960

atencionalcliente@elsevier.com

Indexed in:

Follow us:

Subscribe:

Article

Subscribe to our newsletter