tetano
Editor, Senior Moderator
J Cardiol
. 2021 Sep 28;S0914-5087(21)00255-0.
doi: 10.1016/j.jjcc.2021.09.013. Online ahead of print.
Impact of body mass index on the outcome of Japanese patients with cardiovascular diseases and/or risk factors hospitalized with COVID-19 infection
Takafumi Saito[SUP] 1 [/SUP], Tetsuo Yamaguchi[SUP] 2 [/SUP], Shunsuke Kuroda[SUP] 3 [/SUP], Takeshi Kitai[SUP] 4 [/SUP], Taishi Yonetsu[SUP] 5 [/SUP], Shun Kohsaka[SUP] 6 [/SUP], Sho Torii[SUP] 7 [/SUP], Koichi Node[SUP] 8 [/SUP], Shingo Matsumoto[SUP] 9 [/SUP], Yuya Matsue[SUP] 10 [/SUP], Takahide Kodama[SUP] 1 [/SUP]
Affiliations
Abstract
Background: Obesity is reported to be a predictor of adverse clinical events in coronavirus disease 2019 (COVID-19) in Western countries. However, there are limited data reported regarding the prognostic impact of obesity in Asian patients. We investigated the relationship between body mass index (BMI) and in-hospital outcomes in 580 Japanese patients with cardiovascular disease and/or risk factors and who were admitted for COVID-19 infection using data from 49 hospitals in Japan.
Methods: We analyzed data from the Clinical Outcomes of COVID-19 Infection in Hospitalized Patients with Cardiovascular Disease and/or Risk Factors (CLAVIS-COVID) registry. BMI was classified into four groups accordance with the definition of the Japan Society for the Study of Obesity, as follows: underweight, <18.5 kg/m[SUP]2[/SUP]; normal range, 18.5 to <25 kg/m[SUP]2[/SUP]; pre-obese, 25 to 30 kg/m[SUP]2[/SUP]; and obese, ≥30 kg/m[SUP]2[/SUP].
Results: In-hospital death occurred in 15.0% (n=87) of the patients and intubation was performed for 139 (24.0%) patients. In a multivariate analysis, we found a significant association between higher BMI and in-hospital mortality [underweight: hazard ratio (HR) 0.47, 95% confidence interval (CI) 0.23-0.97; p=0.041; pre-obese: HR 1.46, 95%CI 0.84-2.55; p=0.18; and obese: HR 3.28, 95%CI 1.34-8.02; p=0.009 vs. normal range]. In contrast, the association between BMI and the intubation rate was not statistically significant.
Conclusions: Obesity was associated with a stepwise increase in the risk of in-hospital mortality in Japanese patients with COVID-19 infection. The threshold BMI for the increased risk of a worse outcome was 30, which was much lower in comparison to Western countries.
Keywords: Body mass index; Cardiovascular disease; Coronavirus disease 2019 (COVID-19); In-hospital mortality; Obesity.
. 2021 Sep 28;S0914-5087(21)00255-0.
doi: 10.1016/j.jjcc.2021.09.013. Online ahead of print.
Impact of body mass index on the outcome of Japanese patients with cardiovascular diseases and/or risk factors hospitalized with COVID-19 infection
Takafumi Saito[SUP] 1 [/SUP], Tetsuo Yamaguchi[SUP] 2 [/SUP], Shunsuke Kuroda[SUP] 3 [/SUP], Takeshi Kitai[SUP] 4 [/SUP], Taishi Yonetsu[SUP] 5 [/SUP], Shun Kohsaka[SUP] 6 [/SUP], Sho Torii[SUP] 7 [/SUP], Koichi Node[SUP] 8 [/SUP], Shingo Matsumoto[SUP] 9 [/SUP], Yuya Matsue[SUP] 10 [/SUP], Takahide Kodama[SUP] 1 [/SUP]
Affiliations
- PMID: 34625315
- PMCID: PMC8479451
- DOI: 10.1016/j.jjcc.2021.09.013
Abstract
Background: Obesity is reported to be a predictor of adverse clinical events in coronavirus disease 2019 (COVID-19) in Western countries. However, there are limited data reported regarding the prognostic impact of obesity in Asian patients. We investigated the relationship between body mass index (BMI) and in-hospital outcomes in 580 Japanese patients with cardiovascular disease and/or risk factors and who were admitted for COVID-19 infection using data from 49 hospitals in Japan.
Methods: We analyzed data from the Clinical Outcomes of COVID-19 Infection in Hospitalized Patients with Cardiovascular Disease and/or Risk Factors (CLAVIS-COVID) registry. BMI was classified into four groups accordance with the definition of the Japan Society for the Study of Obesity, as follows: underweight, <18.5 kg/m[SUP]2[/SUP]; normal range, 18.5 to <25 kg/m[SUP]2[/SUP]; pre-obese, 25 to 30 kg/m[SUP]2[/SUP]; and obese, ≥30 kg/m[SUP]2[/SUP].
Results: In-hospital death occurred in 15.0% (n=87) of the patients and intubation was performed for 139 (24.0%) patients. In a multivariate analysis, we found a significant association between higher BMI and in-hospital mortality [underweight: hazard ratio (HR) 0.47, 95% confidence interval (CI) 0.23-0.97; p=0.041; pre-obese: HR 1.46, 95%CI 0.84-2.55; p=0.18; and obese: HR 3.28, 95%CI 1.34-8.02; p=0.009 vs. normal range]. In contrast, the association between BMI and the intubation rate was not statistically significant.
Conclusions: Obesity was associated with a stepwise increase in the risk of in-hospital mortality in Japanese patients with COVID-19 infection. The threshold BMI for the increased risk of a worse outcome was 30, which was much lower in comparison to Western countries.
Keywords: Body mass index; Cardiovascular disease; Coronavirus disease 2019 (COVID-19); In-hospital mortality; Obesity.