tetano
Editor, Senior Moderator
J Clin Endocrinol Metab
. 2024 Apr 18:dgae273.
doi: 10.1210/clinem/dgae273. Online ahead of print. Obesity, Inflammation, and Clinical Outcomes in COVID-19: A Multicenter Prospective Cohort Study
Christina G Hutten[SUP] 1 [/SUP], Kishan Padalia[SUP] 2 [/SUP], Alexi Vasbinder[SUP] 1 [/SUP], Yiyuan Huang[SUP] 3 [/SUP], Anis Ismail[SUP] 1 [/SUP], Ian Pizzo[SUP] 1 [/SUP], Kristen Machado Diaz[SUP] 1 [/SUP], Tonimarie Catalan[SUP] 1 [/SUP], Feriel Presswalla[SUP] 1 [/SUP], Elizabeth Anderson[SUP] 1 [/SUP], Grace Erne[SUP] 1 [/SUP], Brayden Bitterman[SUP] 1 [/SUP], Pennelope Blakely[SUP] 1 [/SUP], Evangelos J Giamarellos-Bourboulis[SUP] 4 [/SUP], Sven H Loosen[SUP] 5 [/SUP], Frank Tacke[SUP] 6 [/SUP], Athanasios Chalkias[SUP] 7 [/SUP], Jochen Reiser[SUP] 8 [/SUP], Jesper Eugen-Olsen[SUP] 9 [/SUP], Mousumi Banerjee[SUP] 3 [/SUP], Rodica Pop-Busui[SUP] 10 [/SUP], Salim S Hayek[SUP] 1 [/SUP]
Affiliations
Context: Obesity is a risk factor for coronavirus disease 2019 (COVID-19)-related outcomes; however, the mechanism remains unclear.
Objective: The objective of this analysis was to determine whether inflammation mediates the association between obesity and COVID-19 outcomes.
Design: The International Study of Inflammation in Covid-19 (ISIC): A Prospective Multi-Center Observational Study Examining the Role of Biomarkers of Inflammation in Predicting Covid-19 Related Outcomes in Hospitalized Patients.
Setting: Ten hospitals in the United States and Europe.
Participants: Adults hospitalized specifically for COVID-19 between February 1, 2020, through October 19, 2022.
Main outcome measures: Inflammatory biomarkers, including soluble urokinase plasminogen activator receptor (suPAR), were measured at admission. Associations were examined between body-mass index (BMI, kg/m2) and a composite of death, need for mechanical ventilation, and renal replacement therapy, stratified by pre- and post-Omicron variants. The contribution of inflammation to the relationship between obesity and outcomes was assessed.
Results: Among 4644 participants (mean age 59.3, 45.6% male, 21.8% BMI≥35), those with BMI>40 (n=485) had 55% higher odds of the composite outcome (95% CI[1.21 to 1.98]) compared to non-obese individuals (BMI<30, n=2358) in multivariable analysis. In multiple mediation analysis, only suPAR remained a significant mediator between BMI and composite outcome. Associations were amplified for participants younger than 65 years and with pre-Omicron variants.
Conclusion: Obesity is associated with worse outcomes in COVID-19, notably in younger participants and in the pre-Omicron era. Inflammation, as measured by suPAR, is a significant mediator of the association between obesity and COVID-19 outcomes.
Keywords: BMI; COVID-19; SARS-CoV-2; biomarkers; coronavirus; inflammation; obesity.
. 2024 Apr 18:dgae273.
doi: 10.1210/clinem/dgae273. Online ahead of print. Obesity, Inflammation, and Clinical Outcomes in COVID-19: A Multicenter Prospective Cohort Study
Christina G Hutten[SUP] 1 [/SUP], Kishan Padalia[SUP] 2 [/SUP], Alexi Vasbinder[SUP] 1 [/SUP], Yiyuan Huang[SUP] 3 [/SUP], Anis Ismail[SUP] 1 [/SUP], Ian Pizzo[SUP] 1 [/SUP], Kristen Machado Diaz[SUP] 1 [/SUP], Tonimarie Catalan[SUP] 1 [/SUP], Feriel Presswalla[SUP] 1 [/SUP], Elizabeth Anderson[SUP] 1 [/SUP], Grace Erne[SUP] 1 [/SUP], Brayden Bitterman[SUP] 1 [/SUP], Pennelope Blakely[SUP] 1 [/SUP], Evangelos J Giamarellos-Bourboulis[SUP] 4 [/SUP], Sven H Loosen[SUP] 5 [/SUP], Frank Tacke[SUP] 6 [/SUP], Athanasios Chalkias[SUP] 7 [/SUP], Jochen Reiser[SUP] 8 [/SUP], Jesper Eugen-Olsen[SUP] 9 [/SUP], Mousumi Banerjee[SUP] 3 [/SUP], Rodica Pop-Busui[SUP] 10 [/SUP], Salim S Hayek[SUP] 1 [/SUP]
Affiliations
- PMID: 38635301
- DOI: 10.1210/clinem/dgae273
Context: Obesity is a risk factor for coronavirus disease 2019 (COVID-19)-related outcomes; however, the mechanism remains unclear.
Objective: The objective of this analysis was to determine whether inflammation mediates the association between obesity and COVID-19 outcomes.
Design: The International Study of Inflammation in Covid-19 (ISIC): A Prospective Multi-Center Observational Study Examining the Role of Biomarkers of Inflammation in Predicting Covid-19 Related Outcomes in Hospitalized Patients.
Setting: Ten hospitals in the United States and Europe.
Participants: Adults hospitalized specifically for COVID-19 between February 1, 2020, through October 19, 2022.
Main outcome measures: Inflammatory biomarkers, including soluble urokinase plasminogen activator receptor (suPAR), were measured at admission. Associations were examined between body-mass index (BMI, kg/m2) and a composite of death, need for mechanical ventilation, and renal replacement therapy, stratified by pre- and post-Omicron variants. The contribution of inflammation to the relationship between obesity and outcomes was assessed.
Results: Among 4644 participants (mean age 59.3, 45.6% male, 21.8% BMI≥35), those with BMI>40 (n=485) had 55% higher odds of the composite outcome (95% CI[1.21 to 1.98]) compared to non-obese individuals (BMI<30, n=2358) in multivariable analysis. In multiple mediation analysis, only suPAR remained a significant mediator between BMI and composite outcome. Associations were amplified for participants younger than 65 years and with pre-Omicron variants.
Conclusion: Obesity is associated with worse outcomes in COVID-19, notably in younger participants and in the pre-Omicron era. Inflammation, as measured by suPAR, is a significant mediator of the association between obesity and COVID-19 outcomes.
Keywords: BMI; COVID-19; SARS-CoV-2; biomarkers; coronavirus; inflammation; obesity.