tetano
Editor, Senior Moderator
Mayo Clin Proc
. 2021 Apr;96(4):921-931.
doi: 10.1016/j.mayocp.2021.01.021. Epub 2021 Feb 4.
Obesity is a Major Risk Factor for Hospitalization in Community-Managed COVID-19 Pneumonia
Marcello Cottini[SUP] 1 [/SUP], Carlo Lombardi[SUP] 2 [/SUP], Alvise Berti[SUP] 3 [/SUP], Primary Care Physicians, ATS Province of Bergamo, Italy
Collaborators, Affiliations
Abstract
Objective: We aimed to investigate whether the stratification of outpatients with coronavirus disease 2019 (COVID-19) pneumonia by body mass index (BMI) can help predict hospitalization and other severe outcomes.
Patients and methods: We prospectively collected consecutive cases of community-managed COVID-19 pneumonia from March 1 to April 20, 2020, in the province of Bergamo and evaluated the association of overweight (25 kg/m[SUP]2[/SUP] ? BMI <30 kg/m[SUP]2[/SUP]) and obesity (?30 kg/m[SUP]2[/SUP]) with time to hospitalization (primary end point), low-flow domiciliary oxygen need, noninvasive mechanical ventilation, intubation, and death due to COVID-19 (secondary end points) in this cohort. We analyzed the primary end point using multivariable Cox models.
Results: Of 338 patients included, 133 (39.4%) were overweight and 77 (22.8%) were obese. Age at diagnosis was younger in obese patients compared with those overweight or with normal weight (P<.001), whereas diabetes, dyslipidemia, and heart diseases were differently distributed among BMI categories. Azithromycin, hydroxychloroquine, and prednisolone use were similar between BMI categories (P>.05). Overall, 105 (31.1%) patients were hospitalized, and time to hospitalization was significantly shorter for obese vs over- or normal-weight patients (P<.001). In the final multivariable analysis, obese patients were more likely to require hospitalization than nonobese patients (hazard ratio, 5.83; 95% CI, 3.91 to 8.71). Results were similar in multiple sensitivity analyses. Low-flow domiciliary oxygen need, hospitalization with noninvasive mechanical ventilation, intubation, and death were significantly associated with obesity (P<.001).
Conclusion: In patients with community-managed COVID-19 pneumonia, obesity is associated with a higher hospitalization risk and overall worse outcomes than for nonobese patients.
. 2021 Apr;96(4):921-931.
doi: 10.1016/j.mayocp.2021.01.021. Epub 2021 Feb 4.
Obesity is a Major Risk Factor for Hospitalization in Community-Managed COVID-19 Pneumonia
Marcello Cottini[SUP] 1 [/SUP], Carlo Lombardi[SUP] 2 [/SUP], Alvise Berti[SUP] 3 [/SUP], Primary Care Physicians, ATS Province of Bergamo, Italy
Collaborators, Affiliations
- PMID: 33814092
- DOI: 10.1016/j.mayocp.2021.01.021
Abstract
Objective: We aimed to investigate whether the stratification of outpatients with coronavirus disease 2019 (COVID-19) pneumonia by body mass index (BMI) can help predict hospitalization and other severe outcomes.
Patients and methods: We prospectively collected consecutive cases of community-managed COVID-19 pneumonia from March 1 to April 20, 2020, in the province of Bergamo and evaluated the association of overweight (25 kg/m[SUP]2[/SUP] ? BMI <30 kg/m[SUP]2[/SUP]) and obesity (?30 kg/m[SUP]2[/SUP]) with time to hospitalization (primary end point), low-flow domiciliary oxygen need, noninvasive mechanical ventilation, intubation, and death due to COVID-19 (secondary end points) in this cohort. We analyzed the primary end point using multivariable Cox models.
Results: Of 338 patients included, 133 (39.4%) were overweight and 77 (22.8%) were obese. Age at diagnosis was younger in obese patients compared with those overweight or with normal weight (P<.001), whereas diabetes, dyslipidemia, and heart diseases were differently distributed among BMI categories. Azithromycin, hydroxychloroquine, and prednisolone use were similar between BMI categories (P>.05). Overall, 105 (31.1%) patients were hospitalized, and time to hospitalization was significantly shorter for obese vs over- or normal-weight patients (P<.001). In the final multivariable analysis, obese patients were more likely to require hospitalization than nonobese patients (hazard ratio, 5.83; 95% CI, 3.91 to 8.71). Results were similar in multiple sensitivity analyses. Low-flow domiciliary oxygen need, hospitalization with noninvasive mechanical ventilation, intubation, and death were significantly associated with obesity (P<.001).
Conclusion: In patients with community-managed COVID-19 pneumonia, obesity is associated with a higher hospitalization risk and overall worse outcomes than for nonobese patients.