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. 2020 Dec 16;15(12):e0243888.
doi: 10.1371/journal.pone.0243888. eCollection 2020.

Clinical outcomes and inflammatory marker levels in patients with Covid-19 and obesity at an inner-city safety net hospital

Anahita Mostaghim  1 , Pranay Sinha  2 , Catherine Bielick  1 , Selby Knudsen  2 , Indeevar Beeram  3 , Laura F White  4 , Caroline Apovian  5 , Manish Sagar  2 , Natasha S Hochberg  2   6
Affiliations

Clinical outcomes and inflammatory marker levels in patients with Covid-19 and obesity at an inner-city safety net hospital

Anahita Mostaghim et al. PLoS One. .

Abstract

Objectives: Patients with Covid-19 and obesity have worse clinical outcomes which may be driven by increased inflammation. This study aimed to characterize the association between clinical outcomes in patients with obesity and inflammatory markers.

Methods: We analyzed data for patients aged ≥18 years admitted with a positive SARS-CoV-2 PCR test. We used multivariate logistic regression to determine the association between BMI and intensive care unit (ICU) transfer and all-cause mortality. Inflammatory markers (C-reactive protein [CRP], lactate dehydrogenase [LDH], ferritin, and D-dimer) were compared between patients with and without obesity (body mass index [BMI] ≥30 kg/m2).

Results: Of 791 patients with Covid-19, 361 (45.6%) had obesity. In multivariate analyses, BMI ≥35 was associated with a higher odds of ICU transfer (adjusted odds ratio [aOR] 2.388 (95% confidence interval [CI]: 1.074-5.310) and hospital mortality (aOR = 4.3, 95% CI: 1.69-10.82). Compared to those with BMI<30, patients with obesity had lower ferritin (444 vs 637 ng/mL; p<0.001) and lower D-dimer (293 vs 350 mcg/mL; p = 0.009), non-significant differences in CRP (72.8 vs 84.1 mg/L, p = 0.099), and higher LDH (375 vs 340, p = 0.009) on the first hospital day.

Conclusions: Patients with obesity were more likely to have poor outcomes even without increased inflammation.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Median, IQR, and range of inflammatory markers and absolute lymphocyte count on hospital days 1 and 2 as well as maximum FiO2 during hospitalization by body mass index (BMI) group.
CRP = C reactive protein, LDH = lactate dehydrogenase ALC = absolute lymphocyte count. * = 0.01 < p < 0.05, ** = p<0.01.
See this image and copyright information in PMC

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