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. 2021 Jan-Feb;15(1):96-99.
doi: 10.1016/j.orcp.2020.12.004. Epub 2020 Dec 23.

The role of obesity in inflammatory markers in COVID-19 patients

Jenna N McNeill  1 , Emily S Lau  2 , Samantha M Paniagua  3 , Elizabeth E Liu  3 , Jessica K Wang  3 , Ingrid V Bassett  4 , Caitlin A Selvaggi  5 , Steven A Lubitz  6 , Andrea S Foulkes  5 , Jennifer E Ho  7
Affiliations

The role of obesity in inflammatory markers in COVID-19 patients

Jenna N McNeill et al. Obes Res Clin Pract. 2021 Jan-Feb.

Abstract

Obesity has emerged as a significant risk factor for severe COVID-19 worldwide. Given both COVID-19 infection and obesity have been associated with increased systemic inflammation, we evaluated inflammatory markers in obese and non-obese individuals hospitalized for COVID-19 at Massachusetts General Hospital. We hypothesized that obese patients would have a more exuberant inflammatory response as evidenced by higher initial and peak inflammatory markers along with worse clinical outcomes. Of the 781 patients, 349 were obese (45%). Obese individuals had higher initial and peak levels of CRP and ESR as well as higher peak d-dimer (P < 0.01 for all) in comparison to non-obese individuals, while. IL-6 and ferritin were similar. In addition, obese individuals had a higher odds of requiring vasopressor use (OR 1.54, 95% CI 1.00-2.38, P = 0.05), developing hypoxemic respiratory failure (OR 1.58, 95% CI 1.04-2.40, P = 0.03) and death (OR 2.20, 95% CI 1.31-3.70, P = 0.003) within 28 days of presentation to care. Finally, higher baseline levels of CRP and D-dimer were associated with worse clinical outcomes even after adjustment for BMI. Our findings suggest greater disease severity in obese individuals is characterized by more exuberant inflammation.

Keywords: COVID-19; CRP; D-dimer; ESR; Inflammation; Obesity.

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Figures

Fig. 1
Fig. 1
Obesity status is associated with inflammatory markers and clinical outcomes among hospitalized COVID-19 patients. Obese patients had higher initial and peak CRP and ESR as well as higher peak D-dimer in comparison to non-obese patients (mean and s.e.; *denotes P < 0.05 using multi-variable linear regression). Obese patients demonstrated greater odds for death, hypoxemic respiratory failure and vasopressor use.
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