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. 2021 Oct;29(10):1719-1730.
doi: 10.1002/oby.23245. Epub 2021 Aug 6.

Obesity, inflammatory and thrombotic markers, and major clinical outcomes in critically ill patients with COVID-19 in the US

Allon N Friedman  1 , John Guirguis  1 , Rajat Kapoor  2 , Shruti Gupta  3 , David E Leaf  3 , Lava R Timsina  4 ; STOP-COVID Investigators
Collaborators, Affiliations
Free article

Obesity, inflammatory and thrombotic markers, and major clinical outcomes in critically ill patients with COVID-19 in the US

Allon N Friedman et al. Obesity (Silver Spring). 2021 Oct.
Free article

Abstract

Objective: This study aimed to determine whether obesity is independently associated with major adverse clinical outcomes and inflammatory and thrombotic markers in critically ill patients with COVID-19.

Methods: The primary outcome was in-hospital mortality in adults with COVID-19 admitted to intensive care units across the US. Secondary outcomes were acute respiratory distress syndrome (ARDS), acute kidney injury requiring renal replacement therapy (AKI-RRT), thrombotic events, and seven blood markers of inflammation and thrombosis. Unadjusted and multivariable-adjusted models were used.

Results: Among the 4,908 study patients, mean (SD) age was 60.9 (14.7) years, 3,095 (62.8%) were male, and 2,552 (52.0%) had obesity. In multivariable models, BMI was not associated with mortality. Higher BMI beginning at 25 kg/m2 was associated with a greater risk of ARDS and AKI-RRT but not thrombosis. There was no clinically significant association between BMI and inflammatory or thrombotic markers.

Conclusions: In critically ill patients with COVID-19, higher BMI was not associated with death or thrombotic events but was associated with a greater risk of ARDS and AKI-RRT. The lack of an association between BMI and circulating biomarkers calls into question the paradigm that obesity contributes to poor outcomes in critically ill patients with COVID-19 by upregulating systemic inflammatory and prothrombotic pathways.

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Comment in

  • Inflammation, Obesity, and COVID-19: Facts and Flaws.
    Di Vincenzo A, Rossato M. Di Vincenzo A, et al. Obesity (Silver Spring). 2021 Nov;29(11):1747-1748. doi: 10.1002/oby.23277. Epub 2021 Aug 31. Obesity (Silver Spring). 2021. PMID: 34467656 Free PMC article. No abstract available.

References

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