Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Apr 11;23(1):228.
doi: 10.1186/s12877-023-03937-8.

Mortality in COVID-19 older patients hospitalized in a geriatric ward: Is obesity protective?

Julien Lagrandeur  1 , Pauline Putallaz  2   3 , Hélène Krief  3 , Christophe J Büla  3 , Martial Coutaz  2
Affiliations

Mortality in COVID-19 older patients hospitalized in a geriatric ward: Is obesity protective?

Julien Lagrandeur et al. BMC Geriatr. .

Abstract

Backgrounds: To investigate the relationship between obesity and 30-day mortality in a cohort of older hospitalized COVID-19 inpatients.

Methods: Included patients were aged 70 years or more; hospitalized in acute geriatric wards between March and December 2020; with a positive PCR for COVID-19; not candidate to intensive care unit admission. Clinical data were collected from patients electronic medical records. Data on 30-day mortality were retrieved from the hospital administrative database.

Results: Patients included (N = 294) were on average 83.4 ± 6.7 years old, 50.7% were women, and 21.7% were obese (BMI > 30 kg/m2). At 30-day, 85 (28.9%) patients were deceased. Compared to survivors in bivariable analysis, deceased patients were older (84.6 ± 7.6 vs 83.0 ± 6.3 years), more frequently with very complex health status (63.5% vs 39.7%, P < .001), but less frequently obese (13.4% vs 24.9%, P = .033) at admission. Over their stay, deceased patients more frequently (all P < .001) developed radiologic signs of COVID-19 (84.7% vs 58.9%), anorexia (84.7% vs 59.8%), hypernatremia (40.0% vs 10.5%), delirium (74.1% vs 30.1%), and need for oxygen (87.1% vs 46.4%) compared to survivors. In multivariable analysis that controlled for all markers of poor prognosis identified in bivariable analysis, obese patients remain with 64% (adjOR 0.36, 95%CI 0.14-0.95, P = .038) lower odds to be deceased at 30-day than non-obese patients.

Conclusions: In this population of older COVID-19 inpatients, an inverse association between obesity and 30-day mortality was observed even after adjusting for all already-known markers of poor prognosis. This result challenges previous observations in younger cohorts and would need to be replicated.

Keywords: COVID-19; Mortality; Obesity; Older persons.

PubMed Disclaimer

Conflict of interest statement

The authors declare non conflict of interest in this study.

Figures

Fig. 1
Fig. 1
Proportions of deceased patients according to Body Mass Index (BMI) categories. (N = 3 missing BMI). OB + : Obese patients (BMI > 30 kg/m2). OB -: Non obese patients (BMI < 30 kg/2). PCT + : Procalcitonine maximum level ≥ 0.25 ng/ml. PCT -: Procalcitonine maximum level < 0.25 ng/mL
Fig. 2
Fig. 2
Proportions of deceased patients according to the presence ( +) or absence (-) of obesity (OB) and PCT status (N = 3 missing BMI)
Fig. 3
Fig. 3
Results from multivariable logistic regression analysis with corresponding adjusted odds ratios and 95% confidence intervals
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Fei Z, Ting Y, Ronghui D, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395:1054–1062. doi: 10.1016/S0140-6736(20)30566-3. - DOI - PMC - PubMed
    1. Petrilli CM, Jones SA, Yang J, et al. Factors associated with hospital admission and critical illness among 5279 people with coronavirus disease2019 in New York City. Prospective cohort study BMJ. 2020;369:m1966. - PMC - PubMed
    1. Stefan N, Birkenfeld AL, Schulze MB, et al. Obesity and impaired metabolic health in patients with COVID-19. Nat Rev Endocrinol. 2020;16:341–342. doi: 10.1038/s41574-020-0364-6. - DOI - PMC - PubMed
    1. Williamson EJ, Walker AJ, Bashkaran K, et al. Factors associated with COVID-19-related death using OpenSAFELY. Nature. 2020;584:430–436. doi: 10.1038/s41586-020-2521-4. - DOI - PMC - PubMed
    1. Caussy C, Pattou F, Wallet F, et al. Prevalence of obesity among adult inpatients with COVID-19 in France. Lancet Diab Endocr. 2020;8:562–564. doi: 10.1016/S2213-8587(20)30160-1. - DOI - PMC - PubMed