Body mass index and severe COVID-19

The COVID-19 pandemic has affected more than 60 million people worldwide, with nearly 1.43 million suffering from severe COVID-19 disease and nearly 40 million recovering. Severe Acute Respiratory Syndrome The COVID-19 disease caused by coronavirus 2 (SARS-CoV-2) is severe and causes life-threatening complications in a small proportion of individuals. Several risk factors are associated with severe COVID-19, one of which is obesity.

A French researcher led by Abdullah Alsalame, lead author of the Department of Endocrinology, Diabetes and Nutrition at the Amiens University Hospital in Amiens, France, titled “Relationship between Body Mass Index Class and Coronavirus Disease 2019 Results” We announced the research results. , ”In the latest issue International Journal of Obesity..

Background and purpose of research

Obesity, high obesity index, and diabetes are known to be risk factors for the severe course of COVID-19. Researchers have found that nearly 40% of hospitalized patients are obese with a high BMI, based on the evidence available in the scientific literature. For example, pathological obesity is usually associated with the severe clinical course of the illness they wrote.

Obesity and COVID-19 pathology

Researchers explain that obese people often have impaired respiratory function, which tends to yield to other respiratory infections as well as SARS-CoV-2 infections.

In addition, abdominal obesity is associated with mild inflammation, which can alter the immune response to infections, including COVID-19 disease. Researchers explain that obese people are most often diabetic and may have heart disease and other metabolic problems. They add that these comorbidities make them vulnerable to SARSCoV-2 infection.

The main purpose of this study was to quantify the association between the classification of obesity index (a measure of obesity) and important forms of COVID-19. Researchers say it’s important to understand the relationship between obesity and COVID-19 in order to provide care to vulnerable individuals and prevent adverse consequences.

Study design

For this study, researchers included a series of adult patients with COVID-19 identified in the laboratory who needed to be hospitalized. They were all admitted to the Amiens University Hospital (Amiens, France). Data on patients were collected retroactively from the hospital database.

Confirmed COVID-19 was a case confirmed by reverse transcriptase-polymerase chain reaction (RT-PCR) assay. Nasopharyngeal swab Specimen. Only patients who agreed to participate in the study or their legal guardians were included in the analysis. For the purposes of this study, normal body weight patients had a BMI of less than 25 kg / m.²..

The important parameters recorded are:

• Demographic data including age, gender, BMI and social factors
• Risk factor
• Medical history
• Ingestion history of drugs of particular concern
• Detailed clinical data
• Daily test results
• Patient outcome

The main endpoints of the evaluation are:

• With admission to the intensive care unit (ICU)
• death

The secondary endpoints of the study are:

• Need for mechanical ventilation
• Diagnosis of acute respiratory distress syndrome (ARDS, according to Berlin standards) specified in the ICU exit note
• Diagnosis of acute coronary syndrome (serum levels of sensitive cardiac troponin Ic above the 99th percentile of the normal population as seen on ECG / echocardiography)
• Acute renal failure (according to the Global Outcome Guidelines for Kidney Disease Improvement)
• Secondary infection
• Whole hospital stay

The association between BMI categories and endpoints was made using logistic regression analysis.

Survey results

Overall, a total of 433 patients admitted with COVID-19 were included in the study. The summary of the results is as follows.

• Among the 329 patients for whom BMI was collected:
  • 20 (6.1 percent) were underweight
  • 95 (28.9 percent) was normal weight
  • 90 (27.4 percent) was overweight
  • 124 (37.7 percent) were obese
• The median ages for the various BMI categories are:
  • Underweight – 84.5 years
  • Normal weight – 81 years
  • Overweight – 71 years old
  • Obesity – 66 years old
• ICU admission was 35.1% and 52.6% for overweight and obese patients, respectively.
• 23% and 36.1% of deaths were seen in overweight and obese patients, respectively.
• The odds ratios for serious illness associated with death or major endpoints of ICU admission by various BMI categories are as follows:
  • Overweight – odds ratio 1.58 [0.77–3.24]
  • Obesity-odds ratio 2.58 [1.28–5.31]
• The odds ratios for serious illnesses associated with ICU admission by different BMI categories are:
  • Overweight – odds ratio 3.16 [1.29–8.06]
  • Obesity-odds ratio 3.05 [1.25–7.82]
• Unadjusted OR of death was the same for all BMI categories

Conclusions and implications

The team wrote that “… obesity was significantly associated with a higher likelihood of developing a primary endpoint (death or ICU admission).”The researcher wrote it Overweight More clearly associated with ICU entry. The team concluded that: “The frequency of the primary endpoint for COVID-19 patients was found to be twice as high in obese individuals as in individuals with a BMI of less than 25 kg / m.².. They called for future, larger studies in other populations to understand the association between BMI and the adverse outcomes of COVID-19 patients.