Background: SARS-CoV-2disease (COVID-19) has become pandemic all over world. This study aimed to investigate the clinical characteristics and severe outcomes of COVID-19 patients with high body mass index (BMI). Methods: A cohort study included 114 adult patients confirmed COVID-19 were classified by BMI levels on admission: overweight (25–29.9 kg/m2), and obesity (four categories: 30–34.9 kg/m2, 35–39.9 kg/m2, 40–44.9 kg/m2, and ≥45 kg/m2). The rate of pneumonia, severe pneumonia and ICU admission were our primary outcomes, complications and length of hospital stay were the secondary outcome. Results: In Qena University isolation Hospital, study was conducted in 114 patients confirmed COVID-19. The mean age of patients was 42.1±11.1 years and males were 53.5%. Hypertension and diabetes common comorbidities, 54 patients (47.3%) had pneumonia and 28 patients (24.6%) had progressed to severe pneumonia with significant difference across BMI level (p<0.05). The rates of admission to ICU were 13.1%, acute kidney injury (7.8%), acute liver injury (5.2%) and shock (7%), ICU mortality with BMI 40–44.9 kg/m2 and ≥45 kg/m2 showed 100% mortality among patients admitted (p <0.001), with median of days of hospitalization (12days). Multivariable analysis demonstrated that; BMI (increase one kg/m2), Hypertension, Dyslipidemia, Lymphopenia, CRP and IL6 independent risk factors for severe illness. Conclusion: Serious outcomes such as severe pneumonia, acute kidney injury and ICU mortality are associated with obesity and COVID-19. Call for future studies to find out the correlation between obesity and COVID-19.
| Published in | International Journal of Anesthesia and Clinical Medicine (Volume 9, Issue 1) |
| DOI | 10.11648/j.ijacm.20210901.14 |
| Page(s) | 16-22 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2021. Published by Science Publishing Group |
High BMI, COVID-19, Sever Pneumonia, IL6
| [1] | Cossarizza A, De Biasi S, Guaraldi G, Girardis M, Mussini C. SARS-CoV-2, the virus that causes COVID-19: Cytometry and the new challenge for Global Health. Cytometry A. 2020; 97 (4): 340–3. |
| [2] | Ayittey FK, Ayittey MK, Chiwero NB, Kamasah JS, Dzuvor C. Economic impacts of Wuhan 2019-nCoV on China and the world. J Med Virol. 2020; 92 (5): 473–5. |
| [3] | Armocida B, Formenti B, Ussai S, Palestra F, Missoni E. The Italian health system and the COVID-19 challenge. Lancet Public Health. 2020; 5 (5): e253. |
| [4] | Zhu N, Zhang D, Wang W, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020; 382 (8): 727–33. |
| [5] | Phelan AL, Katz R, Gostin LO. The novel coronavirus originating in Wuhan, China: challenges for Global Health governance. Jama. 2020. https://doi.org/10.1001/jama.2020.1097. |
| [6] | Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet (London, England). 2020; 395 (10223): 507–13. |
| [7] | Guan W-jie, Liang W-hua, Zhao Y, et al. Comorbidity and its impact on 1590 patients with Covid-19 in China: A Nationwide Analysis. Eur Respir J 2020; inpress (https://doi.org/10.1183/13993003.00547-2020). |
| [8] | Kassir, R. (2020). Risk of COVID-19 for patients with obesity. Obesity Reviews, 21 (6). doi: 10.1111/obr.13034. |
| [9] | Keys A, Fidanza F, Karvonen MJ, Kimura N, Taylor HL. Indices of relative weight and obesity. J Chron Dis 1972; 25 (6): 329–43. https://doi.org/10.1016/0021-9681(72)90027-6 PMID: 4650929. |
| [10] | Fischer-Posovszky P, Moller P. [The immune system of adipose tissue: obesity-associated inflammation]. Pathologe 2020. |
| [11] | Letko M, Marzi A, Munster V. Functional assessment of cell entry and receptor usage for SARS-CoV-2 and other lineage B betacoronaviruses. Nat Microbiol. 2020; 5 (4): 562–9. |
| [12] | Gu J, Korteweg C. Pathology and pathogenesis of severe acute respiratory syndrome. Am J Pathol. 2007; 170 (4): 1136–47. |
| [13] | Guo Y, Korteweg C, McNutt MA, Gu J. Pathogenetic mechanisms of severe acute respiratory syndrome. Virus Res. 2008; 133 (1): 4–12. |
| [14] | Xiao F, Tang M, Zheng X, Liu Y, Li X, Shan H. Evidence for gastrointestinal infection of SARS-CoV-2. Gastroenterology. 2020; 158 (6): 1831–1833. e3. |
| [15] | Zou X, Chen K, Zou J, Han P, Hao J, Han Z. Single-cell RNA-seq data analysis on the receptor ACE2 expression reveals the potential risk of different human organs vulnerable to 2019-nCoV infection. Front Med. 2020; 14 (2): 185–92. |
| [16] | Jia X, Yin C, Lu S, Chen Y, Liu Q, Bai J, Lu Y. Two things about COVID-19 might need attention. Preprint at https://www.preprints.org/manuscript/202002.0315/v1. Accessed 27 Jan 2021. |
| [17] | Van Kerkhove MD, Vandemaele KA, Shinde V, et al. Risk factors for severe outcomes following 2009 influenza a (H1N1) infection: a global pooled analysis. PLoS Med. 2011; 8 (7): e1001053. |
| [18] | Sun Y, Wang Q, Yang G, Lin C, Zhang Y, Yang P. Weight and prognosis for influenza A (H1N1) pdm 09 infection during the pandemic period between 2009 and 2011: a systematic review of observational studies with metaanalysis. Infect Dis. 2016; 48 (11–12): 813–#. |
| [19] | Defining Adult Overweight & Obesity https://www.cdc.gov/obesity/adult/defining.html#. |
| [20] | World Health Organization. Clinical management of severe acute respiratory infection when Novel Coronavirus (nCoV) infection is suspected: interim guidance. January 28, 2020. [cited 2020/4/15]; Available from: https://www.who.int/publications-detail/clinical-management-of-severe-acute-respiratoryinfection-when-novel-coronavirus- (ncov)-infection-is-suspected. |
| [21] | Kidney Disease: Improving Global Outcomes (KDIGO) Acute Kidney Injury Work Group KDIGO clinical practice guidelines for acute kidney injury. Kidney Int. Suppl. 2012; 2: 1–138. |
| [22] | Pranata R, Lim MA, Yonas E, Vania R, Lukito AA, Siswanto BB, et al. Body mass index and outcome in patients with COVID-19: A dose-response meta-analysis. Diabetes Metab 2020; S1262-3636 (20) 30097-5. https://doi.org/10.1016/j.diabet.2020.07.005 PMID: 32738402. |
| [23] | Murugan AT, Sharma G. Obesity and respiratory diseases. Chron Respir Dis 2008; 5 (4): 233–42. https://doi.org/10.1177/1479972308096978 PMID: 19029235. |
| [24] | Tartof SY, Qian L, Hong V, et al. Obesity and mortality among patients diagnosed with COVID-19: results from an integrated health care organization. Ann Intern Med 2020; 173: 773–81. PMID: 32783686 https://doi.org/10.7326/M20-3742. |
| [25] | Anderson MR, Geleris J, Anderson DR, et al. Body mass index and risk for intubation or death in SARS-CoV-2 infection: a retrospective cohort study. Ann Intern Med 2020; 173: 782–90. PMID: 32726151 https://doi.org/10.7326/M20-321. |
| [26] | Bourgeois C, Gorwood J, Barrail-Tran A, et al. Specific biological features of adipose tissue, and their impact on HIV persistence. Front Microbiol. 2019; 10: 2837. |
| [27] | Huttunen R, Syrjänen J. Obesity and the risk and outcome of infection. Int JObes. 2013; 37 (3): 333–40. |
| [28] | Dobner J, Kaser S. Body mass index and the risk of infection – from underweight to obesity. Clin Microbiol Infect. 2018; 24 (1): 24–8. |
| [29] | Wu C, Chen X, Cai Y, Xia J, Zhou X, Xu S, et al. Risk Factors Associated With Acute Respiratory Distress Syndrome and Death in Patients With Coronavirus Disease 2019 Pneumonia in Wuhan, China. JAMA Intern Med. 2020; e200994. https://doi.org/10.1001/jamainternmed.2020.0994 PMID: 32167524. |
| [30] | Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical Characteristics of 138 Hospitalized PatientsWith 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020; 323 (11): 1061-9. https://doi.org/10.1001/jama.2020.1585 PMID: 32031570. |
| [31] | Stefan N, Birkenfeld AL, Schulze MB, Ludwig DS. Obesity and Impaired Metabolic Health in Patients With COVID-19. Nat Rev Endocrinol 2020; 16 (7): 341–342. https://doi.org/10.1038/s41574-020-0364-6PMID: 32327737. |
| [32] | Strissel KJ, DeFuria J, Shaul ME, Bennett G, Greenberg AS, Obin MS. T-cell recruitment and Th1 polarization in adipose tissue during diet-induced obesity in C57BL/6 mice. Obesity (Silver Spring). 2010; 18 (10): 1918-25. |
| [33] | McGonagle D, Sharif K, O’Regan A, Bridgewood C. The Role of Cytokines including Interleukin-6 inCOVID-19 induced Pneumonia and Macrophage Activation Syndrome-Like Disease. Autoimmun Rev. 2020; 19 (6): 102537. https://doi.org/10.1016/j.autrev.2020.102537 PMID: 32251717. |
| [34] | Batlle D, Soler MJ, Sparks MA, Hiremath S, South AM, Welling PA, et al. Acute Kidney Injury in COVID-19: Emerging Evidence of a Distinct Pathophysiology. JASN May 2020, ASN. 2020040419. https://doi.org/10.1681/ASN.2020040419 PMID: 32366514. |
| [35] | Joannidis M, Forni LG, Klein SJ, Honore PH, Kashani K, Ostermann M, et al. Lung-kidney interactions in critically ill patients: consensus report of the Acute Disease Quality Initiative (ADQI) 21 Workgroup. Intensive Care Med. 2020; 46 (4): 654-72. https://doi.org/10.1007/s00134-019-05869-7 PMID: 31820034. |
| [36] | Sun J, Aghemo A, Forner A, Valenti L. COVID-19 and liver disease. Liver Int. 2020 Apr 6. |
| [37] | Gerberding JL, Morgan JG, Shepard JA, Kradin RL. Case records of theMassachusetts General Hospital. Weekly clinicopathological exercises. Case9-2004. An 18-year-old man with respiratory symptoms and shock. N Engl JMed. 2004; 350 (12): 1236–47. |
| [38] | Fleury H, Burrel S, Balick Weber C, et al. Prolonged shedding of influenza (H1N1) virus: two case reports from France 2009. Euro Surveill. 2009; 14 (49): 19434. |
| [39] | Nakajima N, Hata S, Sato Y, et al. The first autopsy case of pandemic influenza (a/H1N1pdm) virus infection in Japan: detection of a high copynumber of the virus in type II alveolar epithelial cells by pathological andvirological examination. Jpn J Infect Dis. 2010; 63 (1): 67–71. |
| [40] | Caci G, Albini A, Malerba M, Noonan DM, Pochettiand P, Polosa R. COVID-19and obesity: dangerous liaisons. J Clin Med. 2020; 9 (8): 2511. |
APA Style
Gad Sayed Gad Abdel-Gelil. (2021). High Body Mass Index and Severity of Coronavirus Disease 2019 (COVID-19): A Cohort Study. International Journal of Anesthesia and Clinical Medicine, 9(1), 16-22. https://doi.org/10.11648/j.ijacm.20210901.14
ACS Style
Gad Sayed Gad Abdel-Gelil. High Body Mass Index and Severity of Coronavirus Disease 2019 (COVID-19): A Cohort Study. Int. J. Anesth. Clin. Med. 2021, 9(1), 16-22. doi: 10.11648/j.ijacm.20210901.14
Share This Article
Twitter
Linked In
Facebook
Copy
Download@article{10.11648/j.ijacm.20210901.14,
author = {Gad Sayed Gad Abdel-Gelil},
title = {High Body Mass Index and Severity of Coronavirus Disease 2019 (COVID-19): A Cohort Study},
journal = {International Journal of Anesthesia and Clinical Medicine},
volume = {9},
number = {1},
pages = {16-22},
doi = {10.11648/j.ijacm.20210901.14},
url = {https://doi.org/10.11648/j.ijacm.20210901.14},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijacm.20210901.14},
abstract = {Background: SARS-CoV-2disease (COVID-19) has become pandemic all over world. This study aimed to investigate the clinical characteristics and severe outcomes of COVID-19 patients with high body mass index (BMI). Methods: A cohort study included 114 adult patients confirmed COVID-19 were classified by BMI levels on admission: overweight (25–29.9 kg/m2), and obesity (four categories: 30–34.9 kg/m2, 35–39.9 kg/m2, 40–44.9 kg/m2, and ≥45 kg/m2). The rate of pneumonia, severe pneumonia and ICU admission were our primary outcomes, complications and length of hospital stay were the secondary outcome. Results: In Qena University isolation Hospital, study was conducted in 114 patients confirmed COVID-19. The mean age of patients was 42.1±11.1 years and males were 53.5%. Hypertension and diabetes common comorbidities, 54 patients (47.3%) had pneumonia and 28 patients (24.6%) had progressed to severe pneumonia with significant difference across BMI level (p2 and ≥45 kg/m2 showed 100% mortality among patients admitted (p 2), Hypertension, Dyslipidemia, Lymphopenia, CRP and IL6 independent risk factors for severe illness. Conclusion: Serious outcomes such as severe pneumonia, acute kidney injury and ICU mortality are associated with obesity and COVID-19. Call for future studies to find out the correlation between obesity and COVID-19.},
year = {2021}
}
TY - JOUR T1 - High Body Mass Index and Severity of Coronavirus Disease 2019 (COVID-19): A Cohort Study AU - Gad Sayed Gad Abdel-Gelil Y1 - 2021/05/15 PY - 2021 N1 - https://doi.org/10.11648/j.ijacm.20210901.14 DO - 10.11648/j.ijacm.20210901.14 T2 - International Journal of Anesthesia and Clinical Medicine JF - International Journal of Anesthesia and Clinical Medicine JO - International Journal of Anesthesia and Clinical Medicine SP - 16 EP - 22 PB - Science Publishing Group SN - 2997-2698 UR - https://doi.org/10.11648/j.ijacm.20210901.14 AB - Background: SARS-CoV-2disease (COVID-19) has become pandemic all over world. This study aimed to investigate the clinical characteristics and severe outcomes of COVID-19 patients with high body mass index (BMI). Methods: A cohort study included 114 adult patients confirmed COVID-19 were classified by BMI levels on admission: overweight (25–29.9 kg/m2), and obesity (four categories: 30–34.9 kg/m2, 35–39.9 kg/m2, 40–44.9 kg/m2, and ≥45 kg/m2). The rate of pneumonia, severe pneumonia and ICU admission were our primary outcomes, complications and length of hospital stay were the secondary outcome. Results: In Qena University isolation Hospital, study was conducted in 114 patients confirmed COVID-19. The mean age of patients was 42.1±11.1 years and males were 53.5%. Hypertension and diabetes common comorbidities, 54 patients (47.3%) had pneumonia and 28 patients (24.6%) had progressed to severe pneumonia with significant difference across BMI level (p2 and ≥45 kg/m2 showed 100% mortality among patients admitted (p 2), Hypertension, Dyslipidemia, Lymphopenia, CRP and IL6 independent risk factors for severe illness. Conclusion: Serious outcomes such as severe pneumonia, acute kidney injury and ICU mortality are associated with obesity and COVID-19. Call for future studies to find out the correlation between obesity and COVID-19. VL - 9 IS - 1 ER -
Information
Email: