Plain language summary
Patients at risk for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) have been characterized as having pre-existing diseases, such as hypertension, cardiovascular disease, diabetes, chronic respiratory disease or cancer. The aim of this study was to investigate the association between body mass index (BMI) and clinical characteristics and the need for invasive mechanical ventilation (IMV) in patients admitted to intensive care for SARS-CoV-2. The study is a single-centred retrospective cohort study which enrolled patients (n=124) admitted to intensive care for SARS-CoV-2. Results demonstrated high frequency of obesity among patients admitted to intensive care for SARS-CoV-2. Furthermore, the need for IMV, a robust proxy for the severity of SARS-CoV-2, gradually increased with body mass categories, reaching nearly 90% in patients with BMI ≥ 35. Authors conclude that patients with obesity, especially those with severe obesity, should take extra measures to avoid COVID-19 contamination by enforcing prevention during the current pandemic.
Abstract
OBJECTIVE The COVID-19 pandemic is rapidly spreading worldwide, notably in Europe and North America where obesity is highly prevalent. The relation between obesity and severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has not been fully documented. METHODS This retrospective cohort study analyzed the relationship between clinical characteristics, including BMI, and the requirement for invasive mechanical ventilation (IMV) in 124 consecutive patients admitted in intensive care for SARS-CoV-2 in a single French center. RESULTS Obesity (BMI > 30) and severe obesity (BMI > 35) were present in 47.6% and 28.2% of cases, respectively. Overall, 85 patients (68.6%) required IMV. The proportion of patients who required IMV increased with BMI categories (P < 0.01, χ2 test for trend), and it was greatest in patients with BMI > 35 (85.7%). In multivariate logistic regression, the need for IMV was significantly associated with male sex (P < 0.05) and BMI (P < 0.05), independent of age, diabetes, and hypertension. The odds ratio for IMV in patients with BMI > 35 versus patients with BMI < 25 was 7.36 (1.63-33.14; P = 0.02). CONCLUSIONS The present study showed a high frequency of obesity among patients admitted in intensive care for SARS-CoV-2. Disease severity increased with BMI. Obesity is a risk factor for SARS-CoV-2 severity, requiring increased attention to preventive measures in susceptible individuals.
Methodological quality
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