Key result
Higher BMI in critical COVID-19 links to ARDS and AKI-RRT but not mortality or thrombosis.
Why the study?
It was unknown whether obesity is independently associated with major adverse clinical outcomes and inflammatory and thrombotic markers in critically ill patients with COVID-19.
Does obesity increase the risk of major adverse clinical outcomes and inflammatory/thrombotic markers in critically ill patients with COVID-19?
Observational
Yes
Does obesity increase the risk of major adverse clinical outcomes and inflammatory/thrombotic markers in critically ill patients with COVID-19?
In critically ill COVID-19 patients, higher BMI is associated with increased risk of ARDS and AKI-RRT, but not with mortality, thrombotic events, or elevated inflammatory/thrombotic markers.
Obesity may link to worse ICU outcomes in COVID-19 via inflammation; leaves open targeted interventions pending prospective data.
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: 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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Friedman et al. (2021) conducted an observational in critically ill patients with COVID-19. Obesity / Higher BMI was evaluated on in-hospital mortality. In critically ill patients with COVID-19, higher BMI was not associated with in-hospital mortality or thrombotic events, but was associated with a greater risk of ARDS and AKI-RRT.
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