Journal Article

Impact of obesity on intensive care outcomes in patients with COVID-19 in Sweden—A cohort study

Martikainen, Jari, Stenberg, Erik, Kindblom, Jenny M., Sjögren, Lovisa, Olbers, Torsten, Wallenius, Ville, Rylander, Christian, Thuccani, Meena

2021

Overview

Previous studies have shown that a high body mass index (BMI) is a risk factor for severe COVID-19. The aim of the present study was to assess whether a high BMI affects the risk of death or prolonged length of stay (LOS) in patients with COVID-19 during intensive care in Sweden. In this observational, register-based study, we included patients with COVID-19 from the Swedish Intensive Care Registry admitted to intensive care units (ICUs) in Sweden. Outcomes assessed were death during intensive care and ICU LOS [greater than or equal to]14 days. We used logistic regression models to evaluate the association (odds ratio [OR] and 95% confidence interval [CI]) between BMI and the outcomes. Valid weight and height information could be retrieved in 1,649 patients (1,227 (74.4%) males) with COVID-19. We found a significant association between BMI and the risk of the composite outcome death or LOS [greater than or equal to]14 days in survivors (OR per standard deviation [SD] increase 1.30, 95%CI 1.16-1.44, adjusted for sex, age and comorbidities), and this association remained after further adjustment for severity of illness (simplified acute physiology score; SAPS3) at ICU admission (OR 1.30 per SD, 95%CI 1.17-1.45). Individuals with a BMI [greater than or equal to] 35 kg/m.sup.2 had a doubled risk of the composite outcome. A high BMI was also associated with death during intensive care and a prolonged LOS in survivors assessed as separate outcomes. In this large cohort of Swedish ICU patients with COVID-19, a high BMI was associated with increasing risk of death and prolonged length of stay in the ICU. Based on our findings, we suggest that individuals with obesity should be more closely monitored when hospitalized for COVID-19.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Anestesi och intensivvård / Anesthesiology / Anesthesiology and Intensive Care / Biology and Life Sciences / Body mass / Body mass index / Body size / Cardiovascular disease / Care and treatment / Cohort analysis / Confidence intervals / Coronaviruses / COVID-19 / Death / Diabetes / Evaluation / Health risks / Hospital patients / Hospitalization / Hospitals / Hypertension / Information retrieval / Intensive care / Intensive care nursing / Intensive care units / Internal medicine / Investigations / Kidney diseases / Length of stay / Liver diseases / Medicine / Medicine and Health Sciences / Mortality / Nutrition / Obesity / Overweight / Pandemics / Pediatrics / Pneumonia / Regression analysis / Regression models / Risk analysis / Risk factors / Severe acute respiratory syndrome coronavirus 2 / Socio-economic aspects / Socioeconomics / Statistical analysis / Variables / Ventilators