Diabetes and Overweight/Obesity Are Independent, Nonadditive Risk Factors for In-Hospital Severity of COVID-19: An International, Multicenter Retrospective Meta-analysis.
Journal
Diabetes care
ISSN: 1935-5548
Titre abrégé: Diabetes Care
Pays: United States
ID NLM: 7805975
Informations de publication
Date de publication:
06 2021
06 2021
Historique:
received:
29
10
2020
accepted:
14
01
2021
pubmed:
17
4
2021
medline:
3
11
2021
entrez:
16
4
2021
Statut:
ppublish
Résumé
Obesity is an established risk factor for severe coronavirus disease 2019 (COVID-19), but the contribution of overweight and/or diabetes remains unclear. In a multicenter, international study, we investigated if overweight, obesity, and diabetes were independently associated with COVID-19 severity and whether the BMI-associated risk was increased among those with diabetes. We retrospectively extracted data from health care records and regional databases of hospitalized adult patients with COVID-19 from 18 sites in 11 countries. We used standardized definitions and analyses to generate site-specific estimates, modeling the odds of each outcome (supplemental oxygen/noninvasive ventilatory support, invasive mechanical ventilatory support, and in-hospital mortality) by BMI category (reference, overweight, obese), adjusting for age, sex, and prespecified comorbidities. Subgroup analysis was performed on patients with preexisting diabetes. Site-specific estimates were combined in a meta-analysis. Among 7,244 patients (65.6% overweight/obese), those with overweight were more likely to require oxygen/noninvasive ventilatory support (random effects adjusted odds ratio [aOR], 1.44; 95% CI 1.15-1.80) and invasive mechanical ventilatory support (aOR, 1.22; 95% CI 1.03-1.46). There was no association between overweight and in-hospital mortality (aOR, 0.88; 95% CI 0.74-1.04). Similar effects were observed in patients with obesity or diabetes. In the subgroup analysis, the aOR for any outcome was not additionally increased in those with diabetes and overweight or obesity. In adults hospitalized with COVID-19, overweight, obesity, and diabetes were associated with increased odds of requiring respiratory support but were not associated with death. In patients with diabetes, the odds of severe COVID-19 were not increased above the BMI-associated risk.
Identifiants
pubmed: 33858854
pii: dc20-2676
doi: 10.2337/dc20-2676
pmc: PMC8247499
doi:
Types de publication
Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1281-1290Investigateurs
F Anfasa
(F)
T L Benfield
(TL)
M J T Blaauw
(MJT)
L J M Boonman-de Winter
(LJM)
A L Brucato
(AL)
E A Buanes
(EA)
E Burhan
(E)
E Calabro
(E)
A Ceschi
(A)
R L Chinhoyi
(RL)
H F E W Cuijpers
(HFEW)
A Dofferhoff
(A)
X Fang
(X)
L Favre
(L)
P Ferrari
(P)
T Fomina
(T)
J A Fulcher
(JA)
A Giacomelli
(A)
D Goodman-Meza
(D)
P Goyal
(P)
A L Groenendijk
(AL)
J Hoogerwerf
(J)
S B Israelsen
(SB)
M Karolyi
(M)
A P M Kerckhoffs
(APM)
D M Kirkegaard-Klitbo
(DM)
S Koesnoe
(S)
C Luo
(C)
D C Lye
(DC)
N A B Ntusi
(NAB)
S W X Ong
(SWX)
L Oreni
(L)
H Pangestu
(H)
M Papadimitriou-Olivgeris
(M)
S Paramita
(S)
E Pawelka
(E)
L Persani
(L)
C W Pitoyo
(CW)
None Plataki
M Prasenohadi
(M)
I B Prasetya
(IB)
X Qu
(X)
M Rajan
(M)
J B Ringel
(JB)
M Safford
(M)
T Santoso
(T)
D Soranna
(D)
T Sprong
(T)
C R T Stoll
(CRT)
A D Susanto
(AD)
A F Syam
(AF)
C Torlasco
(C)
M van Apeldoorn
(M)
J S van de Maat
(JS)
K Veerman
(K)
A Verbon
(A)
X Wen
(X)
M Westerman
(M)
E-J Wils
(EJ)
Y Xia
(Y)
B E Young
(BE)
Informations de copyright
© 2021 by the American Diabetes Association.
Références
Diabetes Care. 2020 Jul;43(7):1382-1391
pubmed: 32409504
Int J Obes (Lond). 2020 Sep;44(9):1832-1837
pubmed: 32712623
Diabetes Care. 2020 Aug;43(8):1690-1694
pubmed: 32540920
PLoS One. 2020 Dec 22;15(12):e0238552
pubmed: 33351817
Metabolism. 2020 Oct;111:154319
pubmed: 32712222
Nature. 2020 Aug;584(7821):430-436
pubmed: 32640463
Diabetologia. 2007 Mar;50(3):549-54
pubmed: 17187246
Obes Rev. 2020 Nov;21(11):e13128
pubmed: 32845580
Ann Intern Med. 2020 Nov 17;173(10):773-781
pubmed: 32783686
Eur J Endocrinol. 2020 Oct;183(4):389-397
pubmed: 32674071
Diabetes Care. 2020 Oct;43(10):2345-2348
pubmed: 32788285
Lancet. 2004 Jan 10;363(9403):157-63
pubmed: 14726171
Eur J Prev Cardiol. 2020 Jul 7;:2047487320939675
pubmed: 32635756
Obesity (Silver Spring). 2013 Nov;21(11):2377-86
pubmed: 23512822
Diabetes Metab Res Rev. 2021 Jul;37(5):e3398
pubmed: 32852883
Diabetes Care. 2020 Oct;43(10):e118-e119
pubmed: 32647055
Obes Rev. 2020 Jun;21(6):e13034
pubmed: 32281287
Immunology. 2009 Feb;126(2):268-79
pubmed: 18754811
Epidemiol Rev. 2007;29:29-48
pubmed: 17478442
Cell Metab. 2020 Jun 2;31(6):1068-1077.e3
pubmed: 32369736
Endocrinol Jpn. 1992 Feb;39(1):1-7
pubmed: 1318829
Ann Intern Med. 2020 Nov 17;173(10):782-790
pubmed: 32726151
Int J Biochem Cell Biol. 2012 Aug;44(8):1203-13
pubmed: 22565168
Proc Natl Acad Sci U S A. 2020 Sep 1;117(35):21011-21013
pubmed: 32788355
BMJ. 2020 May 22;369:m1966
pubmed: 32444366
Elife. 2020 Jul 22;9:
pubmed: 32697191
Obesity (Silver Spring). 2020 Sep;28(9):1595-1599
pubmed: 32445512
Front Cell Infect Microbiol. 2018 Oct 08;8:343
pubmed: 30349811
Prim Care. 2016 Mar;43(1):121-35, ix
pubmed: 26896205
J Infect Dis. 2020 Aug 4;222(5):820-831
pubmed: 32246148
Diabetologia. 2020 Aug;63(8):1500-1515
pubmed: 32472191
Diabetes Metab Syndr. 2020 Sep - Oct;14(5):1133-1142
pubmed: 32663789
Obesity (Silver Spring). 2020 Jul;28(7):1195-1199
pubmed: 32271993
Med (N Y). 2020 Dec 18;1(1):33-42
pubmed: 32838359