Age Moderates the Effect of Obesity on Mortality Risk in Critically Ill Patients With COVID-19: A Nationwide Observational Cohort Study.
Journal
Critical care medicine
ISSN: 1530-0293
Titre abrégé: Crit Care Med
Pays: United States
ID NLM: 0355501
Informations de publication
Date de publication:
01 04 2023
01 04 2023
Historique:
pubmed:
11
2
2023
medline:
22
3
2023
entrez:
10
2
2023
Statut:
ppublish
Résumé
A high body mass index (BMI) is associated with an unfavorable disease course in COVID-19, but not among those who require admission to the ICU. This has not been examined across different age groups. We examined whether age modifies the association between BMI and mortality among critically ill COVID-19 patients. An observational cohort study. A nationwide registry analysis of critically ill patients with COVID-19 registered in the National Intensive Care Evaluation registry. We included 15,701 critically ill patients with COVID-19 (10,768 males [68.6%] with median [interquartile range] age 64 yr [55-71 yr]), of whom 1,402 (8.9%) patients were less than 45 years. None. In the total sample and after adjustment for age, gender, Acute Physiology and Chronic Health Evaluation IV, mechanical ventilation, and use of vasoactive drugs, we found that a BMI greater than or equal to 30 kg/m 2 does not affect hospital mortality (adjusted odds ratio [OR adj ] = 0.98; 95% CI, 0.90-1.06; p = 0.62). For patients less than 45 years old, but not for those greater than or equal to 45 years old, a BMI greater than or equal to 30 kg/m 2 was associated with a lower hospital mortality (OR adj = 0.59; 95% CI, 0.36-0.96; p = 0.03). A higher BMI may be favorably associated with a lower mortality among those less than 45 years old. This is in line with the so-called "obesity paradox" that was established for other groups of critically ill patients in broad age ranges. Further research is needed to understand this favorable association in young critically ill patients with COVID-19.
Identifiants
pubmed: 36762902
doi: 10.1097/CCM.0000000000005788
pii: 00003246-202304000-00005
pmc: PMC10012838
doi:
Types de publication
Observational Study
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
484-491Investigateurs
M S Arbous
(MS)
M G W Barnas
(MGW)
D P Boer
(DP)
R J Bosman
(RJ)
G B Brunnekreef
(GB)
M Th de Bruin
(MT)
M J de Graaff
(MJ)
R M de Jong
(RM)
A R de Meijer
(AR)
W de Ruijter
(W)
R de Waal
(R)
A Dijkhuizen
(A)
D A Dongelmans
(DA)
T P J Dormans
(TPJ)
A Draisma
(A)
I Drogt
(I)
B J W Eikemans
(BJW)
P W G Elbers
(PWG)
J L Epker
(JL)
M L Erkamp
(ML)
B Festen-Spanjer
(B)
T Frenzel
(T)
L Georgieva
(L)
N C Gritters
(NC)
I Z Hené
(IZ)
M Hoeksema
(M)
J W M Holtkamp
(JWM)
M E Hoogendoorn
(ME)
C J G M Jacobs
(CJGM)
I T A Janssen
(ITA)
H Kieft
(H)
M P Koetsier
(MP)
T J J Koning
(TJJ)
H Kreeftenberg
(H)
N Kusadasi
(N)
J A Lens
(JA)
J G Lutisan
(JG)
D J Mehagnoul-Schipper
(DJ)
D Moolenaar
(D)
F Nooteboom
(F)
N Postma
(N)
R V Pruijsten
(RV)
D Ramnarain
(D)
A C Reidinga
(AC)
E Rengers
(E)
A A Rijkeboer
(AA)
T Rijpstra
(T)
F W Rozendaal
(FW)
R M Schnabel
(RM)
V M Silderhuis
(VM)
J J Spijkstra
(JJ)
P E Spronk
(PE)
L F Te Velde
(LF)
L C Urlings-Strop
(LC)
A E van den Berg
(AE)
R van den Berg
(R)
I C C van der Horst
(ICC)
E M van Driel
(EM)
L van Gulik
(L)
F M van Iersel
(FM)
M van Lieshout
(M)
J A H van Oers
(JAH)
E R van Slobbe-Bijlsma
(ER)
M van Tellingen
(M)
J Vandeputte
(J)
D P Verbiest
(DP)
D J Versluis
(DJ)
E Verweij
(E)
M Vrolijk-de Mos
(M)
R M J Wesselink
(RMJ)
Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine and Wolters Kluwer Health, Inc.
Déclaration de conflit d'intérêts
Dr. Rietdijk, Sablerolles, and van der Kuy received funding for conducting COVID-19 research from the Leading Online Entrepreneur of the Year (LOEY) foundation. Drs. Termorshuizen’s and de Keizer’s institutions received funding from the National Intensive Care Evaluation (NICE) Foundation. Dr. Termorshuizen received funding from the Mental Health Care Institute Rivierduinen. Dr. de Keizer’s institution received funding from The Netherlands Organisation for Health Research and Development (ZonMw) COVID-19 Programme; she disclosed that she is a NICE board member. Although, the LOEY foundation and ZonMw provided a grant to conduct COVID-19 research, they were not involved in the design, execution, and/or publication of this study. The remaining authors have disclosed that they do not have any potential conflicts of interest.
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