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

<h4>Background</h4>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...

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Autores principales:	Lovisa Sjögren, Erik Stenberg, Meena Thuccani, Jari Martikainen, Christian Rylander, Ville Wallenius, Torsten Olbers, Jenny M Kindblom
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/b4166b73cd904841ac16fc63c4b86fb4
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spelling	oai:doaj.org-article:b4166b73cd904841ac16fc63c4b86fb42021-12-02T20:07:55ZImpact of obesity on intensive care outcomes in patients with COVID-19 in Sweden-A cohort study.1932-620310.1371/journal.pone.0257891https://doaj.org/article/b4166b73cd904841ac16fc63c4b86fb42021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0257891https://doaj.org/toc/1932-6203<h4>Background</h4>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.<h4>Methods and findings</h4>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 ≥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 ≥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 ≥ 35 kg/m2 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. The main limitations were the restriction to the first wave of the pandemic, and the lack of information on socioeconomic status as well as smoking.<h4>Conclusions</h4>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.Lovisa SjögrenErik StenbergMeena ThuccaniJari MartikainenChristian RylanderVille WalleniusTorsten OlbersJenny M KindblomPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 10, p e0257891 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Lovisa Sjögren Erik Stenberg Meena Thuccani Jari Martikainen Christian Rylander Ville Wallenius Torsten Olbers Jenny M Kindblom Impact of obesity on intensive care outcomes in patients with COVID-19 in Sweden-A cohort study.
description	<h4>Background</h4>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.<h4>Methods and findings</h4>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 ≥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 ≥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 ≥ 35 kg/m2 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. The main limitations were the restriction to the first wave of the pandemic, and the lack of information on socioeconomic status as well as smoking.<h4>Conclusions</h4>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.
format	article
author	Lovisa Sjögren Erik Stenberg Meena Thuccani Jari Martikainen Christian Rylander Ville Wallenius Torsten Olbers Jenny M Kindblom
author_facet	Lovisa Sjögren Erik Stenberg Meena Thuccani Jari Martikainen Christian Rylander Ville Wallenius Torsten Olbers Jenny M Kindblom
author_sort	Lovisa Sjögren
title	Impact of obesity on intensive care outcomes in patients with COVID-19 in Sweden-A cohort study.
title_short	Impact of obesity on intensive care outcomes in patients with COVID-19 in Sweden-A cohort study.
title_full	Impact of obesity on intensive care outcomes in patients with COVID-19 in Sweden-A cohort study.
title_fullStr	Impact of obesity on intensive care outcomes in patients with COVID-19 in Sweden-A cohort study.
title_full_unstemmed	Impact of obesity on intensive care outcomes in patients with COVID-19 in Sweden-A cohort study.
title_sort	impact of obesity on intensive care outcomes in patients with covid-19 in sweden-a cohort study.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/b4166b73cd904841ac16fc63c4b86fb4
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Impact of obesity on intensive care outcomes in patients with COVID-19 in Sweden-A cohort study.

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