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Age Moderates the Effect of Obesity on Mortality Risk in Critically Ill Patients With COVID-19: A Nationwide Observational Cohort Study*

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 COV...

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Autores principales: den Uil, Corstiaan A., Termorshuizen, Fabian, Rietdijk, Wim J. R., Sablerolles, Roos S. G., van der Kuy, Hugo P. M., Haas, Lenneke E. M., van der Voort, Peter H. J., de Lange, Dylan W., Pickkers, Peter, de Keizer, Nicolette F.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10012838/
https://www.ncbi.nlm.nih.gov/pubmed/36762902
http://dx.doi.org/10.1097/CCM.0000000000005788
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author den Uil, Corstiaan A.
Termorshuizen, Fabian
Rietdijk, Wim J. R.
Sablerolles, Roos S. G.
van der Kuy, Hugo P. M.
Haas, Lenneke E. M.
van der Voort, Peter H. J.
de Lange, Dylan W.
Pickkers, Peter
de Keizer, Nicolette F.
author_facet den Uil, Corstiaan A.
Termorshuizen, Fabian
Rietdijk, Wim J. R.
Sablerolles, Roos S. G.
van der Kuy, Hugo P. M.
Haas, Lenneke E. M.
van der Voort, Peter H. J.
de Lange, Dylan W.
Pickkers, Peter
de Keizer, Nicolette F.
author_sort den Uil, Corstiaan A.
collection PubMed
description 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. DESIGN: An observational cohort study. SETTING: A nationwide registry analysis of critically ill patients with COVID-19 registered in the National Intensive Care Evaluation registry. PATIENTS: 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. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: 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). CONCLUSIONS: 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.
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spelling pubmed-100128382023-03-14 Age Moderates the Effect of Obesity on Mortality Risk in Critically Ill Patients With COVID-19: A Nationwide Observational Cohort Study* den Uil, Corstiaan A. Termorshuizen, Fabian Rietdijk, Wim J. R. Sablerolles, Roos S. G. van der Kuy, Hugo P. M. Haas, Lenneke E. M. van der Voort, Peter H. J. de Lange, Dylan W. Pickkers, Peter de Keizer, Nicolette F. Crit Care Med Clinical Investigations 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. DESIGN: An observational cohort study. SETTING: A nationwide registry analysis of critically ill patients with COVID-19 registered in the National Intensive Care Evaluation registry. PATIENTS: 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. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: 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). CONCLUSIONS: 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. Lippincott Williams & Wilkins 2023-02-10 2023-04 /pmc/articles/PMC10012838/ /pubmed/36762902 http://dx.doi.org/10.1097/CCM.0000000000005788 Text en 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. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY) (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Investigations
den Uil, Corstiaan A.
Termorshuizen, Fabian
Rietdijk, Wim J. R.
Sablerolles, Roos S. G.
van der Kuy, Hugo P. M.
Haas, Lenneke E. M.
van der Voort, Peter H. J.
de Lange, Dylan W.
Pickkers, Peter
de Keizer, Nicolette F.
Age Moderates the Effect of Obesity on Mortality Risk in Critically Ill Patients With COVID-19: A Nationwide Observational Cohort Study*
title Age Moderates the Effect of Obesity on Mortality Risk in Critically Ill Patients With COVID-19: A Nationwide Observational Cohort Study*
title_full Age Moderates the Effect of Obesity on Mortality Risk in Critically Ill Patients With COVID-19: A Nationwide Observational Cohort Study*
title_fullStr Age Moderates the Effect of Obesity on Mortality Risk in Critically Ill Patients With COVID-19: A Nationwide Observational Cohort Study*
title_full_unstemmed Age Moderates the Effect of Obesity on Mortality Risk in Critically Ill Patients With COVID-19: A Nationwide Observational Cohort Study*
title_short Age Moderates the Effect of Obesity on Mortality Risk in Critically Ill Patients With COVID-19: A Nationwide Observational Cohort Study*
title_sort age moderates the effect of obesity on mortality risk in critically ill patients with covid-19: a nationwide observational cohort study*
topic Clinical Investigations
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10012838/
https://www.ncbi.nlm.nih.gov/pubmed/36762902
http://dx.doi.org/10.1097/CCM.0000000000005788
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