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The Effect of Body Mass Index on Outcomes among COVID-19 Patients with Left Ventricular Assist Devices: A Multi-Institutional Study

PURPOSE: Infection with the Coronavirus (SARS-CoV-2) is particularly dangerous for patients with left ventricular assist devices (LVAD). Obesity is associated with worse outcomes among both LVAD and SARS-CoV-2 patients. This study evaluated the risk of obesity among LVAD patients who contracted SARS...

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Detalles Bibliográficos
Autores principales: Han, J.J., Iyengar, A., Helmers, M.R., Smood, B.F., Patrick, W.L., Kelly, J.J., Moss, N., Najjar, S.S., Houston, B.A., Tedford, R.J., Shore, S., Vorovich, E., Hsich, E., Alexander, K.M., Chaudhry, S., Vidula, H., Kilic, A., Genuardi, M.V., Birati, E.Y., Atluri, P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Published by Elsevier Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7979333/
http://dx.doi.org/10.1016/j.healun.2021.01.331
Descripción
Sumario:PURPOSE: Infection with the Coronavirus (SARS-CoV-2) is particularly dangerous for patients with left ventricular assist devices (LVAD). Obesity is associated with worse outcomes among both LVAD and SARS-CoV-2 patients. This study evaluated the risk of obesity among LVAD patients who contracted SARS-CoV-2. METHODS: A prospectively maintained Trans-CoV-VAD Registry of LVAD patients from 11 institutions who presented with SARS-CoV-2 was analyzed. Two cohorts, 1) non-obese and 2) obese, were formed utilizing a body mass index (BMI) cutoff of 30 k/m(2). Presenting characteristics, hospitalization rates, ventilator & intensive care unit usage, and mortality were compared. Chi-squared, Fisher's exact test, Mann-Whitney U-tests and multivariable logistic regression models were utilized. RESULTS: Across all centers, 46 LVAD patients contracted SARS-CoV-2 during the study period of whom 19 (41%) were obese. Time from LVAD implantation to infection was 2.4±2.5 years. Age and gender profiles were similar. Non-obese and obese patients had similar presenting symptoms, most commonly cough (52% vs 47%), fever (48% vs 37%), dyspnea (41% vs 47%) and fatigue (41% vs 37%). No difference in rates of hospital (70% vs 63%, p 0.8) and ICU admissions (26% vs 37%, p 0.3) was observed. Hospital (20.0±23.2 vs 17.1±14.2) and ICU length of stay were similar (16.2±26.1 vs. 13.9±13.1 days). Obese patients were more likely to require mechanical ventilation than non-obese patients (7% vs 26%, p<0.05). Overall risk of mortality was significantly elevated but similar (19% vs 16%, p 0.9). On multivariable modeling, BMI was not associated with increased risk of hospitalization, ICU admission or mechanical ventilation (p>0.10). CONCLUSION: Among LVAD patients who contract SARS-CoV-2, obese patients appear to have higher risk of intubation, but did not experience increased ICU requirements or mortality.