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Impact of body mass index on the outcome of Japanese patients with cardiovascular diseases and/or risk factors hospitalized with COVID-19 infection

BACKGROUND: Obesity is reported to be a predictor of adverse clinical events in coronavirus disease 2019 (COVID-19) in Western countries. However, there are limited data reported regarding the prognostic impact of obesity in Asian patients. We investigated the relationship between body mass index (B...

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Detalles Bibliográficos
Autores principales: Saito, Takafumi, Yamaguchi, Tetsuo, Kuroda, Shunsuke, Kitai, Takeshi, Yonetsu, Taishi, Kohsaka, Shun, Torii, Sho, Node, Koichi, Matsumoto, Shingo, Matsue, Yuya, Kodama, Takahide
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Japanese College of Cardiology. Published by Elsevier Ltd. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8479451/
https://www.ncbi.nlm.nih.gov/pubmed/34625315
http://dx.doi.org/10.1016/j.jjcc.2021.09.013
Descripción
Sumario:BACKGROUND: Obesity is reported to be a predictor of adverse clinical events in coronavirus disease 2019 (COVID-19) in Western countries. However, there are limited data reported regarding the prognostic impact of obesity in Asian patients. We investigated the relationship between body mass index (BMI) and in-hospital outcomes in 580 Japanese patients with cardiovascular disease and/or risk factors and who were admitted for COVID-19 infection using data from 49 hospitals in Japan. METHODS: We analyzed data from the Clinical Outcomes of COVID-19 Infection in Hospitalized Patients with Cardiovascular Disease and/or Risk Factors (CLAVIS-COVID) registry. BMI was classified into four groups accordance with the definition of the Japan Society for the Study of Obesity, as follows: underweight, <18.5 kg/m(2); normal range, 18.5 to <25 kg/m(2); pre-obese, 25 to 30 kg/m(2); and obese, ≥30 kg/m(2). RESULTS: In-hospital death occurred in 15.0% (n=87) of the patients and intubation was performed for 139 (24.0%) patients. In a multivariate analysis, we found a significant association between higher BMI and in-hospital mortality [underweight: hazard ratio (HR) 0.47, 95% confidence interval (CI) 0.23-0.97; p=0.041; pre-obese: HR 1.46, 95%CI 0.84-2.55; p=0.18; and obese: HR 3.28, 95%CI 1.34-8.02; p=0.009 vs. normal range]. In contrast, the association between BMI and the intubation rate was not statistically significant. CONCLUSIONS: Obesity was associated with a stepwise increase in the risk of in-hospital mortality in Japanese patients with COVID-19 infection. The threshold BMI for the increased risk of a worse outcome was 30, which was much lower in comparison to Western countries.