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Outcomes by Severity of Obesity During Extracorporeal Membrane Oxygenation Support for COVID-19
PURPOSE: Obesity adversely impacts outcomes during COVID-19 but its relation to mortality in those receiving extracorporeal membrane oxygenation (ECMO) is uncertain. METHODS: A retrospective multicenter study was conducted. Adult patients (≥18 years old) with severe COVID-19 infection placed on ECMO...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Published by Elsevier Inc.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8988478/ http://dx.doi.org/10.1016/j.healun.2022.01.1597 |
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author | Farooq, M. Patel, S.R. Rahmanian, M. Uehara, M. Aldabagh, M.A. Madan, S. Forest, S. Silvestry, S. Jorde, U.P. Goldstein, D. Saeed, O. |
author_facet | Farooq, M. Patel, S.R. Rahmanian, M. Uehara, M. Aldabagh, M.A. Madan, S. Forest, S. Silvestry, S. Jorde, U.P. Goldstein, D. Saeed, O. |
author_sort | Farooq, M. |
collection | PubMed |
description | PURPOSE: Obesity adversely impacts outcomes during COVID-19 but its relation to mortality in those receiving extracorporeal membrane oxygenation (ECMO) is uncertain. METHODS: A retrospective multicenter study was conducted. Adult patients (≥18 years old) with severe COVID-19 infection placed on ECMO between March 1, 2020 to April 30, 2021, across the United States were included. A web-based database application, REDCap, was utilized to capture clinical characteristics and outcomes. Patients were grouped into tertiles of body mass index (BMI). The primary outcome was in-hospital mortality after ECMO placement assessed by a time-to-event analysis. RESULTS: Overall 444 patients (age 49, IQR: 38-57 years, 29% female, BMI: 33, IQR: 29-39 kg/m2) from 17 centers comprised the study cohort. Patients that expired during hospitalization had a similar BMI in comparison to those that were discharged (33, IQR: 29-38 vs. 34, IQR: 30-40 kg/m2, p=0.13). BMI across groups was 27, IQR: 25-29 (lowest tertile), 33, IQR: 32-34 (middle tertile), 41, IQR: 38-45 kg/m2 (highest tertile). At 90 days, in-hospital mortality between BMI tertiles was 53%, 59%, and 53%, p=0.99 (figure). After adjustment for clinical covariates including age, sex, presence of preexisting co-morbidities, cardiopulmonary arrest prior to ECMO, serum creatinine and arterial partial pressure of oxygen (PaO2) to inspired oxygen concentration (FiO2) ratio, there was no difference in hospital mortality in the middle (aHR:1.13, CI: 0.79-1.63, p=0.5) and highest (aHR: 1.38, CI: 0.95-2.01, p=0.09) tertiles in comparison to the lowest BMI tertile. CONCLUSION: Severity of obesity is not associated with death during hospitalization in patients placed on ECMO for COVID-19 |
format | Online Article Text |
id | pubmed-8988478 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Published by Elsevier Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-89884782022-04-07 Outcomes by Severity of Obesity During Extracorporeal Membrane Oxygenation Support for COVID-19 Farooq, M. Patel, S.R. Rahmanian, M. Uehara, M. Aldabagh, M.A. Madan, S. Forest, S. Silvestry, S. Jorde, U.P. Goldstein, D. Saeed, O. J Heart Lung Transplant (418) PURPOSE: Obesity adversely impacts outcomes during COVID-19 but its relation to mortality in those receiving extracorporeal membrane oxygenation (ECMO) is uncertain. METHODS: A retrospective multicenter study was conducted. Adult patients (≥18 years old) with severe COVID-19 infection placed on ECMO between March 1, 2020 to April 30, 2021, across the United States were included. A web-based database application, REDCap, was utilized to capture clinical characteristics and outcomes. Patients were grouped into tertiles of body mass index (BMI). The primary outcome was in-hospital mortality after ECMO placement assessed by a time-to-event analysis. RESULTS: Overall 444 patients (age 49, IQR: 38-57 years, 29% female, BMI: 33, IQR: 29-39 kg/m2) from 17 centers comprised the study cohort. Patients that expired during hospitalization had a similar BMI in comparison to those that were discharged (33, IQR: 29-38 vs. 34, IQR: 30-40 kg/m2, p=0.13). BMI across groups was 27, IQR: 25-29 (lowest tertile), 33, IQR: 32-34 (middle tertile), 41, IQR: 38-45 kg/m2 (highest tertile). At 90 days, in-hospital mortality between BMI tertiles was 53%, 59%, and 53%, p=0.99 (figure). After adjustment for clinical covariates including age, sex, presence of preexisting co-morbidities, cardiopulmonary arrest prior to ECMO, serum creatinine and arterial partial pressure of oxygen (PaO2) to inspired oxygen concentration (FiO2) ratio, there was no difference in hospital mortality in the middle (aHR:1.13, CI: 0.79-1.63, p=0.5) and highest (aHR: 1.38, CI: 0.95-2.01, p=0.09) tertiles in comparison to the lowest BMI tertile. CONCLUSION: Severity of obesity is not associated with death during hospitalization in patients placed on ECMO for COVID-19 Published by Elsevier Inc. 2022-04 2022-04-07 /pmc/articles/PMC8988478/ http://dx.doi.org/10.1016/j.healun.2022.01.1597 Text en Copyright © 2022 Published by Elsevier Inc. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. |
spellingShingle | (418) Farooq, M. Patel, S.R. Rahmanian, M. Uehara, M. Aldabagh, M.A. Madan, S. Forest, S. Silvestry, S. Jorde, U.P. Goldstein, D. Saeed, O. Outcomes by Severity of Obesity During Extracorporeal Membrane Oxygenation Support for COVID-19 |
title | Outcomes by Severity of Obesity During Extracorporeal Membrane Oxygenation Support for COVID-19 |
title_full | Outcomes by Severity of Obesity During Extracorporeal Membrane Oxygenation Support for COVID-19 |
title_fullStr | Outcomes by Severity of Obesity During Extracorporeal Membrane Oxygenation Support for COVID-19 |
title_full_unstemmed | Outcomes by Severity of Obesity During Extracorporeal Membrane Oxygenation Support for COVID-19 |
title_short | Outcomes by Severity of Obesity During Extracorporeal Membrane Oxygenation Support for COVID-19 |
title_sort | outcomes by severity of obesity during extracorporeal membrane oxygenation support for covid-19 |
topic | (418) |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8988478/ http://dx.doi.org/10.1016/j.healun.2022.01.1597 |
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