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Obesity and Critical Illness in COVID‐19: Respiratory Pathophysiology
Author(s) -
Wolf Molly,
Alladina Jehan,
Navarrete-Welton Allison,
Shoults Benjamin,
Brait Kelsey,
Ziehr David,
Malhotra Atul,
Hardin C. Corey,
Hibbert Kathryn A.
Publication year - 2021
Publication title -
obesity
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.438
H-Index - 199
eISSN - 1930-739X
pISSN - 1930-7381
DOI - 10.1002/oby.23142
Subject(s) - covid-19 , medicine , pathophysiology , critical illness , obesity , respiratory illness , respiratory system , betacoronavirus , medline , coronavirus infections , severity of illness , intensive care medicine , bioinformatics , critically ill , virology , disease , biology , infectious disease (medical specialty) , biochemistry , outbreak
Objective Recent cohort studies have identified obesity as a risk factor for poor outcomes in coronavirus disease 2019 (COVID‐19). To further explore the relationship between obesity and critical illness in COVID‐19, the association of BMI with baseline demographic and intensive care unit (ICU) parameters, laboratory values, and outcomes in a critically ill patient cohort was examined. Methods In this retrospective study, the first 277 consecutive patients admitted to Massachusetts General Hospital ICUs with laboratory‐confirmed COVID‐19 were examined. BMI class, initial ICU laboratory values, physiologic characteristics including gas exchange and ventilatory mechanics, and ICU interventions as clinically available were measured. Mortality, length of ICU admission, and duration of mechanical ventilation were also measured. Results There was no difference found in respiratory system compliance or oxygenation between patients with and without obesity. Patients without obesity had higher initial ferritin and D‐dimer levels than patients with obesity. Standard acute respiratory distress syndrome management, including prone ventilation, was equally distributed between BMI groups. There was no difference found in outcomes between BMI groups, including 30‐ and 60‐day mortality and duration of mechanical ventilation. Conclusions In this cohort of critically ill patients with COVID‐19, obesity was not associated with meaningful differences in respiratory physiology, inflammatory profile, or clinical outcomes.