Clin Res Cardiol (2022). https://doi.org/10.1007/s00392-022-02002-5
Does There Exist an Obesity Paradox in COVID-19? Insights of the international HOPE-COVID-19-Registry
M. Abumayyaleh1, I. J. N. Gil2, I. El-Battrawy3, V. Estrada2, B.-M. Víctor Manuel4, A. Aparisi5, F.-R. Inmaculada6, G. Feltes7, R. Arroyo-Espliguero8, D. Trabattoni9, J. López-País10, M. Pepe11, R. Romero12, D. R. V. García13, C. Biole14, T. C. Astrua15, C. M. Eid16, E. Alfonso17, L. Fernandez-Presa18, C. Espejo19, S. Raposeiras20, D. Buonsenso21, C. Fernández10, C. Macaya22, I. Akin1, für die Studiengruppe: HOPE
1I. Medizinische Klinik, Universitätsklinikum Mannheim, Mannheim; 2Hospital Clinico Universitario San Carlos, Madrid, ES; 3Medizinische Klinik II, Kardiologie und Angiologie, Berufsgenossenschaftlliches Universitätsklinikum Bergmannsheil, Bochum; 4Hospital Clínico Universitario Virgen de la Victoria, Málaga, ES; 5Hospital Clínico Universitario de Valladolid, Valladolid, ES; 6Hospital Severo Ochoa, Leganés, ES; 7Hospital Nuestra Señora de América, Madrid, ES; 8Hospital Universitario Guadalajara, Guadalajara, ES; 9Centro Cardiologico Monzino, Milano, IT; 10Complejo Hospitalario Universitario de Santiago de Compostela Santiago de Compostela, santiago de compostela, ES; 11Azienda ospedaliero-universitaria consorziale policlinico di Bari, Bari, IT; 12Hospital Universitario Getafe, Getafe, ES; 13Hospital General del norte de Guayaquil IESS Los Ceibos, Guayaquil, ES; 14San Luigi Gonzaga University Hospital, Orbassano TO, ES; 15Hospital Virgen del Mar, Madrid, ES; 16Hospital Universitario La Paz, Instituto de Investigacion, Hospital Universitario La Paz (IdiPAZ), Madrid, ES; 17Instituto de Cardiologia, La Habana, EC; 18Hospital Clínico de Valencia, INCLIVA, Valencia, ES; 19Hospital Universitario Príncipe de Asturias, Meco, ES; 20University Hospital Álvaro Cunqueiro, Vigo, ES; 21Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, IT; 22Hospital Clínico San Carlos, Madrid, ES;

Background 

Obesity has been described as a protective factor in cardiovascular and other diseases being expressed as ‘obesity paradox’. However, the impact of obesity on clinical outcomes including mortality in COVID-19 has been poorly systematically investigated until now. We aimed to compare clinical outcomes among COVID-19 patients divided into three groups according to the body mass index (BMI).

 

Methods

We retrospectively collected data up to May 31st, 2020. 3635 patients were divided into three groups of BMI (<25 kg/m2; n=1110, 25-30 kg/m2; n=1464, and >30 kg/m2; n=1061). Demographic, in-hospital complications, and predictors for mortality, respiratory insufficiency, and sepsis were analyzed. 

Results

The rate of respiratory insufficiency was more recorded in BMI 25-30 kg/m2 as compared to BMI <25 kg/m2 (22.8% vs. 41.8%; p<0.001), and in BMI >30 kg/m2 than BMI <25 kg/m2, respectively (22.8% vs. 35.4%; p<0.001). Sepsis was more observed in BMI 25-30 kg/m2 and BMI >30 kg/m2 as compared to BMI <25 kg/m2, respectively (25.1% vs. 42.5%; p=0.02) and (25.1% vs. 32.5%; p=0.006). The mortality rate was higher in BMI 25-30 kg/m2 and BMI >30 kg/m2 as compared to BMI <25 kg/m2, respectively (27.2% vs. 39.2%; p=0.31) (27.2% vs. 33.5%; p=0.004). In the Cox multivariate analysis for mortality, BMI <25 kg/m2 and BMI >30 kg/m2 did not impact the mortality rate (HR 1.15, 95% CI: 0.889-1.508; p=0.27) (HR 1.15, 95% CI: 0.893-1.479; p=0.27). In multivariate logistic regression analyses for respiratory insufficiency and sepsis, BMI <25 kg/m2 is determined as an independent predictor for reduction of respiratory insufficiency (OR 0.73, 95% CI: 0.538-1.004; p=0.05). 

 

Conclusions

HOPE COVID-19-Registry revealed no evidence of obesity paradox in patients with COVID-19. However, Obesity was associated with a higher rate of respiratory insufficiency and sepsis but was not determined as an independent predictor for a high mortality.
https://dgk.org/kongress_programme/jt2022/aV1747.html