BMI and pneumonia outcomes in critically ill covid-19 patients: An international multicenter study

Mikael Chetboun, Violeta Raverdy, Julien Labreuche, Arthur Simonnet, Florent Wallet, Cyrielle Caussy, Massimo Antonelli, Antonio Artigas, Gemma Goma, Ferhat Meziani, Julie Helms, Eleftherios Mylonakis, Mitchell M. Levy, Markos Kalligeros, Nicola Latronico, Simone Piva, Charles Cerf, Mathilde Neuville, Kada Klouche, Romaric LarcherFabienne Tamion, Emilie Occhiali, Morgane Snacken, Jean Charles Preiser, Loay Kontar, Antoine Riviere, Stein Silva, Benjamine Sarton, Raphael Krouchi, Victoria Dubar, Leonidas Palaiodimos, Dimitrios Karamanis, Juliette Perche, Erwan L'Her, Luca Busetto, Dror Dicker, Shaul Lev, Alain Duhamel, Mercè Jourdain*, François Pattou*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

27 Scopus citations

Abstract

Objective: Previous studies have unveiled a relationship between the severity of coronavirus disease 2019 (COVID-19) pneumonia and obesity. The aims of this multicenter retrospective cohort study were to disentangle the association of BMI and associated metabolic risk factors (diabetes, hypertension, hyperlipidemia, and current smoking status) in critically ill patients with COVID-19. Methods: Patients admitted to intensive care units for COVID-19 in 21 centers (in Europe, Israel, and the United States) were enrolled in this study between February 19, 2020, and May 19, 2020. Primary and secondary outcomes were the need for invasive mechanical ventilation (IMV) and 28-day mortality, respectively. Results: A total of 1,461 patients were enrolled; the median (interquartile range) age was 64 years (40.9-72.0); 73.2% of patients were male; the median BMI was 28.1 kg/m2 (25.4-32.3); a total of 1,080 patients (73.9%) required IMV; and the 28-day mortality estimate was 36.1% (95% CI: 33.0-39.5). An adjusted mixed logistic regression model showed a significant linear relationship between BMI and IMV: odds ratio = 1.27 (95% CI: 1.12-1.45) per 5 kg/m2. An adjusted Cox proportional hazards regression model showed a significant association between BMI and mortality, which was increased only in obesity class III (≥40; hazard ratio = 1.68 [95% CI: 1.06-2.64]). Conclusions: In critically ill COVID-19 patients, a linear association between BMI and the need for IMV, independent of other metabolic risk factors, and a nonlinear association between BMI and mortality risk were observed.

Original languageEnglish
Pages (from-to)1477-1486
Number of pages10
JournalObesity
Volume29
Issue number9
DOIs
StatePublished - Sep 2021

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