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KMID : 1044520240870020176
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Tuberculosis and Respiratory Diseases
2024 Volume.87 No. 2 p.176 ~ p.184
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Functional Aspects of the Obesity Paradox in Patients with Severe Coronavirus Disease-2019: A Retrospective, Multicenter Study
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Kim Jeong-Su
Jang Jin-Ho
Kim Ki-Poong
Park Sung-Hoon
Lee Su-Hwan
Park On-Yu
Kim Tae-Hwa
Yeo Hye-Ju
Cho Woo-Hyun
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Abstract
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Background: Results of studies investigating the association between body mass index(BMI) and mortality in patients with coronavirus disease-2019 (COVID-19) have beenconflicting.
Methods: This multicenter, retrospective observational study, conducted between January2020 and August 2021, evaluated the impact of obesity on outcomes in patientswith severe COVID-19 in a Korean national cohort. A total of 1,114 patients were enrolledfrom 22 tertiary referral hospitals or university-affiliated hospitals, of whom 1,099were included in the analysis, excluding 15 with unavailable height and weight information.
The effect(s) of BMI on patients with severe COVID-19 were analyzed.
Results: According to the World Health Organization BMI classification, 59 patientswere underweight, 541 were normal, 389 were overweight, and 110 were obese. Theoverall 28-day mortality rate was 15.3%, and there was no significant difference accordingto BMI. Univariate Cox analysis revealed that BMI was associated with 28-day mortality(hazard ratio, 0.96; p=0.045), but not in the multivariate analysis. Additionally, patientswere divided into two groups based on BMI ≥25 kg/m2 and underwent propensityscore matching analysis, in which the two groups exhibited no significant difference inmortality at 28 days. The median (interquartile range) clinical frailty scale score at dischargewas higher in nonobese patients (3 [3 to 5] vs. 4 [3 to 6], p<0.001). The proportionof frail patients at discharge was significantly higher in the nonobese group (28.1%vs. 46.8%, p<0.001).
Conclusion: The obesity paradox was not evident in this cohort of patients with severeCOVID-19. However, functional outcomes at discharge were better in the obese group.
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KEYWORD
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Body Mass Index, COVID-19, Mortality
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