AI Article Synopsis
- A high BMI is typically linked to worse outcomes in COVID-19, but this study found it may actually be associated with lower mortality in critically ill patients under 45 years old.
- The analysis included over 15,000 critically ill COVID-19 patients from a national registry, controlling for various factors like age and gender.
- The results suggest that while BMI above 30 kg/m² doesn't impact hospital mortality for patients 45 and older, it may have a protective effect for younger patients, supporting the "obesity paradox."
Article Abstract
Objectives: A high body mass index (BMI) is associated with an unfavorable disease course in COVID-19, but not among those who require admission to the ICU. This has not been examined across different age groups. We examined whether age modifies the association between BMI and mortality among critically ill COVID-19 patients.
Design: An observational cohort study.
Setting: A nationwide registry analysis of critically ill patients with COVID-19 registered in the National Intensive Care Evaluation registry.
Patients: We included 15,701 critically ill patients with COVID-19 (10,768 males [68.6%] with median [interquartile range] age 64 yr [55-71 yr]), of whom 1,402 (8.9%) patients were less than 45 years.
Interventions: None.
Measurements And Main Results: In the total sample and after adjustment for age, gender, Acute Physiology and Chronic Health Evaluation IV, mechanical ventilation, and use of vasoactive drugs, we found that a BMI greater than or equal to 30 kg/m 2 does not affect hospital mortality (adjusted odds ratio [OR adj ] = 0.98; 95% CI, 0.90-1.06; p = 0.62). For patients less than 45 years old, but not for those greater than or equal to 45 years old, a BMI greater than or equal to 30 kg/m 2 was associated with a lower hospital mortality (OR adj = 0.59; 95% CI, 0.36-0.96; p = 0.03).
Conclusions: A higher BMI may be favorably associated with a lower mortality among those less than 45 years old. This is in line with the so-called "obesity paradox" that was established for other groups of critically ill patients in broad age ranges. Further research is needed to understand this favorable association in young critically ill patients with COVID-19.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10012838 | PMC |
| http://dx.doi.org/10.1097/CCM.0000000000005788 | DOI Listing |
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