BMI and pneumonia outcomes in critically ill covid-19 patients: An international multicenter study.
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Chetboun Mikael, Raverdy Violeta, Labreuche Julien, Simonnet Arthur, Wallet Florent, Caussy Cyrielle, Antonelli Massimo, Artigas Antonio, Goma Gemma, Meziani Ferhat, Helms Julie, Mylonakis Eleftherios, Levy Mitchell M, Kalligeros Markos, Latronico Nicola, Piva Simone, Cerf Charles, Neuville Mathilde, Klouche Kada, Larcher Romaric, Tamion Fabienne, Occhiali Emilie, Snacken Morgane, Preiser Jean-Charles, Kontar Loay, Riviere Antoine, Silva Stein, Sarton Benjamine, Krouchi Raphael, Dubar Victoria, Palaiodimos Leonidas, Karamanis Dimitrios, Perche Juliette, L'Her Erwan, Busetto Luca, Dicker Dror, Lev Shaul, Duhamel Alain, Jourdain Mercè, Pattou François
Аннотация
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.