Clinical outcomes and inflammatory marker levels in patients with Covid-19 and obesity at an inner-city safety net hospital

• Published in: PloS one 2020-12, Vol.15 (12), p.e0243888-e0243888
• Main Authors: Mostaghim, Anahita, Sinha, Pranay, Bielick, Catherine, Knudsen, Selby, Beeram, Indeevar, White, Laura F, Apovian, Caroline, Sagar, Manish, Hochberg, Natasha S
• Format: Article
• Language: English
• Subjects: Adult; Aged; Biological markers; Biology and Life Sciences; Biomarkers - analysis; Biomarkers - metabolism; Body mass; Body Mass Index; Body size; C-reactive protein; Cardiovascular disease; Clinical outcomes; Confidence intervals; Coronaviruses; COVID-19; COVID-19 - complications; COVID-19 - mortality; COVID-19 - pathology; COVID-19 - virology; Cytokines; Demographics; Diabetes; Dimers; Female; Ferritin; Health aspects; Health risks; Hospital Mortality; Hospitalization; Hospitals; Humans; Hypertension; Infectious diseases; Inflammation; Intensive Care Units; Internal medicine; L-Lactate dehydrogenase; Lactate dehydrogenase; Lactic acid; Logistic Models; Lungs; Male; Markers; Medicine; Medicine and Health Sciences; Middle Aged; Mortality; Multivariate analysis; Obesity; Obesity - complications; Odds Ratio; Overweight; Patient outcomes; Patients; Regression analysis; Retrospective Studies; Risk Factors; Safety-net Providers; SARS-CoV-2 - isolation & purification; Severe acute respiratory syndrome coronavirus 2; Statistical analysis; Treatment Outcome; Ventilators; Weight control
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0243888

Patients with Covid-19 and obesity have worse clinical outcomes which may be driven by increased inflammation. This study aimed to characterize the association between clinical outcomes in patients with obesity and inflammatory markers. We analyzed data for patients aged ≥18 years admitted with a positive SARS-CoV-2 PCR test. We used multivariate logistic regression to determine the association between BMI and intensive care unit (ICU) transfer and all-cause mortality. Inflammatory markers (C-reactive protein [CRP], lactate dehydrogenase [LDH], ferritin, and D-dimer) were compared between patients with and without obesity (body mass index [BMI] ≥30 kg/m2). Of 791 patients with Covid-19, 361 (45.6%) had obesity. In multivariate analyses, BMI ≥35 was associated with a higher odds of ICU transfer (adjusted odds ratio [aOR] 2.388 (95% confidence interval [CI]: 1.074-5.310) and hospital mortality (aOR = 4.3, 95% CI: 1.69-10.82). Compared to those with BMI