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

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 po...

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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
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creator Mostaghim, Anahita
Sinha, Pranay
Bielick, Catherine
Knudsen, Selby
Beeram, Indeevar
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Apovian, Caroline
Sagar, Manish
Hochberg, Natasha S
description 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
doi_str_mv 10.1371/journal.pone.0243888
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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). 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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&lt;30, patients with obesity had lower ferritin (444 vs 637 ng/mL; p&lt;0.001) and lower D-dimer (293 vs 350 mcg/mL; p = 0.009), non-significant differences in CRP (72.8 vs 84.1 mg/L, p = 0.099), and higher LDH (375 vs 340, p = 0.009) on the first hospital day. Patients with obesity were more likely to have poor outcomes even without increased inflammation.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>33326480</pmid><doi>10.1371/journal.pone.0243888</doi><tpages>e0243888</tpages><orcidid>https://orcid.org/0000-0002-5790-9288</orcidid><orcidid>https://orcid.org/0000-0002-5449-9973</orcidid><orcidid>https://orcid.org/0000-0003-1871-3909</orcidid><orcidid>https://orcid.org/0000-0002-0588-8235</orcidid><oa>free_for_read</oa></addata></record>
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identifier ISSN: 1932-6203
ispartof PloS one, 2020-12, Vol.15 (12), p.e0243888-e0243888
issn 1932-6203
1932-6203
language eng
recordid cdi_plos_journals_2470607674
source Publicly Available Content (ProQuest); PubMed Central
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
title Clinical outcomes and inflammatory marker levels in patients with Covid-19 and obesity at an inner-city safety net hospital
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