Respiratory risk, not death, increased for adults with obesi
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Obesity is not associated with an increased risk for death for adults admitted to the ICU with COVID-19, but BMI is linked to acute respiratory distress syndrome in these patients, according to a study published in Obesity.

This study aimed to determine if obesity is independently associated with major adverse clinical outcomes and inflammatory and thrombotic markers in critically ill patients with COVID-19.

The primary outcome was in-hospital mortality in adults with COVID-19 admitted to intensive care units across the US. Secondary outcomes were acute respiratory distress syndrome (ARDS), acute kidney injury requiring renal replacement therapy (AKI-RRT), thrombotic events, and seven blood markers of inflammation and thrombosis. Unadjusted and multivariable-adjusted models were used.

Results:
-- Among the 4908 study patients mean (SD) age was 60.9 (14.7) years, 3095 (62.8%) were male, and 2552 (52.0%) were obese.

-- In multivariable models, BMI was not associated with mortality.

-- Higher BMI beginning at 25 kg/m2 was associated with a greater risk of ARDS and AKI-RRT but not thrombosis.

-- There was no clinically significant association between BMI and inflammatory or thrombotic markers.

Conclusively, in critically ill patients with COVID-19, higher BMI was not associated with death or thrombotic events but was associated with a greater risk of ARDS and AKI-RRT. The lack of an association between BMI and circulating biomarkers raises into question the paradigm that obesity contributes to poor outcomes in critically ill patients with COVID-19 by upregulating systemic inflammatory and prothrombotic pathways.

Source: https://onlinelibrary.wiley.com/doi/10.1002/oby.23245
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